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DOD Health Care: Occurrence Screen Program Undergoing Changes, but Weaknesses Still Exist

HRD-89-36 Published: Jan 05, 1989. Publicly Released: Jan 05, 1989.
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Highlights

In response to a congressional request, GAO reviewed the Department of Defense's (DOD) Occurrence Screen Program, which is intended to identify military hospital's adverse patient-care outcomes.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Defense To help ensure effective implementation of occurrence screen programs in military hospitals, the Secretary of Defense should direct the service secretaries, in conjunction with the Assistant Secretary of Defense for Health Affairs, to collect and analyze occurrence screen data above the hospital level and provide comparative and related analysis to the individual hospital commanders for management purposes.
Closed – Implemented
Since occurrence screen data has not been useful in the past, DOD stated it will collect data when it has determined what will be most useful to higher authority. Ideas about data analysis above the hospital level are emerging, but will take time to refine. Case closed by the Office of the Inspector General (OIG).
Department of Defense To improve the reliability of the initial occurrence screening process, the Secretary of Defense should direct the service secretaries, in conjunction with the Assistant Secretary of Defense for Health Affairs, to: (1) instruct screeners to identify all applicable occurrences during the initial screening process; and (2) discontinue using physicians to screen their own patient records and use properly trained nonphysician personnel to perform this function.
Closed – Implemented
DOD stated that all applicable occurrences should be identified and this concept has been addressed in the redesign of its quality assurance computer software. Although the DOD goal is to have all initial screening done by nonphysician personnel, budget constraints will most likely prevent this until the mid- to late 1990s. Case closed by OIG.

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Topics

Data collectionHealth care personnelInternal controlsManagement information systemsMedical information systemsMedical recordsMilitary hospitalsPatient care servicesQuality assuranceReporting requirements