Community Based Outpatient Clinic Reviews: Delray Beach and Stuart, FL; Portsmouth and Cambridge, OH; Canton and Painesville, OH; South Bend and Muncie, IN

The VA Office of Inspector General reviewed eight Community Based Outpatient Clinics (CBOCs) the week of May 24–28, 2010. The CBOCs reviewed in Veterans Integrated Service Network (VISN) 8 were Delray Beach and Stuart, FL; in VISN 10, Portsmouth and Cambridge, OH; and Canton and Painesville, OH; and in VISN 11, South Bend and Muncie, IN. The parent facilities of these CBOCs are West Palm Beach VA Medical Center (VAMC), Chillicothe VAMC, Louis Stokes (Cleveland) VAMC, and VA Northern Indiana Health Care System (HCS)-Marion, respectively. The purpose of the review was to assess whether CBOCs are operated in a manner that provides veterans with consistent, safe, high-quality health care. The review covered five areas: quality of care measures, credentialing and privileging, environment of care and emergency management, suicide safety plans, and CBOC contracts. We noted several opportunities for improvement and made the following recommendations to the VISN and facility management: • Ensure the Professional Standards Board grants privileges consistent with the services provided. • Require results of Focused Provider Practice Evaluations are documented in the practitioner’s provider profile. • Require an appropriate process be implemented to ensure compliance with the management of health care records. • Require that all patient exam rooms meet safety criteria. • Improve parking space aisle access for disabled veterans. • Monitor and collect measurable data for hand hygiene. • Develop safety plans for patients at high risk for suicide and ensure the patients receive a copy. • Provide administrative support to the Contracting Officer’s Technical Representative to independently validate total billed enrollees in accordance with contract terms and conditions using VA data. • Ensure the Contracting Officer prepares the necessary contract documents to reflect the agreement to compensate the contractor for additional services. • Ensure the Primary Care Management Module Coordinator performs in accordance with VHA Handbook 1101.02 to reduce the number of veterans assigned to more than one primary care provider.