Healthcare Inspection Community Based Outpatient Clinic Reviews Coral Springs and Key West, FL Boca Raton and Vero Beach, FL Denton and Fort Worth, TX

The VA Office of Inspector General reviewed six Community Based Outpatient Clinics (CBOCs) the week of January 19–22, 2010. The CBOCs reviewed in Veterans Integrated Service Network (VISN) 8 were Coral Springs and Key West, FL and Boca Raton and Vero Beach, FL; and, in VISN 17, Denton and Fort Worth, TX. The parent facilities of these CBOCs are Miami VA Healthcare System (HCS), West Palm Beach VA Medical Center (VAMC), and VA North Texas HCS, 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, patient satisfaction, and CBOC contracts. We noted several opportunities for improvement and made the following recommendations to the VISN and facility management: Grant privileges to providers that are facility specific. Ensure that contract providers are privileged for the term of the contract. When reprivileging, compare practitioner data to aggregated data of those practitioners who hold the same or comparable privileges. Ensure staff are trained and evaluated, and that their competencies are documented. Accomplish providers’ background checks according to VHA policy. Ensure all patient exam rooms meet safety criteria. Maintain patients’ auditory privacy during their check-in process. Ensure all cleaning chemicals are properly secured. Require that guidelines regarding electrocautery equipment are developed and documented in the fire and safety plan. Perform a year-end reconciliation as stipulated in the contract. Provide contract oversight and enforcement in accordance with the terms and conditions as stated in the contract.