The Office of Inspector General (OIG) Care in the Community healthcare inspection program examines clinical and administrative processes associated with providing quality outpatient healthcare to veterans. This report provides a focused evaluation of Veterans Integrated Service Network (VISN) 15 and its oversight of the quality of care delivered in community-based outpatient clinics (CBOCs) and through its community care referrals to non-VA providers. Although it is difficult to measure the value of well-delivered and coordinated care between VA and non-VA providers, the findings in this report may help VISN leaders identify vulnerable areas of community care that, if properly addressed, should improve healthcare quality for veterans.
The OIG reviewed care coordination: congestive heart failure management; primary care and mental health (diagnostic evaluations following positive screenings for depression or alcohol misuse); quality of care (home dialysis care); and women’s health (mammography care and communication of results). The OIG issued three recommendations for improvement in one area, quality of care:
• Ensuring an end-stage renal disease provider sees patients in the home dialysis program at least monthly, as evidenced by a progress note in the medical record by the responsible independent renal practitioner
• Performing initial and annual home visits for patients accepted into the VISN 15 home dialysis program
• Monitoring the quality of home dialysis contracted clinical services for patients receiving non-VA home dialysis services
The report can be found online here.
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