Improving Veterans Health Administration wait times for medical care

Improving Veterans Health Administration (VHA) Wait Time for Veterans Care

Veterans are senior citizens who have served the nation in a dedicated manner and in their elder days need to feel the reciprocation of the nation on the sacrifice that they made. The population demography of the U.S.A. is such that more elderly people are to be expected, hence the strain on the economy and the health care in general will definitely have to put in place effective systems that will enable better treatment and handling of the ageing population with the complications that come with old age. The Department of Veterans Affairs (VA) goal is to provide timely, high-quality health care for veterans (Department of Veteran Affairs, 2016: Pp7). In order to achieve this, there are various legislation and steps that come along these legislations that VA has taken. One of the measures that VA works on is to ensure that the wait time for veterans to receive the health care is within a maximum of 30 days from the time that the veteran asks for the medical intervention or from the day that their physician determines that it is medically necessary to be attended to. This goals has become important that the VA has made it possible for veterans to access non-VA care through the Choice Program in order to avail medical aid as soon as it is needed (U.S. Department of Veteran Affairs, 2014: Pp3).

In as much as the VA strives to keep the wait time below 30 days, it is evident from the facts sheet on the VA website that there are many instances where the wait days go well beyond 90 days and some even past four months as is the case in Hawaii where the average wait days is 145 (Bussewitz C., 2014a). These are the worrying trends that form the basis of this paper which looks into why such instances do happen and the possible mitigation measures that can be put in place in order to not only place all the wait time to under 30 days but have ways to further reduce the time to a much shorter duration.

This concern for the veterans taking unnecessarily long time to get the medical attention that they require is important since the aged citizens are often left to suffer the physical torture on top of the never ending psychological torture that they have. This delay in effect compounds their problems with some feeling neglected, desperate and even developing other psychiatric conditions which could have been avoided if the needed help could have been availed in good time (Pizer S.D. & Prentice J.C., 2011). This makes this topic a very important matter that needs to be handled effectively and bring order to the system and peace of mind and good health to the veterans.

According to an extensive research conducted by U.S. Government Accountability Office, (2016), it was noted that one of the major reason for the delayed time of seeing the medical personnel by the veterans was use of wrong communication channels and tools to register and book the veterans in for their medical attention. There have been instances where the veterans are asked to come to the medical centers to schedule their appointments which should not be the case. This means that the ailing veteran will delay for days or even weeks before he gets relief enough to go to the medical center to place the appointments, then go back home to wait for the date they have been booked for attention. The researcher also experienced several instances of requests for appointments made through mail and yet no follow up calls were made until the veterans made a second or even third follow up for the same, all in the process wasting time for the ailing veteran. The newly enrolled veterans were also found to suffer the delays in appointments with the medical centers calling for the first time to explain to them the benefits available for them from VHA health care, after which their names were passed on to the schedulers after which instead of the VHA required appointment call within 7 days, no calls are made.

The intervention that will be proposed herein is aimed at adding efficiency to the system that deals with the veterans. It will enable the scheduling to be done efficiently and the wait time to be reduced into less than 15 days unless there are pressing reasons which necessitates it to be longer than 15 days. This is possible since most of the reasons for the prolonged wait time are due to inefficient communication channels and pure negligence.

Phase 2

The veterans who served the U.S. as whole have over the years been subjected to unnecessary suffering as they are put on along waiting list over days and even months for medical and psychiatric attention. They have grown despondent and need urgent changes, indeed, 6 out of 10 veterans have recorded less favorable experiences in the VA hospitals as compared to the non-VA hospitals (Wax-Thibodeaux E., 2015: Pp2). This shows that this veteran population is subjected to unwarranted poor quality services and yet they need and can be given better services.

The political environment that surrounds the veteran affairs makes it easy for such inefficiencies to prevail unlike other sectors. There is generally lack of strong whistleblower engagements and policies within the veteran affairs environment. The old citizens survive on acts that can almost be termed as favors and yet they deserve these services ore than other healthier and younger Americans. The social is not any better with the old people largely neglected by the family members, most of them relegated to old age care homes hence they have no one to keep track of their appointments with the psychiatrists or doctors. The economic environment is also a significant contributor to the menace since the veterans are not wealthy enough to pursue the individually paid for medical attention which would be much faster and efficient but coming at a high cost as compared to those provided by the VHA program, and with the 5.3 unemployment rate among veterans (U.S. Census Bureau, 2013), most cannot afford the extra costs for treatment. Most of these factors that are occasioned by the social, political and economic environments that the veterans find themselves in are beyond the control of the veterans hence they can do little about it, meaning it is the department of veteran affairs that must initiate deliberate and serious changes that will see the effective changes being initiated to mitigate the suffering of the veterans.

