Open Recommendations

(U) Rec. A.1.d: The DoD OIG recommended that the Commander of the U.S. Africa Command request an exemption from the Secretary of Defense to use the Chabelley dump to dispose of DoD'generated solid waste in accordance with DoD Instruction 4715.19 and the Under Secretary of Defense for Acquisition and Sustainment Memorandum, Interim Policy on Solid Waste Disposal Outside the U.S., October 13, 2022.

(U) Rec. A.2.a: The DoD OIG recommended that the Command Surgeon for U.S. Air Forces Europe" Air Forces Africa review U.S. Air Forces Europe"Air Forces Africas medical logistics support and update sampling procedures to include a plan for securing the equipment needed to sample for known airborne hazards associated with open'air burn pits.

(U) Rec. A.2.b: The DoD OIG recommended that the Command Surgeon for U.S. Air Forces Europe"Air Forces Africa review U.S. Air Forces Europe"Air Forces Africas medical logistics support and update sampling procedures to include a plan for routinely conducting air sampling at Chabelley Airfield for known airborne hazards associated with open'air burn pits, including polycyclic aromatic hydrocarbons, volatile organic compounds, and dioxins.

(U) Rec B.1.a: The DoD OIG recommended that the Camp Lemonnier, Djibouti base operations support contracting officer, Naval Facilities Engineering Systems Command direct the contracting officers representative to update oversight procedures to require the performance assessment representatives to conduct oversight of the transport of solid waste to the Camp Lemonnier, Djibouti incinerator plant and non'incinerated solid waste to the Chabelley dump. The updated procedures should reflect an increased oversight level and outline what sufficient evidence the performance assessment representatives must obtain to hold the contractor accountable in the event of poor performance.

(U) Rec. B.1.b: The DoD OIG recommended that the Camp Lemonnier, Djibouti base operations support contracting officer, Naval Facilities Engineering Systems Command monitor documentation from the performance assessment representatives increased oversight and, if non'incinerated solid waste dumping is substantiated, take immediate action commensurate with the severity and frequency of the noncompliance to hold the contractor accountable to include requiring the contractor to clean up any dumped waste.

(U) Rec. B.1.c: The DoD OIG recommended that the Camp Lemonnier, Djibouti base operations support contracting officer, Naval Facilities Engineering Systems Command review the evidence supporting their December 2024 and April 2025 letters of concern to determine whether solid waste found at the unauthorized dump sites surrounding Camp Lemonnier, Djibouti contained trash generated from Camp Lemonnier, Djibouti. If confirmed, the contracting officer should use the results of this review to reconsider whether they can direct the contractor to clean up the dumped waste.

The Human Capital Officer should coordinate with IT to determine the time frame when managers must request laptops for new employees. Once determined, formalize the requirement in the standard new employee orientation guidance and update the Manager’s Onboarding Checklist.

The Human Capital Officer should update the Manager’s Onboarding Checklist with a step to issue the performance plan within 30 calendar days of the employee’s start date.

The Human Capital Officer should work with the ITM administrator to ensure that processes are put in place to alert managers when important due dates pass; for example, if the performance plan is past due.

The Human Capital Officer should establish a formal written policy that requires managers to conduct quarterly touchpoint discussions with new employees in their first year and require that managers attend the updated training on conducting quarterly touchpoint activities.

The Human Capital Officer should work with the ITM administrator to add quarterly touchpoint activities to the manager’s ITM module as part of the new employee onboarding, send managers notifications of upcoming due dates for quarterly touchpoint activity discussions and alert managers if the discussions are past due.

The Oklahoma City VA Health Care System Director, with Pathology and Laboratory Medicine Service leaders, conducts a comprehensive review of the quality of care for the four patients identified in this report, including determinations of cytopathology processing delays and assessment of patient harm, and takes action as warranted.

The Oklahoma City VA Health Care System Director ensures that routine non-gynecological turnaround time corrective actions are documented and monitored for effectiveness, as required by the Veterans Health Administration.

The Oklahoma City VA Health Care System Director conducts a comprehensive review of the quality of care provided by the Chief of Pathology and Laboratory Medicine Service, identifies deficiencies, and takes action as warranted.

The Oklahoma City VA Health Care System Director reviews the Pathology and Laboratory Medicine Service event reporting requirements for variance events and ensures completion according to facility policy and Veterans Health Administration requirements.

The Oklahoma City VA Health Care System Director, in conjunction with the National Center for Patient Safety, evaluates patient safety event reporting processes within the Pathology and Laboratory Medicine Service, and ensures completion according to Veterans Health Administration requirements.

The Oklahoma City VA Health Care System Director, with Pathology and Laboratory Medicine Service leaders, conducts a comprehensive review of the quality of care for the four patients identified in this report, including determinations of cytopathology processing delays and assessment of patient harm, and takes action as warranted.

The Oklahoma City VA Health Care System Director ensures that routine non-gynecological turnaround time corrective actions are documented and monitored for effectiveness, as required by the Veterans Health Administration.

The Oklahoma City VA Health Care System Director conducts a comprehensive review of the quality of care provided by the Chief of Pathology and Laboratory Medicine Service, identifies deficiencies, and takes action as warranted.

The Oklahoma City VA Health Care System Director reviews the Pathology and Laboratory Medicine Service event reporting requirements for variance events and ensures completion according to facility policy and Veterans Health Administration requirements.

The Oklahoma City VA Health Care System Director, in conjunction with the National Center for Patient Safety, evaluates patient safety event reporting processes within the Pathology and Laboratory Medicine Service, and ensures completion according to Veterans Health Administration requirements.

(U) Rec. 1: Report is Classified.

(U) Rec. 2: Report is Classified.

(U) Rec. 3: Report is Classified.

(U) Rec. 4: Report is Classified.