Healthcare Inspection – Emergency Department Length of Stay and Call Center Wait Times, VA Eastern Colorado Health Care System, Denver, Colorado

OIG conducted an inspection to assess the validity of allegations regarding the Emergency Department (ED) and the Health Information Call Center (Call Center) at the VA Eastern Colorado Health Care System (facility), Denver, CO. We did not substantiate the allegation that the ED “needs help.” While we found some ED wait times (length of stay [LOS]) exceeded 8 hours, we determined the facility met VHA’s target of less than 10 percent of patients with a LOS over 6 hours. We did not substantiate the allegation that ED staff treated two patients discourteously, or that one of the patients was afraid to return to the ED due to alleged discourteous treatment. We substantiated the allegations that Call Center understaffing caused long call waiting times and callers to abandon calls. We found 40 percent of the Call Center’s authorized registered nurse, medical support assistant, and pharmacy technician positions were vacant and determined that inadequate staffing contributed to the Call Center’s failure to meet VHA targets for caller response time and call abandonment rates. We also found that calls were dropped due to the telephone system’s 120-line limitation, and callers who used the automated call return system did not always receive a return call. An upgrade of the phone system is not planned until FY 2016 when the facility relocates. Additional staff and an upgraded system should eliminate the 120-line limitation and reduce callback system failures. We recommended that the Veterans Integrated Service Network and Facility Directors ensure processes are strengthened to improve Health Information Call Center practices and staffing levels.