Phase 3

The employees who engage in the habit of delaying the treatment of the veterans are always those who know that the old veterans will not raise serious objection to the appointment day they are given. The other factor that encourages this behavior is the fact that being a special program, the VA hospitals often get busy hence the high number of veterans occasions the low service delivery as the doctors have too many people to attend toper day (Bussewitz C., 2014b). The reinforcing aspect is the policies that give room for the long waiting periods. The schedulers then exploit such gaps to schedule for long waits knowing well that it is not legal to do so. However, it is possible to change these long wait periods if the VA hospitals decide to dedicate their time and energy t serving the veterans and the schedulers engage in a keen follow up with calls to clients done in good time and follow up calls made to remind the patients of their appointments.

Phase 4

The organization that is best suited to deal with the patient apathy and the long wait periods that the veterans are subjected to is the medical centers and the VHA administration. The medical centers have significant influence and legal influence to change the daily operations of their members of staff. The VHA also have the legal capacity to advice and supervise as well as instruct the schedulers on the best practices that need to be implemented in order to help solve the suffering of the veterans and deliver them the psychiatric and medical services in good time as well as save them the pain of unnecessary long waits between their call for attention to the time they receive the service.

Phase 6

This new measure that is aimed at improving the services to the veterans will be monitored by the person in charge of each medical center. He will be expected to carry out regular checks and verifications on the calling list of the schedulers and see into it that the schedulers actually called the patients. They will be expected to make random follow up calls to the patients just to ensure that the calls were actually made. The person in charge will also ensure that the appointments that have not been honored by the patient are promptly rescheduled by the schedulers in the earliest available time. The rescheduling of such appointments need to be communicated to the patients within 6 days of the aborted appointment.

In the event that a doctor may not be available, he is expected to reassign his patients to his colleagues and notify the head of department through a mail of his absence and the colleagues whoa re taking up his patients. This will help in monitoring the smooth running of the program and effectiveness of trouble shooting measures that are put in place. Such records will help the VHA administration to institute the relevant changes in the VA medical centers with the aim of gradually reducing the wait time by the patients.

Phase 7

There will be monthly consultative meetings between the VHA administrators and the medical center administration which will look into the progress in terms of the wait time and the challenges that the medical centers may be facing. These consultative meetings are expected to be part of the continuous adjustment measures in meeting the intended goals of VHA towards veteran service delivery and will hence give VHA administrators the indicative direction of the positive changes that the intervention is having on the operating environment of the doctors.

Phase 8

In order to be sure that the desired outcome of reduction in wait time by the veterans is achieved, the filling in of the scheduled appointment for each veteran will carry on just as it is currently being done. The use of the same mode of measurement of the waiting time will enable the comparative evaluation of the wait time before the intervention and the wait time after the introduction of the various changes.

The research has generally found out that the wait time of 30 days being the standard time is way too long for the veterans to be subjected to and most importantly is that it can be reduced into half the number of days with the aim of better serving the veterans. This possible reduction in the wait duration is possible bearing that the entire delay is not occasioned by technical challenges but by failure of proper scheduling and incoherent communication channels, facts that can be corrected through better scheduling of activities.

Therefore, as seen above, there is need to have the number of days within which a patient is called by the scheduler after being notified of the availability of the benefits or making inquiry of the appointment from seven days to 4 days. There is also need to have the supervisors get more engaged in the entire process in follow up manner and also engage the doctors in finding alternative medical attention for the patients in the event that they are not available, these measures will help reduce the backlog and hence shorten the wait period of the veterans who urgently need medical attention.

The research and proposed solution though have some limitations that come with them, there are logistical issues that will make it hard for the proposed solutions to be implemented as well as issues of finances to facilitate the numerous more calls that will be required. The issue of unwilling participants cannot be overlooked as well since there are bound to be staff members who would like to have the status quo maintained.

The federal government needs therefore facilitate the effective changes within the VHA in order to offer better services to the veterans and this may sound expensive at the onset, but once the backlog has been solved, there will be way lesser pressure on the medical centers system and the operating costs will go much lower, leading to a healthier economy and more importantly a healthier ageing population of veterans.