The Joint Commission releases results of surveys of the VA health care system

Survey by industry-leading group shows VA is making progress and improving access


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VA today released results of The Joint Commission Special Focused Surveys on VA health care facilities. VA invited The Joint Commission to conduct unannounced, focused surveys at 139 medical facilities and 47 community-based outpatient clinics across the country to measure progress on VA access to care, quality improvements and diffusion of best practices across the system. The surveys also assessed barriers that may stand in the way of providing timely care to Veterans. Results indicate VA has made significant progress since The Joint Commission began its surveys two years ago.

“The Joint Commission is one of the most widely-respected health care organizations in the industry,” said VA Under Secretary for Health Dr. David J. Shulkin. “Their analysis shows that VA as national healthcare leader is making progress in improving the care we provide to our Veterans. This affirms our commitment to providing both excellent health care and an exceptional experience of care to all Veterans served.”

The Joint Commission assessed processes related to timely access to care; processes that may potentially indicate delays in care and diagnosis; processes related to patient flow and coordination of care; infection prevention and control; the environment of care; and organizational leadership and culture. For the survey, VA’s Veterans Health Administration provided organization-specific data addressing performance in the key areas targeted for review. This data allowed surveyors to focus on areas of greatest risk for each organization and to validate whether the VA-provided data reflected observed practice. The survey provided an opportunity to recognize patterns across the organization, to make an assessment about the system as a whole and identify solutions to system-wide issues that are best addressed through internal processes.

“We commend VA for being proactive by requesting The Joint Commission to conduct unannounced site visits at all their medical centers to review and evaluate their efforts to improve access and quality of care,” said Dr. Mark Chassin, President and CEO of The Joint Commission. “VA was the first system ever to request an assessment with an important focus on access so that deficiencies could be identified and rapidly addressed. The Joint Commission will track and report on the extent to which improvements were sustained, when the same facilities undergo their triennial accreditation surveys. To date, results from 57 hospitals that have undergone full accreditation are promising. We are pleased with VA’s ongoing commitment to quality improvement and patient safety.”

Among the top findings:

  • Access to CareFacilities have seen improvements in providing patient appointments:Improvement efforts that were undertaken include leadership teams utilizing data to better understand where particular bottlenecks were and taking corrective actions. As the Joint Commission continues the regularly scheduled triennial surveys of VHA facilities after the special surveys were completed, the findings are encouraging. For example, as of April 1, 2016, 57 facilities have undergone follow-up surveys. Of these 57 sites, only one facility was found to have a repeat requirement for improvement (issue) related to patient access. Staffing continued to be a challenge in this area, but as new staff was hired, the wait times for appointments were more effectively addressed.
  • Choice Act: Early discussions with Veterans indicated a strong preference, and even a loyalty, for their “own” VHA organization, even if it would mean waiting longer to be seen. VHA facilities and Veterans also report that many times appointments in the community could not be made any earlier than would have been possible inside VA.

 

