It also said the most troubling part of the review is that though a 2008 study by Booz Allen Hamilton found many of the same problems, the report seemed to have been ignored and the same problems were never addressed. “The recommendations of this report echo those of the earlier (Booz Allen Hamilton) wait times report and suggest that the issues identified are representative and enduring,” the new report says.
The report comes two weeks before new VA Secretary Bob McDonald’s own Veterans Day deadline to put into place sweeping reforms to the scandal-tainted agency.
McDonald’s “Road to Veterans Day,” includes goals such as refocusing everything the Va does “on the needs of the veteran,” and “strengthening lines of communications,” between employees.
Bobbie Kilberg, president and chief executive of the Northern Virginia Technology Council, said in a conference with media that communication breakdowns between departments caused patient follow-up appointments to be forgotten.
“It’s amazing how many people just aren’t talking to each other,” Kilberg said.
The assessment was conducted at the request of Sen. Mark Warner (D-Va.). Warner, who was also on the conference call, said, he was “astonished” to see some the aging systems. “They were basically cobbling together 1980s software,” he said.
Warner said he supports McDonald but that there is much still to be done to improve the VA’s workplace.
“I look forward to continuing to work with Secretary McDonald to make sure these recommendations actually get implemented and don’t just end up on a shelf,” he said.
The VA said in a statement Friday that it had received the report and is reviewing it. “VA appreciates the work of the NVTC, and notes that the majority of the findings in the report appear to be consistent with what VA has identified as areas of improvement, and in numerous cases, mitigation strategies have begun to be implemented,” the statement said. “VA looks forward to further evaluation of the recommendations to assess those that are ‘feasible, advisable, and cost-effective’ for implementation.”
The VA says it is scrambling to make a host improvements, from boosting pay for new medical hires to being able to fire employees more quickly through a new law that empowers the agency. The Veterans Access, Choice and Accountability Act, signed into law in August, included a requirement that the VA ask a technology task force to conduct a review of its scheduling system after a scandal this summer revealed widespread fudging of data to cover up long wait times for former troops.
Over a six-week period, the team conducted visits at VA Medical Centers in Richmond and Hampton, Va., to observe scheduling operations and interview VA staff about the challenges they face. They were also asked for ideas on how veterans might be better served by making changes to current scheduling processes.
The specific recommendations for the VA include:
1. Aggressively redesign the human resources and recruitment process.
2. Prioritize efforts to recruit, retain and train clerical staff.
3. Develop a comprehensive human capital strategy that addresses impending healthcare provider shortages based on projected needs.
4. Create a stronger financial incentive structure.
5. Accelerate steps to improve the agility, usability and flexibility of scheduling-enabling technologies that also facilitate performance measurement and reporting functions.
6. Take aggressive steps to use fixed infrastructure more efficiently.
7. Evaluate the efficiency and patient support gained by centralizing the phone calling functions in facility-based call centers with extended hours of operation.
8. Invest in more current and usable telephone systems and provide adequate space for call center functions.
9. Take aggressive measures to alleviate parking congestion, which impacts timeliness of care.