Med Mal News

Defense Secretary Robert Gates in February ordered a Pentagon review of conditions at Walter Reed Army Medical Center following reports in The Washington Post of substandard patient care there. The first draft of the report created by the evaluation group, made up of former military leaders and lawmakers, was released April 10. It offered a scathing critique of operations at the hospital, but also extended its disapproval to other hospitals in the Army's system.

Among the study's findings:

• Care, treatment and administrative services at Walter Reed are not coordinated to work in harmony;
• The Army, Navy and Air Force lack consistent standards for qualifying and training outpatient case managers;
• There is inconsistent early diagnosis of traumatic brain disorders and post-traumatic stress disorder;
• The diminishing number of mental health professionals in the military medical system is affecting patient diagnosis and treatment;
• The Department of Defense and Department of Veterans Affairs methods for dealing with limb loss are inconsistent with one another, leading to inadequate care, with discharged soldiers often receiving less than optimum treatment; and
• The process followed by the Medical Evaluation Board/Physical Evaluation Board (which, among other things, determines whether the service member's injury qualifies him/her for disability retirement) is convoluted and confusing to providers, patients and their families.

The management of the Army's largest hospital came under special fire for what the study's authors deemed mismanagement, but the blame did not belong only to those in charge of the facility; attempts to save money by consolidating operations ' part of the Base Realignment and Closure program ' were a strong contributor to the difficulties patients encountered. Stated the report, 'The Base Realignment and Closure decision to create the new Walter Reed National Military Medical Center contributed to staffing problems, inattention of leadership to day-to-day operations and a lack of resources for capital improvements.'