Efforts to Improve Veterans Access to Care

  • In 2014, VA introduced MyVA. MyVA is the largest transformation in the history of VA, which focuses on the needs of Veterans. As part of that transformation, in 2016, VA’s Veterans Health Administration established and launched MyVA Access. MyVA Access also puts Veterans more in control of how they receive their health care.
  • VA is moving to incorporate same-day access to primary care and mental health services for Veterans when it is medically necessary. At present, 39 VA facilities offer same-day appointments.
  • A new smart phone app called the Veteran Appointment Request App has been developed and is currently being piloted. This app allows Veterans to view, schedule and cancel primary care and mental health appointments as well as track the status of the appointment request and review upcoming appointments. VA expects to make the app available to all Veterans by early 2017.
  • Website enhancements are underway that will allow Veterans to check wait times in real time wherever they live – this includes a new, easy-to-use scheduling software program. The new program is being piloted and is expected to reduce scheduling errors and enhance VA’s ability to measure and track supply, demand and usage.
  • Nationally, VA completed more than 57.85 million appointments from July 1, 2015 through June 30, 2016. This represents an increase of 1.1 million more appointments than were completed during the same time period in 2014/2015.
  • From FY 2014 to FY 2015, Community Care appointments increased approximately 20 percent from 17.7 million in FY 2014 to 21.3 million in FY 2015.
  • In FY 2015, VA activated 2.2 million square feet of space for clinical, mental health, long-term care, and associated support facilities to care for Veterans.
  • VA held two Access Stand Downs, focusing on patients with the most urgent health care needs first. During a nationwide Access Stand Down that took place on February 27, 2016, the one-day event resulted in VA reviewing the records of more than 80,000 Veterans to get those waiting for urgent care off wait lists; 93 percent of Veterans waiting for urgent care were contacted, with many receiving earlier appointments.
  • VA increased its total clinical work (direct patient care) by 11 percent over the last two years as measured by private sector standards (relative value units). This increase translates to roughly 7.4 million additional provider hours of care for our Veterans.
  • VA is also working to increase clinical staff, add space and locations in areas where demand is increasing and extending clinic hours into nights and weekends, all of which have helped increase access to care even as demand for services increases.
  • In FY 2015, 677,000 Veterans completed more than 2 million telehealth visits, providing enhanced access to care.

The Joint Commission, an independent, not-for-profit organization, accredits and certifies nearly 21,000 health care facilities and programs in the United States. VA’s Veterans Health Administration is the largest integrated health care system in the nation, caring for 9 million Veterans.

 

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Comments

  1. Gary Karl Kirch    

    +The V A Medical Center in Seattle is doing an outstanding job compared to Tri- West. The latter is for profit only. I had to pay for my pain meds. after surgery. Also they would not pay for a follow-up with the surgeon and had to go back and forth to get enough physical therapy. Would not use Tri-West again.

  2. Valerie Elliott    

    I wish someone higher up would address the issue that the Choice Program is not available for millions of people due to the weird (and just plain WRONG) interpretation by the VA of the wording in the Act itself. I seriously don’t think the government officials who enacted this program meant for the VA to twist the meaning of “resides more than 40 miles from the nearest VA medical facility” to mean ANY VA facility. They meant the TREATING VA FACILITY! I cannot use this program because there is a tiny little VA clinic within a few miles of me. They DO NOT offer ANY services except general care. Because the VA has twisted the meaning, I still have to drive hundreds of miles for anything like a colonoscopy, sleep clinic, rheumatology, gastroenterology, etc. I wish I could talk to President Obama about it because I KNOW that is not how this law was intended. That interpretation doesn’t even make sense.

  3. Ronnie Hall    

    I am a Veteran in Bristol ,Virginia and have one of the finest Primary Care Doctors (Col Harden ) , always there for me
    and the same for the Hospital in Johnson City ,TN. (MOUNTAIN Home). . I had rather go to this Hospital than any in
    the Tri City Area.

  4. james c ferrier    

    VA has not gotten to the root of the problem ,we in the draft days were given full health coverage for life,are teeth part of health or not.
    What about co-pay,what is up with that—-
    The VA is a poor mans hospital,if I had insurance I would be else were,don’t you think

  5. Jack Platter, Sr.    

    I do hope that the VA Health Care System is NOT given over to private facilities and/or contractors. The VA has treated me very well.

    I have had immediate family, related family members, and friends that involved physical and/or mental situations……A few had good insurance,a few moderate insurance, and some no coverage from the employers. Many were left out to fend for themselves on serious situations: cancer over $4,000 up front to even begin treatment and other folks helped get the funds started….Sadly, I think most of the folks were given mediocre treatment/concern due to lack of secure funding. (Not having high dollar insurance coverage or lack of cash).

