VHA managerial challenges in 2017

VHA Managerial Challenge

In recent years, the United States Department of Veterans Affairs has experienced a great deal of challenges ranging from lack of accountability and lack of employee apprehension to mismanagement of finances. In particular, a key managerial challenge that the VA faces today is the lack of timely provision of health care to veterans across the nation. Increased wait times at the various VA medical facilities are a key hindrance to obtaining timely medical health care. These protracted wait times have led to hindered accessibility to health care, which causes severe and abrupt occurrences, disability and death of the patients. There is need to assimilate financial and operational decision making to efficaciously meet this challenge and enhance organizational performance. This is because the agency caters to more than six million patients who require health care and benefits. To begin with, there is need to provide funds to employ extra doctors, nurses and other medical staff in different VA medical centers across various states. Financial funding is required to address the lack of balance in the ratio between patients and medical staff. The new hires should be sent out to VA medical centers that are presently experiencing the longest wait times. The VA should also monitor wait times in its different medical facilities. This is to ensure that accurate and suitable patient data is collected and keyed into the system. More so, the medical facilities ought to abide by the established scheduling policies. More importantly, VA medical centers will make it possible to contact the veterans with appointments in a prompt way. The Department of Veterans Affairs should institute a structure for reforming its organizational culture, practices, and capabilities. This takes into account coalescing functions, streamlining operations, providing Veterans a first-class, customer-oriented, Veteran-focused institution.

Introduction

The United States Department of Veteran Affairs (VA) is responsible for the healthcare granted to veterans. The organization's fundamental objective is the provision of quality and prompt service to all veterans. It is accountable for governing and overseeing programs for veteran benefits, their households and survivors. This takes into account benefits such as pension, disability compensation, and life insurance and home loans. The management of the U.S. Department of Veterans Affairs faces one of the most difficult problems in the United States. The organization also encompasses the baggage of a severe image and reputation issue subsequent to four years of scandals concerning delayed provision of health care and accumulated disability claims. In the present year, the VA expects to meet the needs of more than 6 million veterans that require health care and benefits (Steele, 2017). In the contemporary, the Veteran Affairs faces significant challenges. Some of the issues include lack of accountability within the institution to a system-wide failure to correct transgressions and bad behavior. There also includes mismanagement of funds with a financial budget that is just about $200 billion (Boyer, 2016). One of the main managerial challenges that the VA faces in 2017 is lack of timely access to health care for veterans.

Managerial Challenge

According to Heath (2016), more than 33% of veterans struggle to gain access to mental health care within the VA system in spite of a great pervasiveness of post-traumatic stress disorder. Despite the fact that 75% of aggrieved veterans report suffering from PTSD, approximately 35% experienced problems being able to gain access to care for such mental health conditions. This is indicative of the key managerial challenge within the VA, pointing out major gaps in healthcare access for veterans that offer their service in the post-9/11 military. Aside from battling and contending with PTSD, three-quarters of veterans are burdened with sleep problems and 70% of them go through depression. In accordance to research, in general, roughly 54% of respondents managed to gain access to medical treatment for mental health conditions. 69% of these respondents asserted that the VA is their main source for seeking out mental healthcare. However, such medical and health services are not at all times easily accessible or well-matched for patient needs (Heath, 2016).

To accentuate the managerial challenge within the VA, a research study was undertaken by Fales et al. (2016). In the study, 36% of veteran respondents pointed out that they experienced problems scheduling a medical appointment that addressed their timelines as well as those of the healthcare provider. 35% of the participants in the study indicated that they were not contented or satisfied with the treatment offered by the VA and as a result opted not to access them. Moreover, in accordance to the research, results indicate that progressively more veterans are experiencing lack of mental health treatment resources in comparison to research results from two years ago. In particular, two years ago, 16% of veterans pointed out that they lacked medical treatment options in the region. This figure has since risen to 26% (Fales et al., 2016).

Aside from mental health care, the VA is facing a problem in the provision of timely health care for the treatment of Veteran physical sicknesses. Statistics from the research study by Fales et al. (2016) indicate that 43% of participants detailed that they faced problems in accessing healthcare for physical sickness in the past year, or that they faced delays in health care or went without medical treatment at all. In particular, 45% of these participants indicated that the main obstacle faced in obtaining medical treatment included scheduling of appointments. Lack of prompt and sufficient veteran healthcare is a major issue for the Department of Veterans Affairs (VA).

