Federal Reports

The Postal Service monitors service availability for Tier 1 business critical services. These services support core business functions, such as moving the mail, delivery, revenue, and customer service. For example, Click-N-Ship and PostalOne! are Tier 1 business critical services. Outages related to Tier 1 business critical services may potentially cause a loss of current or future revenue and brand value or diminished customer experience. Our objective was to determine if the Postal Service is accurately measuring service availability for its Tier 1 business critical services.

The VA Office of Inspector General (OIG) conducted a focused evaluation of the quality of care delivered at the Gulf Coast Veterans Health Care System (Facility). The review covered key processes associated with promoting quality care—Leadership and Organizational Risks; Quality, Safety, and Value (QSV); Credentialing and Privileging; Environment of Care (EOC); Medication Management: Controlled Substances (CS) Inspection Program; Mental Health Care: Post-Traumatic Stress Disorder Care; Long-Term Care: Geriatric Evaluations; Women’s Health: Mammography Results and Follow-Up; and High-Risk Processes: Central Line-Associated Bloodstream Infections. At the time of our site visit, the Facility leaders were still adjusting to the January 2018 assignment of the Director and Chief of Staff and were actively working to improve employee satisfaction and the patient experience. The leaders appeared to support efforts related to quality care, but the presence of organizational risk factors may contribute to future lapses in patient safety unless corrective processes are implemented and continuously monitored. The leadership appeared knowledgeable about selected Strategic Analytics for Improvement and Learning (SAIL) metrics but should continue to take significant actions to improve care and performance of selected Quality of Care and Efficiency metrics that are likely contributing to the “1-Star” rating. The OIG issued 13 recommendations that are attributable to the Director, Chief of Staff, and Associate Director. Identified areas with deficiencies are: (1) QSV • Interdisciplinary review of utilization management data • Annual patient safety reports (2) Credentialing and Privileging • Approval of clinical privileges by executive leaders • Focused and Ongoing Professional Practice Evaluation processes (3) EOC • EOC rounds attendance • Expiration statements on sterile surgical instruments (4) Medication Management: CS Inspection Program • Annual physical security survey • CS Coordinator position description • Monthly inspections of CS storage areas • Same day completion of CS physical inventories • CS monthly physical counts (5) Mental Health Care: Post-Traumatic Stress Disorder Care • Suicide risk assessments

The Postal Service defines a grievance as a dispute, difference or disagreement between parties or a complaint lodged by a party regarding wages, hours or conditions of employment. The grievance process allows employees to discuss and informally settle grievances with their immediate supervisor; however, if there is no resolution, the union can file a formal grievance. Our objective was to assess the accuracy of grievances recorded in the Grievance and Arbitration Tracking System (GATS) for the Houston District.

What We Looked AtWe reviewed the Confederated Tribes of the Colville Reservation's single audit report for the fiscal year ending September 30, 2017, in order to identify findings that affect directly awarded Department of Transportation programs. An independent auditor prepared the single audit report, dated June 28, 2018.What We FoundWe found that the report contained a reporting finding that needs prompt action from the Federal Highway Administration's (FHWA) management.RecommendationsWe recommend that FHWA ensures that the Confederated Tribes comply with the reporting requirements.

What We Looked AtWe reviewed the State of Michigan's single audit report for the fiscal year ending September 30, 2017, in order to identify findings that affect directly awarded Department of Transportation programs. An independent auditor prepared the single audit report, dated June 21, 2018.What We FoundWe found that the report contained a matching, level of effort, earmarking finding that needs prompt action from the National Highway Traffic Safety Administration's (NHTSA) management.RecommendationsWe recommend that NHTSA ensures that the State complies with the matching, level of effort, earmarking requirements.

What We Looked AtWe reviewed the Chicago Transit Authority's single audit report for the fiscal year ending December 31, 2017, in order to identify findings that affect directly awarded Department of Transportation programs. An independent auditor prepared the single audit report, dated April 25, 2018.What We FoundWe found that the report contained a reporting finding that needs prompt action from the Federal Transit Administration's (FTA) management.RecommendationsWe recommend that FTA ensures that the Authority complies with the reporting requirements.