The OIG conducted this review after receiving a hotline allegation that the 2024 emergency department expansion and renovation at the Audie L. Murphy Memorial Veterans’ Hospital in San Antonio, Texas, did not meet standards. Some exam rooms were said to put patients at risk because the rooms were not equipped for urgent care.
The OIG confirmed the allegation. Fast-track exam rooms, used to quickly assess and treat patients with minor injuries or illnesses, did not have permanent medical air, oxygen, and vacuum outlets, nor did all the rooms have acceptable exam lights. In addition, in one room the contractor failed to install the required plumbing for permanent medical air, oxygen, and vacuum lines. The deficiencies occurred in part because the VHA directive guiding minor construction projects did not incorporate the legal requirement that the director of the Office of Construction and Facilities Management (CFM) manage and oversee the project. Other factors included the contractor’s use of the wrong template to design fast-track rooms and the project engineer’s approval of the room that lacked required plumbing.
When fast-track rooms and procedural and general exam rooms lack the necessary equipment for emergency care, patient care may be delayed while healthcare professionals locate portable equipment. VA officials agreed with the OIG’s four recommendations to ensure processes and guidance are in place for the CFM to provide appropriate oversight and management over minor construction projects, revise the VHA directive on minor construction projects to incorporate legal requirements, review emergency department exam and fast-track rooms for compliance with standards, and review a CFM assessment of emergency department for compliance with design and equipment requirements.
