Healthcare Inspection Evaluation of Emergency Departments and Urgent Care Clinics in Veterans Health Administration Facilities

The purposes of this evaluation were to determine whether Veterans Health Administration (VHA) emergency departments (EDs) and urgent care clinics (UCCs): (a) had the appropriate resources and clinical services to provide all aspects of emergency care, including mental health care; (b) were clean, safe, and well maintained; (c) coordinated consultations and patient transfers appropriately; (d) had sufficient nurse staffing, as required by local policy; and (e) had trained staff with documentation of current competencies and clinical privileges. We performed this review at 46 VHA medical facilities during Combined Assessment Program reviews conducted from July 1, 2008, through June 30, 2009. VHA facilities’ EDs and UCCs generally met VHA guidelines. However, we determined that ED/UCC operations could be strengthened in the areas of documentation, competency evaluations, and privileging requirements. We made the following recommendations: Reinforce compliance with transfer and discharge documentation requirements. Ensure compliance with VHA competency evaluations and privileging requirements.