¶ … Human Resource Development Initiatives for the Department of Veterans Affairs As the nation's largest healthcare provider and second-largest federal agency, the Department of Veterans Affairs (VA) is responsible for administering a multi-billion dollar budget in support of the nation's heroic veterans. The VA fulfills its mandate to care for veterans and their families through a nationwide network of medical centers, outpatient facilities, Vet Centers and domiciliaries that provide the entire spectrum of medical, surgical and rehabilitation healthcare services. Given the importance of its mandate and scope of its budget, the VA is well situated to take advantage of a wide range of human resource initiatives that can save money, improve organizational performance and the quality of healthcare provided to the country's veteran population. This study defines five such human resources initiatives and describes how they can be applied to achieve these goals. A summary of the recommendations and their potential implications for the VA are provided in the conclusion.

RECOMMENDATIONS FOR FUTURE H.R. STRATEGY INITIATIVES FOR THE DEPARTMENT OF VETERANS AFFAIRS

On February 6, 2012, the very last veteran of the First World War died, indicating just how long the nation's commitment to its veterans can be and, given the several wars fought during the 20th century, it is not surprising that today there are more than 23 million veterans in the United States. The Department of Veterans Affairs is ) is currently the nation's largest healthcare provider, delivering a comprehensive range of services to veteran patients through a national system of tertiary healthcare facilities that are organized into 22 semiautonomous, geographically defined service networks (Landrum, Normand & Rosenheck, 2003). The VA's Web site indicates that over the years, the VA healthcare system has increased to its current facility level of 171 medical centers; 350-plus outpatient, community, and outreach clinics; 126 nursing home care units; and 35 domiciliaries that provide tertiary medical, surgical, and rehabilitative care (VA history, 2012).

The VA's mission, taken from Lincoln's second inaugural address, is "To care for him who shall have borne the battle and for his widow and orphan." Fulfilling this mission in a timely fashion requires effective human resources policies that can support this broad array of healthcare services, and five recommended strategy initiatives for this purpose are described further below.

A.

Strategy issue: Improved healthcare professional recruiting function.

Identification of HRDV concepts pertinent to the issue

The Department of Veterans Affairs is the second largest federal government department in the United States and currently employs more than 220,000 people across the entire range of healthcare and administrative services needed to operate its far-flung healthcare facilities. The VA has three major components as follows:

1. The Veterans Benefits Administration (VBA): This component of the VA employs about 13,000 people in 57 regional benefit offices, assisting veterans financially through disability compensation and pension, education, and home loans;

2. The Veterans Health Administration (VHA): This VA component employs about 200,000 people in 163 hospitals and over 700 community-based outpatient clinics, providing medical, surgical and rehabilitative care to veterans; and,

3. The National Cemetery Administration (NCA): This component of the VA employs about 1,400 people who work in 120 national cemeteries (Kowalski, Harmon, Yorks & Kowalski, 2003).

These components are all completely unionized and all three have experiencing significant change in recent years (Kowalski et al., 2003). For example:

1. VHA and VBA are responding to the migration of older Americans from the Rustbelt to the South.

2. VHA continues its shift from hospital-based to community-based health care delivery (Kowalski et al., 2003).

The VA has ongoing requirements for several "hot job" categories in both professional and support services (VA careers, 2012) that require more effective recruitment efforts to satisfy immediate and future needs. For example, current VA career categories include:

1. Health Care;

2. Business / Administration;

3. Legal;

4. Engineering / Architecture / Technical Support; and,

5. Specialized Skilled Occupations -- Trades (VA careers, 2012).

The current "hot job" healthcare professional categories listed by the VA are:

Registered Nurse

Pharmacist

Physician

Practical Nurse (LPN/LVN)

Diagnostic Radiology Technologist

Medical Technologist

Nursing Assistant

Medical Records Technician (MRT)

Certified Registered Respiratory Therapists

Nuclear Medicine Technologist

Diagnostic Radiologic Technologists

Medical Technologists

Physical Therapists

Blind Rehabilitations Specialists (VA careers, 2012).

Describe HRDV activities that would address the issue.

