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The transmittal sheet summarizes amendments and clarifies major changes effective March 7, 2025, including terminology updates and rescission/replacement of a prior directive from March 20, 2023. The document outlines responsibilities, definitions, staffing and supervision expectations, telehealth and operational requirements, airway management, sedation anesthesia guidance, and management of acute ischemic stroke and mental health presentations, including related referenced directives.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/vha-directive-1101141-emergency-medicine-transmittal-sheet/252431/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/vha-directive-1101141-emergency-medicine-transmittal-sheet/252431.png","ImageObject",442,249,{"name":88,"@type":89},"Aldword","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-25","2026-09-13",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",29,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What is the purpose of VHA Directive 1101.14(1)?","Question",{"text":109,"@type":110},"The directive states policy for Veterans Health Administration medical facility Emergency Departments (ED). It sets national expectations for ED operations and requirements.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What major changes were introduced in the March 7, 2025 amendment?",{"text":114,"@type":110},"The amendment changes “gender” to “sex” and updates related terminology to “sex-specific.” It also removes references to VHA Directive 1341 to comply with EO 14168.",{"name":116,"@type":107,"acceptedAnswer":117},"How does the March 20, 2023 version relate to the earlier directive?",{"text":118,"@type":110},"The March 20, 2023 directive rescinded and replaced VHA Directive 1101.05(2), Emergency Medicine, dated September 2, 2016, and separates urgent care policy from ED policy.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},252431,1790005005,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":136,"language":137,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":138,"faqs":139,"seo_title":140,"seo_description":61,"update_tm":141,"read_time":25},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Department of Veterans Affairs Veterans Health Administration Washington, DC 20420  \nAMENDED  \nMarch 7, 2025  \nVHA DIRECTIVE 1101.14(1) Transmittal Sheet March 20, 2023  \nEMERGENCY MEDICINE  \n1. REASON FOR ISSUE: This Veterans Health Administration (VHA) directive states policy for Department of Veterans Affairs (VA) medical facility Emergency Departments (ED) .  \n2. SUMMARY OF MAJOR CHANGES:  \na. Amendment dated March 7, 2025 , changes “gender” to “sex,” changes “genderspecific” to sex-specific,” and removed references to VHA Directive 1341 (in paragraphs 18 and 23) comply with EO 14168.  \nb. As published March 20, 2023, this VHA directive rescinded and replaced VHA Directive 1101.05(2), Emergency Medicine, dated September 2, 2016.  \n(1) Policy governing VHA Urgent Care locations was separated from ED policy. Urgent Care offers acute unscheduled care for illnesses and injuries that are significant but not life threatening. Refer to VHA Directive 1101.13 , VHA Urgent Care , dated March 20, 2023 , for more information.  \n(2) Major changes to ED requirements included:  \n(a) Removed physician credentialing and privileging details and residency supervision requirements which are provided in other VHA policies, and consolidates staffing criteria in new Appendix A. For staffing and supervision requirements, see VA Directive 5007, Pay Administration, dated April 15, 2002; VHA Directive 1400.01, Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents, dated November 7, 2019; and VHA Handbook 1400.04, Supervision of Associated Health Trainees, dated March 19, 2015.  \n(b) Updated definitions and terminology in paragraph 3.  \n(c) Added a requirement for VA medical facilities with EDs to have a Provider Staffing Contingency written plan or Standard Operating Procedure (SOP) (see paragraph 6.c. (3)) and procedures or SOP for Managing High Risk Mental Health Presentations (for further details, see paragraph 13.g. ) .  \n(d) Removed requirements for VA medical facilities with EDs to have local policies on care for Observation patients , patient transfers , Acute Ischemic Stroke care and outof-operating-room airway management because these areas are addressed in other VHA national policies noted in this directive. In some cases, written plans are still necessary, as noted in this directive.  \n(e) Removed requirements for VA medical facilities with EDs to have local policies on diversion, placement of overflow patients in temporary bed locations , access to support services, coordination of elective and surgical patients , and minimum staffing requirements for EDs to allow for flexibility in local implementation. In some cases, written plans are still necessary, as noted in this directive.  \n(f) Relocated information in the appendices to the Emergency Medicine SharePoint, including recommended medical, pharmacy and laboratory equipment supplies for the ED; Emergency Medicine Field Advisory Board information; guidance for care of pregnant patients; and Emergency Medicine Improvement Initiative information.  \n3. RELATED ISSUES: VHA Directive 1094, Inter-Facility Transfer, dated January 11 , 2017.  \n4. RESPONSIBLE OFFICE: The Specialty Care Services Program Office (11SPEC) is responsible for the content of this directive. Questions may be referred to the VHA [Emergency Medicine Program at](Emergency Medicine Program at vhaemx@va.gov)[ ](Emergency Medicine Program at vhaemx@va.gov)[vhaemx@va.gov](Emergency Medicine Program at vhaemx@va.gov).  \n5. RESCISSIONS: VHA Directive 1101.05(2) , Emergency Medicine, dated September  \n2, 2016; and VHA Memorandum 2020-09-10, OIG-CHIP Recommendations for Emergency Departments and Urgent Care Centers, dated September 8, 2020 , are rescinded.  \n6. RECERTIFICATION: This VHA directive is scheduled for recertification on or before the last working day of March 2028. This VHA directive will continue to serve as national VHA policy until it is recertified or rescinded.  \nBY DIRECTION OF THE OF","cbCairIT9sfH1MJ8","https://ap.wps.com/l/cbCairIT9sfH1MJ8","pdf",362048,44,"English","# PURPOSE\n# BACKGROUND\n# DEFINITIONS\n# POLICY\n# RESPONSIBILITIES\n# EMERGENCY DEPARTMENT STAFFING\n# TELEHEALTH\n# EMERGENCY DEPARTMENT REQUIREMENTS\n# GENERAL OPERATIONS REQUIREMENTS\n# AIRWAY MANAGEMENT\n# USE OF ANESTHETIC AGENTS FOR SEDATION IN THE EMERGENCY DEPARTMENT\n# EMERGENCY DEPARTMENT ACUTE ISCHEMIC STROKE MANAGEMENT\n# EMERGENCY DEPARTMENT MANAGEMENT OF PATIENTS WHOSE PRESENTATION INCLUDES MENTAL HEALTH CONCERNS","[{\"question\":\"What is the purpose of VHA Directive 1101.14(1)?\",\"answer\":\"The directive states policy for Veterans Health Administration medical facility Emergency Departments (ED). It sets national expectations for ED operations and requirements.\"},{\"question\":\"What major changes were introduced in the March 7, 2025 amendment?\",\"answer\":\"The amendment changes “gender” to “sex” and updates related terminology to “sex-specific.” It also removes references to VHA Directive 1341 to comply with EO 14168.\"},{\"question\":\"How does the March 20, 2023 version relate to the earlier directive?\",\"answer\":\"The March 20, 2023 directive rescinded and replaced VHA Directive 1101.05(2), Emergency Medicine, dated September 2, 2016, and separates urgent care policy from ED policy.\"}]","VHA Directive 1101.14(1) - Emergency Medicine - Transmittal Sheet | PDF",1789261456]