- Even though VA has taken steps to improve administration and management of its healthcare delivery systems, the Government Accountability Office (GAO) found six action items that allows the VA to adjust policies that improve data sharing and oversight of healthcare delivery systems.
“As one of the largest health care delivery systems in the nation, it is important for VHA to ensure that its facilities consistently implement national policies as intended to ensure timely, high-quality care for the nation’s veterans,” GAO said in a report.
“VHA has taken a number of steps to improve its policy management; however, this is a substantial undertaking, and much work remains that will require a sustained focus to remedy a number of issues,” the agency continued.
Currently, VA lacks a centralized place of administrative resources that VA medical centers (VAMCs) and Veterans Integrated Service Networks (VISNs) can readily access, and that lack of access makes it difficult to adhere care delivery operations for local communities and beneficiaries.
“Specifically, there is no central repository, such as a publications website, for guidance documents, and the program offices do not track or consistently disseminate the guidance documents they issue,” GAO said. Without a standard process for consistently maintaining and disseminating guidance, VHA lacks assurance that staff receive and follow the same guidance, as intended.”
After reviewing VAMC and VISN data, GAO found that facilities within those care networks experienced constraints when seeking resources and attempting to share data with other facilities. The VAMCs and VISNs also experienced issues when implementing local care policies because they didn't have a process to align them with VA national care standards.
To correct this, VA established a committee that addresses challenges policy implementation and resource allocation for individual VAMCs and VISNs.
However, even with the committee more focus is needed to improve healthcare delivery within one of the largest healthcare providers in the country.
“It is important for VHA to ensure that its facilities consistently implement national policies as intended to ensure timely, high-quality care for the nation’s veterans,” GAO said.
GAO provided six major actions VA should implement in their day-to-day operations to improve administrative oversight and resource allocation for VA healthcare services.
VA needs to clarify the purposes each national policy, and which guidance document type should be used, and if program office memos, should be vetted and recertified.
GAO also suggested that VA should develop standard processes for consistently maintaining and disseminating guidance documents to each level of the organization.
Guidance suggested for the Under Secretary of Health that improves policy and resource administration included establishment of a mechanism that obtains program feedback from VISNs and VAMCs, a policy exemption waiver process that centrally tracks and monitors approved waivers, and a process that monitors local policies established by VISNs and VAMCs.
As VA moves forward with these policy and data sharing fixes, the outcome of these fixes is intended to improve healthcare services and healthcare delivery for many veterans who rely on quality care access.
“Collectively, if these issues persist, VHA will be unable to ensure that its policies are being consistently and effectively implemented as intended at the local level, potentially impacting veterans’ access to timely, safe, and high-quality care,” GAO concluded.