Human resource recruiters from each of the 22 regional service networks responsible for the VA's far-flung human resource function would personally visit colleges and universities in their service areas to conduct job fairs that emphasize current and projected position openings as well as the numerous benefits offered by the VA, including the following:

Nationwide job transfer opportunities

Tuition...

Colleges and universities that offer coursework leading to credentialed licensure in these professions.
2.

Organizational resources. Each of the foregoing professional position categories also has a professional association or associations that can serve as a valuable recruiting resource.

3.

HRDV program outcomes. An improved recruiting function for high priority healthcare professionals.

B.

Identify 2nd issue within organization: Reducing stress in the VA workplace.

Identify HRDV concepts pertinent to the issue

Employee stress has been well documented as adversely affecting productivity and performance and is a major contributor to unplanned employee turnover, absenteeism and even substance abuse (Shell, 2003). The costs that are associated with these undesirable outcomes are truly enormous and should serve as a wake-up call to larger organizations such as the VA that employ hundreds of thousands of employees. In this regard, Dalton and Mesch (1999) emphasize that the cost and disruptiveness that are typically associated with employee absenteeism in the workplace are alarming: "For every .5% of increase in national absence rates in the United States, the gross national product goes down by some $10 billion. Absenteeism in hours lost is some 40% as large as the total number of hours lost to unemployment" (p. 371). High stress levels can also adversely affect organizational performance, an issue that is of special concern for the VA given the urgency and importance of its mandate.

Not surprisingly, the need for informed human resource practices to address this problem has been the focus of an increasing amount of research in recent years. For instance, a study by Kowalski, Harmon, Yorks and Kowalski (2003) involved a multi-year project at the VA that was designed to improve organizational performance by reducing workplace stress and aggression. The study involved eleven pilot sites, more than 7,000 VA employees, and a project team comprised a numerous disciplines (Kowalski et al., 2003). The results of this study showed that a number of positive outcomes were achieved through the stress-reduction initiative beyond the reduction of stress in the workplace. Given the problems the VA has experienced in recruiting in recent years, the results of the study also underscored the need for ongoing initiatives of this type to reduce unplanned turnover that would further exacerbate such personnel shortages.

For example, according to Abbasi and Hollman, "By whatever name or form, labor turnover is one of the most significant causes of declining productivity and sagging morale in both the public and private sectors. Management theorists say it lies behind the failure of U.S. employee productivity to keep pace with foreign competition" (p. 333). Therefore, reducing stress in the VA workplace represents a valuable opportunity for human resources activities and these issues are discussed further below.

Describe HRDV activities that would address the issue.

Irrespective of the position that is involved, the VA workplace can be a highly stressful environment and that the shift differentials that are involved can add further stress to the environment. According to Dennis, "Job satisfaction is positively correlated with age, tenure, salary and supervisory status. It is negatively correlated with stress and shift work, indicating that the less stress a person was under, the more satisfied the person was; people who worked the day shift are also more satisfied than their night-shift counterparts" (p. 97). Currently, eight work climate factors appear to be the primary sources of stress in the VA workplace: aggression, satisfaction, turnover, grievances, sick leave, and service delivery time and costs (Kowalski et al., 2003).

Design HRDV program concerning the issue

Beyond the foregoing steps to reducing stress in the workplace, studies have shown that governmental employee wellness programs have also been shown to be highly effective in reducing healthcare costs and employee stress (Benavides & David, 2010). Accoriding to Sims (2002), "Wellness programs, sometimes called Health Promotion Programs, focus on the employee's overall physical and mental health. Simply stated, any activity an organization engages in that is designed to identify and assist in preventing or correcting specific health problems, health hazards, or negative health habits can be thought of as wellness-related" (p. 129). Although employee wellness programs differ in offerings, the most common types such programs include those emphasizing:

Hypertension identification and control;

Smoking cessation;

Physical fitness and exercise;

Nutrition and diet control; and,

Job and personal stress management (Sims, 2002).

1.

Organizational partners. Employee unions.

2.

Organizational resources. Wellness programs could be developed in-house drawing on VA healthcare professionals' expertise or the initiative could be outsourced depending on the facilities that are available.

3.

HRDV program outcomes. Employee…