VA Access Improves, Work Still Needed: Report

A new independent report on Department of Veterans Affairs hospitals and clinics found that although improvements have been made on issues such as access to care, there is still work to do.

The Joint Commission, which conducts organization health care audits, began unannounced surveys on hospitals in the VA system between September 2014 and August 2015 at the VA's request, VA officials said. Some of the surveyed hospitals were then visited again through April of this year as part of a separate, previously scheduled round of visits, and their progress on key issues was examined, they said. The program looked at problems such as access to care, leadership and staffing.

"Phones were inconsistently answered when patients called to make appointments, even though insufficient staffing did not appear to be the reason," the investigation found. "Staff absenteeism also caused problems with access. There were often no plans for coverage. As a result, veterans would arrive with no one to see them and no process in place to assist them in rescheduling their appointment."

The initial review looked at 139 medical facilities and 47 community-based clinics nationwide, the VA said, while the follow-up surveys revisited 57 of those locations. More than 220 requirements for improvement were identified at those sites, according to the report.

Seventy-one of those were related to care access, coordination or timeliness, some of which was caused by staff confusion about expectations, the report says. While some of the scheduling issues were improved by a clarification given to the clinics from top VA officials during the survey period, problems lingered, the report says.

However, improvements were made at the 57 locations that received follow-up visits, the report says. Of those, only three received a repeat citation for access, coordination and timeliness issues.

To address those continued problems, the report recommends that officials continue to monitor appointment scheduling timeframes and have better patient engagement, among other suggestions.

"Their analysis shows that VA as national health care leader is making progress in improving the care we provide to our Veterans," said Dr. David Shulkin, a VA under secretary for health, in a statement on the report. "This affirms our commitment to providing both excellent health care and an exceptional experience of care to all Veterans served."

-- Amy Bushatz can be reached at amy.bushatz@military.com.