Open Recommendations

Update the SRB Handbook to reflect current policy, processes, and practices

Evaluate whether the preference for using civil servants is necessary for all disciplines. If not
necessary, consider promoting the use of contractors for board membership in disciplines
where the pool of civil servant expertise may be limited

Evaluate the potential for developing a more formalized pipeline and recruitment process for
SRB participants that could include maintaining a skills database of past members

Review existing conflict of interest policy and processes and consider:
a. clarifying terminology and developing definitions to aid Agency personnel in
consistently identifying which affiliation types are included in existing categories and
the review process used for each, and/or
b. expanding the number of affiliation categories to account for, at a minimum,
international partner agencies

Establish a process for verifying that mission directorates are conducting the required conflict
of interest reviews timely and implement record retention policies regarding SRB conflict of
interest review documents

Verify that contracts used to engage SRB members through contractors adhere to the conflict
of interest processes established in the SRB Handbook

Determine whether there is a need for individual mission directorate guidance for SRB
execution or if individualized mission directorate tailoring can be more effectively accomplished
in the ToR. If mission directorate guidance is determined to be needed, update them
accordingly and establish a frequency for their review and updating

Develop a formal, role-based training program with a focus on first time members in SRB roles

Determine the optimal method(s) and frequency required to keep an SRB appropriately
engaged and informed of program and project status between life-cycle reviews and implement
an applicable procedure in the SRB Handbook or other policy or guidance

Identify obstacles that inhibit programs and projects from providing timely information to SRBs
and implement solutions so that timelines agreed to for data deliverables are met

Implement a process for mission directorates to facilitate the collection and sharing of lessons
learned and document that process in the SRB Handbook

We recommend that the Grantee establish policies and procedures for the timely submission of progress reports in accordance with the Uniform Guidance and ARC grant agreement requirements.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures community care oversight councils function according to their charters and meet the required number of times per fiscal year.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care leaders complete the staffing tool reassessment every 90 days.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff enter patient safety events into the Joint Patient Safety Reporting system.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures patient safety managers or designees brief community care patient safety event trends, lessons learned, and corrective actions at community care oversight council meetings.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures staff import all community care documents into patients’ electronic health records within five business days of receipt.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff confirm patients attended their appointments and attempt to obtain community providers’ medical documents prior to administratively closing consults.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff make two additional attempts to obtain community providers’ medical documents within 90 days of the appointment following administrative closure of non-low-risk consults.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff process community providers’ requests for additional services within three business days of receipt.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff send approval or denial letters to community providers for requests for additional services.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff send approval or denial letters to patients for requests for additional services.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff create and use the Community Care–Care Coordination Plan note in the electronic health record to document all care coordination activities for consults with an assigned level of care coordination other than basic.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff confirm patients attended their scheduled community care appointments and received care.

The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff create the Community Care–Urgent Care Record note in the electronic health record when they receive urgent care documents.