University of Arizona-Phoenix Receives Full Accreditation

University of Arizona (UA) officials announced yesterday that the UA College of Medicine-Phoenix, which was originally a branch of the UA-Tucson medical school, was granted full accreditation by the Liaison Committee on Medical Education (LCME) (1). The College of Medicine-Phoenix was created 10 years ago. In 2012, the UA College of Medicine-Phoenix received “preliminary” accreditation with the LCME, then “provisional” accreditation in 2015 and now full accreditation.

To date, the UA College of Medicine-Phoenix has graduated 354 physicians, with classes of about 80 students per year. One year ago this month, the Arizona Medical Association asked for an investigation after a half-dozen of the Phoenix medical school’s top leaders left for positions out of state. Among those departures was the school’s dean, Dr. Stuart D. Flynn. Dr. Kenneth Ramos served as interim dean and helped lead the Phoenix medical school through the accreditation. Dr. Guy Reed from Tennessee was recently hired as the school’s new dean and assumes his duties in July.

There are now five medical schools in Arizona: the two UA medical schools; the Mayo Clinic School of Medicine, which is opening its Arizona campus in Scottsdale this summer; and Midwestern University and A.T. Still University, which both operate osteopathic medical schools in the Phoenix area. A sixth medical school, Omaha-based Creighton University School of Medicine, has medical students doing third- and fourth-year rotations in Arizona.

Richard A. Robbins, MD

Editor, SWJPCC

Reference

1. Innes S. University of Arizona's Phoenix medical school receives full accreditation. Arizona Star. June 14, 2017. Available at: http://tucson.com/news/local/education/college/university-of-arizona-s-phoenix-medical-school-receives-full-accreditation/article_64a1da80-1866-5a51-a062-7cc04ecd261d.html (accessed 6/15/17).

Cite as: Robbins RA. University of Arizona-Phoenix receives full accreditation. Southwest J Pulm Crit Care. 2017;14(6):311. doi: https://doi.org/10.13175/swjpcc077-17 PDF 

Troubles Continue for the Phoenix VA

According to the Joint Commission on the Accreditation of Healthcare Organizations (Joint Commission, JCAHO), an independent organization that reviews hospitals, the Phoenix VA does not comply with U.S. standards for safety, patient care and management (1). The hospital was at the epicenter of the national scandal over the quality of care being afforded to the nation's veterans where the now notorious practice of double-booking patient appointments was first exposed. The hospital's indifferent management provoked congressional investigations that uncovered still more system-wide abuses leading to the removal of the hospital director and the resignation of then VA secretary, Eric Shinseki. The hospital maintains its accreditation but with a follow-up survey in 1-6 months where it must show that it has successfully addressed the 13 identified problems (1). Inspectors who conducted the review in July found that VA employees were unable to report concerns "without retaliatory action from the hospital." Other alarming deficiencies were that Phoenix administrators did not maintain a "safe, functional environment" or "a culture of safety and quality." They concluded that the hospital does not have adequate policies and procedures to "guide and support patient care, treatment and services."

Elizabeth Eaken Zhani, a media relations manager at the JCAHO, stressed that noncompliance findings do not typically lead to a loss of accreditation (2). Of more than 4,000 medical facilities evaluated each year, she said, less than 1 percent are denied accreditation. The Phoenix VA has a right to appeal and an opportunity to correct failings so the hospital meets national standards. In a written statement October 20, VA officials said plans have been developed with an expectation that compliance issues will be resolved within 120 days. "We are also working diligently to address the cultural issues identified by The Joint Commission and have implemented a number of items to enable employees to raise concerns about safety or quality without fear of retaliation...".

In 2010, the Phoenix VA was among 20 VA medical centers to earn The JCAHO's "Top Performer" honor. The most recent audit, in 2011, showed Phoenix at or above target values established by the commission for every major category of health care and administration. It is unclear if care quickly deteriorated at the VA over three short years or previous JCAHO evaluations were inadequate. JCAHO inspections usually are conducted by a retired hospital administrator, physician and nurse. They usually review policies and procedures and rarely meet with physicians, nurses, technicians or clerks directly involved in patient care.

In an editorial entitled "After ALL THAT, Phoenix VA still fails review?!" the Arizona Republic (3) stated the "Phoenix VA is the hospital the VA would want to get right. The one at which the troubled agency would throw all its resources to assure that, despite all evidence to the contrary, VA leaders really did know what they were doing. And, yet, the Phoenix VA flunked its review". The editorial goes on to say that, "Perhaps the most fundamental flaw in the VA system is the forbidding culture of the organization, which regularly and ruthlessly punished whistle-blowers. You would think that, above all else, the VA's new administrators would strive to assure that that malignant practice was banished. Didn't happen. Failure to assure that a VA worker could 'report concerns about safety or the quality of care to (the reviewing agency) without retaliatory action from the hospital' was at the top of the Joint Commission's list of findings". The Republic goes on to say that "The Joint Commission's audit provides still more evidence of the intransigence [pigheaded] and resistance to change that the VA presents to even the most determined reformers".

Richard A. Robbins, MD

Editor

Southwest Journal of Pulmonary and Critical Care

References

1. The Joint Commission. Phoenix VA Health Care System: Summary of accreditation quality information. Available at: http://www.qualitycheck.org/qualityreport.aspx?hcoid=2508# (accessed 10/23/14).
2. Wagner D. Phoenix VA hospital fails outside compliance review. Arizona Republic. October 21, 2014. Available at: http://www.azcentral.com/story/news/arizona/investigations/2014/10/21/phoenix-va-hospital-fails-outside-compliance-review/17649623/ (accessed 10/23/14).
3. Editorial board. After ALL THAT, Phoenix VA still fails review?! Arizona Republic. October 22, 2014. Available at: http://www.azcentral.com/story/opinion/editorial/2014/10/22/phoenix-va-downsize/17748023/ (accessed 10/23/14).  

Reference as: Robbins RA. Troubles continue for the Phoenix VA. Southwest J Pulm Crit Care. 2014;9(4):240-1. doi: http://dx.doi.org/10.13175/swjpcc140-14 PDF