The Department of Veterans Affairs Office of Inspector General Aug. 26 released the final report of its review of systemic issues with patient scheduling and access issues at the Phoenix VA Health Care System.
VA concurred with the recommendations in the final report and, in many cases, has already implemented action plans and made improvements that respond to the OIG’s recommendations.
We sincerely apologize to all veterans who experienced unacceptable delays in receiving care, said VA Secretary Robert A. McDonald. We will continue to listen to veterans, our VA employees, and veterans service organizations to improve access to quality care in Phoenix and across the country and we will work hard to rebuild trust with Veterans and the American public.
The final report updates the information previously provided by the OIG in its Interim Report and contains final results from the review of the PVAHCS. VA outlined key action plans that expand access to care, improve staffing for primary care, and accountability measures in response to the final OIG report.
In response to recommendations in the May 2014 OIG Interim Report, the following improvements were initiated in Phoenix and across the VA system:
As of Aug. 15, the Veterans Health Administration has reached out to over 266,000 veterans to get them off wait lists and into clinics.
- As a result of the Accelerating Access to Care Initiative, approximately 200,000 new VA appointments nationwide were scheduled for veterans between May 15 and June 15, 2014.
- Nearly 912,000 total referrals to non-VA care providers have been made in the last two months. That is, over 190,000 more referrals to non-VA care providers than the same period in 2013 (721,000).
- As of August 15, VA has decreased the number of veterans on the Electronic Wait List 57 percent.
- Reduced the New Enrollee Appointment Report from its peak of 63,869 on June 1, 2014, to 1,717 as of August 15, 2014
- VA has reached out to more than 5,000 veterans in Phoenix to coordinate the acceleration of their care including all veterans in Phoenix identified as being on unofficial lists or the facility Electronic Wait List.
- Since May 15, VA has scheduled 2,300 appointments at the Phoenix VA Health Care System and made 2,713 referrals for appointments to community providers through non-VA care.
Even before the OIG’s interim report, VA had taken actions to address the issue of patient scheduling and access, working in close concert with veteran service organizations, said Interim Under Secretary for Health Carolyn Clancy. We’ve initiated development of a more robust process for continuously measuring patient satisfaction at each site, and will expand our patient satisfaction survey capabilities in the coming year, to capture more Veteran experience data through telephone, social media, and on-line means.
Additional actions include:
- Began updating the antiquated appointment scheduling system beginning with near-term enhancements to the existing system and ending with the acquisition of a comprehensive, state-of-the-art, commercial off-the-shelf scheduling system.
- Directed that every Medical Center Director conduct regular in-person visits to all of their clinics, to include interacting with scheduling staff to ensure all scheduling practices are appropriate. Veterans’ Integrated Systems Network cirectors conducted similar visits. So far, 2,450 visits have been conducted nationwide.
- Removed the 14-day access measure from all individual employee performance plans to eliminate any motive for inappropriate scheduling practices or behaviors. In the course of completing this task, over 13,000 performance plans were amended.
- Added primary care to the services available to veterans through VA’s Patient-Centered Community Care contracts, a key and evolving part of the non-VA medical care program.
- Established an interdisciplinary accountability review team to ensure leadership accountability for improprieties related to patient scheduling and access to care, whistleblower retaliation, and related matters that impact public trust in VA.
On Aug. 8, McDonald announced in Phoenix, Ariz., that every VA medical center will undergo an independent review of scheduling and access practices beginning this fall by the Joint Commission, the nation’s oldest and largest standards-setting and accrediting body in health care. On Aug. 5, McDonald directed all VA health care and benefits facilities to hold town-hall events by the end of September to improve communication with, and hear directly from, Veterans nationwide.