Open Recommendations

The VA New Mexico Health Care System Director ensures Sterile Processing Service leaders demonstrate clear communication of Sterile Processing Service staff roles and responsibilities in accordance with Veterans Health Administration High Reliability Organization principles and values.

The VA New Mexico Health Care System Director ensures the facility’s Sterile Processing Service identifies and resolves high-level disinfection documentation errors as they occur, prior to use of associated reusable medical devices on patients.

The VA New Mexico Health Care System Director ensures Sterile Processing Service has a process to communicate all instances when high-level disinfection documentation cannot be located to the associated clinical services when the reusable medical devices was used in patient care.

An update on the status and future milestones of NextGen programs and their capabilities, including Trajectory Based Operations.

Complete Privacy policy

We recommend the Vice President and Chief Information and Digital Officer, Technology and Innovation, implement the planned project to upgrade software and hardware to supported versions.

We recommend the Vice President and Chief Information and Digital Officer, Technology and Innovation, take action to remediate both instances of insecure protocols in use where technically and operationally possible.

We recommend the Vice President and Chief Information and Digital Officer, Technology and Innovation, implement baselines, baseline monitoring, and deviation risk tracking as required by TVA policy.

The Associate Director ensures staff document VA police response times for panic alarm testing in the inpatient mental health unit.

The Executive Director ensures staff store reusable medical equipment in temperature- and humidity-controlled storage locations.

Re-evaluate the OSTEM performance goals to ensure they are distinct and well correlated with outcomes.

Develop a procedure to ensure OSTEM tracks and reports funding for all Agency STEM engagement activities.

Re-evaluate jurisdictions eligible for EPSCoR funds to ensure effective and equitable distribution of Agency funds.

Require all NASA organizations capture STEM engagement activities in STEM Gateway.

The Commissioner, SB/SE Division, and Chief, Criminal Investigation, should identify opportunities to partner with the EPA to use the agency’s expertise and data when selecting, conducting examinations and investigations involving taxpayers that claimed biofuel tax credits and revise the MOU as needed.

The Under Secretary for Health, Veterans Integrated Service Network directors, and facility leaders ensure staff enter data into the local cancer registry database in a timely manner.

Develop and communicate a plan with specific actions, milestones, and metrics to attract more applicants in locations with hiring challenges.

Provide facility management an opportunity to include facility specific information when requesting a job posting to help ensure external applicants are aware of job requirements.

Create processing timeframes for returned funds for current and future disaster programs.

Rec. 1.a: The DoD OIG recommended that the DoD Education Activity Director develop and implement policy that requires the DoD Education Activity Civil Rights Program to review all Serious Incident Reports, including ensuring that Serious Incident Reports related to discriminatory conduct are linked when appropriate.

Rec. 1.b: The DoD OIG recommended that the DoD Education Activity Director develop and implement policy that requires updating incorrectly identified discriminatory conduct Serious Incident Reports.

Rec. 1.c: The DoD OIG recommended that the DoD Education Activity Director develop and implement policy that requires documenting in the Serious Incident Report or Director?s Critical Information Report database all instances of reported discriminatory conduct.

Rec. 1.d: The DoD OIG recommended that the DoD Education Activity Director direct the Civil Rights Program to create and provide to all current and incoming administrators a mandatory training class on identifying and reporting discriminatory conduct and harassment.

Rec. 1.e: The DoD OIG recommended that the DoD Education Activity Director develop and implement policy that requires updates to Serious Incident Reports at the Civil Rights Program's request and requires the Civil Rights Program to approve all civil rights related Serious Incident Reports prior to closing the records.

Rec. 1.f: The DoD OIG recommended that the DoD Education Activity Director develop and implement policy that requires that the Civil Rights Program records and tracks all informally resolved complaints of hostile environments and discriminatory conduct (as identified in DoDEA AI 1443.01, section 4.1.a) in a standardized format.