Healthcare Inspection Resident Credentialing and Supervision Central Arkansas Veterans Healthcare System Little Rock, Arkansas

The purpose of the inspection was to determine the validity of allegations that cardiology fellows interpret electrocardiograms and perform treadmill tests and heart catheterizations without supervision; reports for those studies lack supervisor signatures, or the fellows sign the supervisor’s name on the report; and the Acting Chief of Cardiology inflates the number of hours worked. We concluded the original allegations reviewed were not substantiated. However, at the time of our inspection, the credentialing process for residents completing the cardiology fellowship program did not meet the requirements of VA Handbook 5005/12, Part II, Chapter 3, Section 21, Credentials of Residents and Trainees. In addition, a 2005 cardiac catheterization report had not been cosigned by a staff cardiologist. We recommended that the system maintain current Resident/Trainee Credentials Verification Letters in accordance with VA and local requirements. We also recommended that the system require cardiac catheterization reports to be cosigned by staff cardiologists.