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Community Based Outpatient Clinic and Primary Care Clinic Reviews at Portland VA Medical Center, Portland, Oregon

Report Information

Issue Date
Report Number
13-03417-34
VISN
State
Oregon
Washington
District
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Healthcare Inspections
Report Type
Comprehensive Healthcare Inspection Program
Recommendations
9
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
The VA Office of Inspector General reviewed the Community Based Outpatient Clinics (CBOCs) and primary care clinics (PCCs) of the Portland VA Medical Center. The purpose of the review was to determine whether the CBOCs and PCCs provide safe, consistent and high-quality health care for our veterans. The review covered the clinical care components of alcohol use disorder and medication management and evaluated if processes were in place for designated women’s health providers to maintain proficiency in women’s health. We also randomly selected the North Coast CBOC, Warrenton, OR; and Salem CBOC, Salem, OR, for site visits during the week of November 4, 2013, to evaluate the environments of care. OIG noted opportunities for improvement and made nine recommendations in the following reviews: Alcohol Use Disorder, Medication Management, Designated Women’s Health Provider Proficiency, and Environment of Care.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that a separate room is provided to store medical (infectious) waste at the Salem CBOC.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that signage is installed at the North Coast CBOC to clearly identify the location of fire extinguishers.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that the IT server closet at the North Coast CBOC is maintained according to IT safety and security standards.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that CBOC/PCC staff consistently document the offer of further treatment to patients diagnosed with alcohol dependence.
No. 5
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that CBOC/PCC RN Care Managers receive MI and health coaching training within 12 months of appointment to PACT.
No. 6
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that CBOC/PCC staff document medication reconciliation that includes the newly prescribed fluoroquinolone in the EHR.
No. 7
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that CBOC/PCC staff provide and document medication counseling/education that includes the fluoroquinolone.
No. 8
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that CBOC/PCC staff document the evaluation of patient's level of understanding for the medication education.
No. 9
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that the Chief of Staff consistently ensure that all DWHPs are designated with the WH indicator in the PCMM.