Community Based Outpatient Clinics Summary Report ─ Evaluation of Medication Oversight and Education at Community Based Outpatient Clinics and Other Outpatient Clinics

The purpose of this systematic review of the Veterans Health Administration’s (VHA’s) Community Based Outpatient Clinics (CBOCs) and other outpatient clinics was to evaluate for compliance with selected VHA requirements regarding clinical oversight and education for patients prescribed oral fluoroquinolone antibiotics in the outpatient setting. The objective was to determine the extent of counseling provided to patients who were prescribed an oral fluoroquinolone antibiotic. This included the care elements of medication reconciliation, patient education, and assessment of the patient’s understanding as performed by clinical staff. We conducted this focused review at 57 VA medical centers through the evaluation of the electronic health records of 2,098 patients who were first prescribed a fluoroquinolone antibiotic during July 1, 2012, through June 30, 2013. OIG recommended that clinicians: (1) perform and document medication reconciliation at each outpatient episode of care when a new medication is prescribed, (2) consistently provide and document patient education for new outpatient medications, and (3) consistently assess and document outpatients’ understanding of medication education.