The managerial challenge at the VA takes into account protracted wait times at the VA as the major obstacle to obtaining prompt medical health care. Lead times give rise to delayed accessibility to health care, which causes severe and abrupt occurrences, disability and death of the patients. As a result, veterans don't just experience lower quality of life, but also an adverse effect on their psychosomatic and psychological wellbeing. Along with significant medical, individual, and financial costs is the risk that wait times may also affect patient safety and care. This enforced waiting leads to numerous veterans undergoing sustained and protracted pain, debility, and even at times demise. Hindered medical diagnosis and treatment can be shattering for persons, their relatives, employees and the individuals that depend on them (Globerman et al., 2013). Another downside to increased wait times is that sickness advances can possibly and adversely affect medical treatment and outcomes. From time to time, the magnitude of this influence causes efficacious treatment to be impossible. When this worsens, it also gives rise to complications, putting the lives and welfare of patients in danger. Increased waiting times for health care more often than not take into account substantial personal expenditures. Although short, it involves some degree of pain and distress, psychological torment, absent productivity at work and relaxation, and stressed personal interactions (Globerman et al., 2013).

In an ideal world, the scheduling of patients undertaken by the VA works efficaciously in order for veterans to have the ability to access primary care physicians in an easy way. Regrettably, numerous veterans experience difficulties in accessing primary care providers, owing to the reason that medical centers of the Department of Veterans Affairs do not undertake efficacious management of patient scheduling. In accordance to a report by the Government Accountability Office (GAO), a population sample of 180 veterans took part in a new enrollment for primary health at the Department of Veterans Affairs (Sampson, 2016). 30% of the veterans were not seen by physicians for obtaining primary care, owing to the reason that staff within the VA medical centers failed to schedule medical appointments in line with VHA policy. A number of veterans failed to see doctors as a result of restricted appointment obtainability. More so, veterans that did manage to have medical appointments with physicians faced wait times that fluctuated between 22 to 71 days. The key managing challenge in this failure to provide timely medical access is that the scheduling policy undertaken by the Veterans Health Administration failed to meet federal standards (Sampson, 2016).

According to Slack (2017), several VA medical facilities ascertained extensive and prevalent imprecisions that substantially played down veteran wait times for appointments. The ineffective and undependable health care provided by the VA is linked to the unreliable VA scheduling data and causes a great deal of risk. These inaccuracies disguised and concealed actual demand for care and hindered veterans from obtaining private sector medical care, which they are meant to be able to obtain if they wait for a lengthier period than one month for an appointment in the VA. Moreover, directors together with supervisory personnel differed with state courses of action purposed to make sure veterans visit specialists within a particular period of time determined by their doctor (Slack, 2017).

Plan

Providing United States veterans with timely access to primary care is a fundamental and vital responsibility of the Department of Veterans Affairs. Lack of fast and accessible care in all regions for veterans has come to be a major problem across the nation and this is an overwhelming problem for the VA. This is a managerial challenge that necessitates swift resolve and enhancement. The following is a plan that assimilates effective financial and operational decision making to successfully meet this significant challenge and improve organizational performance.

From a financial perspective, there is need to inject funds into the Department of Veterans Affairs. There is need for channeling finances into the establishment to hire additional physicians, nurses, as well as other medical staff in the various medical centers for Veterans Affairs. In the recent number of years, there has been a significant increase in the number of veterans seeking healthcare and benefits from the VA. As a result, there is need for budgeting for new hires to cope with this imbalance in staff and patient ratio (Walsh et al., 2017). More importantly, there is a need for having a sensible pattern of distribution for the doctors and nurses and administrative staff in the various centers. From an operational perspective, the new hires should be sent out to VA medical centers that are presently experiencing the longest wait times. For instance, according to Walsh et al. (2017), Albuquerque faces one of the most severe wait times in the nation whereas Cincinnati experiences one of the best wait times. Therefore, this implies that the distribution of additional staff should not be equivalent. The Albuquerque medical center should be apportioned additional staff compared to the one in Cincinnati. This is largely for the reason that such medical centers are bound to experience improved waiting times. Therefore, progressively more veterans will be able to gain access to medical care and less lead times subsequent to obtaining appointments (Walsh et al., 2017).

An additional aspect of the plan is to undertake auditing and monitoring of wait times. It is imperative for VA medical centers to strictly adhere to scheduling policies that are set by the establishment. The supervisors within these medical centers should allow auditing of employees and following of scheduling policies to ensure that there is no falsification of patient wait times present at the VA medical facilities. This should include adequate monitoring of wait times for primary care. At the present moment, Veterans Health Administration solely monitors a section of the general time it takes fresh and newly registered veterans to access primary care. The plan for the VA should be in compliant with federal internal control standards, and as a result, it is important to monitor all wait times. This will make it possible to have the correct data that will be employed for monitoring and oversight to analyze the general experiences of veterans, for instance, the time freshly registered veterans have to wait prior to being communicated to by a Veterans Affairs scheduler (Sampson, 2016). Proper scheduling done by VA medical centers will make it possible to contact the veterans with appointments in a prompt way.