Following its nationwide wait times scandal in 2014, the Department of Veterans Affairs’ health system has taken steps to improve transparency and increase veterans’ access—steps that could be replicated by other healthcare providers.
The VA has faced intense scrutiny in the wake of the wait time scandal. Since then, hospitals from North Carolina to Houston to the District of Columbia have come under fire for practices that may have put patients at risk.
The VA took a three-pronged approach to increasing access following the scandal, Poonam Alaigh, M.D., acting under secretary for Health for the VA, said in interview with Thomas Lee, M.D., chief medical officer at Press Ganey, in an interview for NEJM Catalyst.
- Take a good, hard look. The VA took stock of its wait times and set strong guiding principles for transformation. These principles were deployed across all of the hospitals in the system.
- Scale up solutions. Alaigh said the VA took a grassroots approach to test promising ideas from facilities across the system. From there, it developed a guidebook of best practices for more streamlined, efficient care.
- Get boots on the ground. The VA sent systems engineers into its hospitals to determine which facilities had the greatest needs and lowest performance before deploying staff to make changes.
Solutions included launching an access website that allows veterans to access data on local facilities, including patient satisfaction scores and quality information. Alaigh said the goal was to allow veterans to make more of their own care choices.
The system had made strides in reducing the wait for appointments, she said. About 97% of VA patients are seen within 30 days.
The Veterans Choice program was another solution to the 2014 scandal, which revealed thousands of veterans faced long waits before they got care at VA facilities.
It allowed veterans to seek care outside of the VA system if the nearest facility is too far away from where they live or if they had to wait more than 30 days for an appointment in the VA network. The program was recently extended beyond its Aug. 7 end date by the Trump administration.
The program was in financial peril, but Congress reached a last-minute deal to save it.