Q&A
In August 2014, the Veterans Choice Act (VCA) allowed veterans to access care from non-VA providers. Eligibility was based on the distance a veteran lived from a VA facility or the inability to be seen within a specified time period. The VCA provided PVACHS with an additional tool to meet veterans’ care needs as it increased the hiring of permanent staff. After about 3 months, PVAHCS succeeded in contacting > 6,000 veterans and providing > 3,200 veterans with appointments at the either PVAHCS or local civilian partners. Despite the initial successes, the preliminary gains in patient access at PVAHCS will not be sustainable, and wait times will not decrease substantially without increased permanent staff and further improvements in both the facility and its processes. Although these improvements are a priority, progress has been slow.
Efforts are underway to enhance operational integration between providers, nursing, and administrative support personnel. Congress has renewed its support of a larger and more functional health care center along with the addition of 2 more clinics within the metro Phoenix area. The PVAHCS has since stood down the ICS and ACI operations and transferred these operations to a newly created Patient Flow Committee. This group is chaired by the COS and meets monthly to supervise process improvement teams using lean modalities to address issues creating excessive waits or delays in patient care throughout the facility.
This access to care crisis was exacerbated by intense media and political attention. Further disarray resulted from the abrupt loss of several senior executives at PVAHCS—all the way up to former VA Secretary Eric K. Shinseki. Use of the ICS was highly effective in providing the necessary organizational structure for key staff to focus on solving the immediate problems locally while managing external resources that were in constant flux. The authors strongly recommend consideration of the ICS as a management framework to tackle similar problems.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies.