Federal Reports

The VA Office of Inspector General (OIG) conducted a review to evaluate (1) VHA and medical center leaders’ awareness and incorporation of social determinants of health (SDOH) and health-related social needs (HRSN) into inpatient medical unit discharge assessments, planning, policies, and templates; and (2) VHA’s efforts to address SDOH/HRSN with tools and community resources. The OIG determined there were no national policies or procedures that integrated SDOH/HRSN into discharge assessment and planning. Although the OIG found three national reference documents incorporating SDOH/HRSN, these documents were not considered formal guidance and were largely unknown to leaders responsible for discharge assessment and planning within inpatient units. Most medical center staff developed their own discharge policies and procedures addressing SDOH/HRSN, according to an OIG survey. The OIG also identified national templates incorporating SDOH/HRSN for primary care social workers but no template for discharge planning within medical units. VHA leaders recognized the impact of incorporating SDOH/HRSN into a screening tool and launched the Assessing Circumstances and Offering Resources for Needs initiative. The templated screening expands VHA’s capability to collect and capture SDOH/HRSN data in the electronic health record. As of July 2023, only two medical centers used the tool within inpatient medical units. The VHA Office of Health Equity developed health mapping tools to assist staff in identifying and addressing health disparities within their communities; however, few medical center leaders reported using these tools. Almost half of the surveyed leaders did not participate in formal partnerships with community resources to address SDOH. The OIG made five recommendations to the Under Secretary for Health regarding the development of national policy on incorporating SDOH/HRSN into discharge assessment and planning, implementation of a standardized template, evaluation of barriers to assessing SDOH/HRSN at discharge, use of health equity tools, and establishment of community resource partnerships to address SDOH.

The audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements.

NASA’s Office of STEM Engagement is making progress managing and coordinating a diverse group of STEM engagement activities across the Agency and continues to operate against a backdrop of uncertainty, with its efforts challenged by a history of budget cuts and proposed elimination of the office.

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the Central Virginia VA Health Care System, which includes the Richmond VA Medical Center and multiple outpatient clinics in Virginia. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (suicide prevention initiatives)The OIG issued six recommendations for improvement in three areas:1. Quality, safety, and value• Recommendations and improvement actions for Level 3 peer reviews2. Medical staff privileging• Recommendations for privileges based on professional practice evaluation results3. Environment of care• Temperature- and humidity-controlled storage of reusable medical equipment• Clean and safe storage rooms and patient areas• Medication access limited to approved staff• Availability of feminine hygiene products in restrooms at no cost

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the Kansas City VA Medical Center, which includes multiple outpatient clinics in Kansas and Missouri. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (suicide prevention initiatives)The OIG issued five recommendations for improvement in three areas:1. Leadership and organizational risks• Institutional disclosures for sentinel events2. Environment of care• Environment of care inspections• Electrical receptacles covered with metal plates in the Inpatient Mental Health Unit3. Mental health• Comprehensive Suicide Risk Evaluation completion• Suicide behaviors reported to suicide prevention team