This Office of Inspector General Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the inpatient and outpatient care provided at the Veterans Health Care System of the Ozarks, which includes the Fayetteville VA Medical Center and multiple outpatient clinics in Arkansas, Missouri, and Oklahoma. This evaluation focused on five key operational areas:
• Leadership and organizational risks
• Quality, safety, and value
• Medical staff privileging
• Environment of care
• Mental health (emergency department and urgent care center suicide prevention initiatives)
The OIG issued five recommendations for improvement in four areas:
1. Leadership and Organizational Risks
• Institutional disclosures for sentinel events
2. Medical Staff Privileging
• Service-specific criteria in Ongoing Professional Practice Evaluations
3. Environment of Care
• Contaminated, damaged, expired, or recalled medical supplies
• Notices in treatment areas subject to photography or video recording
4. Mental Health
• Safety plans for patients discharged from the Emergency Department with a positive suicide risk screen
The report can be found online here.