This Office of Inspector General (OIG) Care in the Community healthcare inspection program report describes the results of a focused evaluation of community care processes at seven VA Sierra Pacific Veterans Integrated Service Network (VISN) 21 medical facilities with a community care program. This evaluation focused on five domains:
• Leadership and Administration of Community Care
• Community Care Diagnostic Imaging Results
• Administratively Closed Community Care Consults
• Community Care Provider Requests for Additional Services
• Care Coordination: Scheduling and Communication with Patients Referred for Community Care
The OIG issued 13 recommendations for improvement in the five domains:
• Leadership and Administration of Community Care
o Community oversight councils functioning according to charters
o Entering patient safety events in the Joint Patient Safety Reporting system
o Briefing patient safety trends, lessons learned, and corrective actions
o Scanning community care documents into the electronic health record
• Community Care Diagnostic Imaging Results
o Using the significant findings alert for abnormal diagnostic imaging results
• Administratively Closed Community Care Consults
o Confirming patients attended appointments obtaining medical documents
o Making two attempts to obtain medical documents after administratively closing consults
• Community Care Provider Requests for Additional Services
o Processing requests
o Sending approval and denial letters to community providers and patients
• Care Coordination: Scheduling and Communication with Patients Referred for Community Care
o Timely scheduling of patients
o Confirming patients attended appointments
o Using the Community Care–Care Coordination Plan note to document care coordination activities