    Luckily I stumbled into a VA facility by chance after becoming ill several years ago. Never have they lost hope for me, never have I been denied treatment, and I have always been treated with kindness, compassion, and what I believe is true concern for my well being and the effect my health has had upon my family. After reaching retirement age and negative health situations increasing due to age — the VA staff still display feelings of compassion, caring, and dedication upon each visit/appointment attended.

    I do not know who to write in the government maze to request that the VA Health Care System remain as it is. Funding for more professional staff of health workers is needed: doctors and all medically related staff (physical/mental/social workers/counselors/clerks…all areas!). The quality and dedication to those being served, in my opinion, will be greatly jeopardized if private sector health providers become involve.

  6. Danny Boy Crawford    

    dannyboyeire317@windstream.net

    To be honest these Credentials are earned passing a test by Investigators of Joint Commission. That is to say a checkoff list is simply created and then compliance of these competencies and requirements are reviewed.

    It is too bad that there is really no activity regarding these Joint Commission requirements until 90 days before the Inspection. Though no dates of their arrival to these hospitals are not given, a window is given in which the Joint Commission could appear in the hospitals and clinics.

    All employees strat getting together information, implementing programs, rewriting protocols, procedures, programs etc. in that 90 day period. The upper echelon and bosses start to insure policy and procedure are followed. Members of the hospital and clinics are prepped in answers of questions most likelya sked by these Inspection Teams.

    I don’t really hold Joint Commission i high regard as I believe there are more creditable and more stringent Hospital Inspection Companied that would bring VA to their knees.
    Remember the VA is paying Joint Commission to inspect their hospitals and clinics. By no means would they hire an agency to complete these same Inspections as they most likely would really come down on VA.

    It is better than nothing but certainly JOINT COMMISSION is not the best for these Inspections and Certifications.

  7. louie martinez    

    i have had 21 appts from april 2016 to july 2016 and 7 more in august to wyoming, battle creek, ann arbor and detroit muskegon I do not get milage and had to stay at hotels at the cost of over $500. This is proposing a hardship on me as i have had over $4000 in medical and insurance cost and co-pays and still have rent ,food, utilites,insurance, taxes,gas and other misc. I am laided up now after knee replacement and having to pay for home health care.I don’t believe this is how a world war two vet should be treated and there are many more that agree. thanks for listening to a disgrunted VET.

    1. louie martinez    

      I have had 21 appts from april 2016 to july 2016 and 7 more in august to muskegon ,wyoming,battle creek,ann arbor and detroit i do not get milage and had to stay at hotels on some occasions at the cost of over $500.. This is starting to cause a hardship on me as I have had out of pocket medical cost of over $4000 plus co-pays and still have rent,food,utilies,insurance, taxes,GAS and other misc.I am laid up now following knee replacement and having to pay for home health care.I don’t believe this is how a world war two VET should be treated and everyone agrees. Thanks for listening to a disgrunted VET.

  8. Richard V. Jones    

    Since the changes have gone into effect at the VA it is more difficult to make arrangements to see doctors. If I had called before this change I could get the Nurse who talks to the doctor. Now I am put on hold until they call me back which now as a rule takes even longer. What the hell is going on!!! I would also like to know why we bought $200,000,000 in Art work for the V.A.’s? Hell there are artist in the community that would have given it for free! Its just one more thoughtless endeavor the high ups think will sooth the poor wounded soldiers! Give us good doctors and I’ll go see them in a mud hut for that that matters! Christ what wrong with you people!

  9. Colonel Stephen E. Katz    

    The VA Inspector General Program is completely unresponsive to patient complaints and inquiries. They go without action even when patient safety is involved, and suggestions are ignored. The staff is either woefully undermanned or
    totally indifferent to the population they are employed to assist. I’m a former USAF IG & would be ashamed to work in that office.

  10. Scott Matsumoto    

    Please help me out let me know if I have good outstanding career path for future reference

  11. Travis    

    I find this hard to believe since my uncle two weeks ago went into the VA in Iowa because he was not feeling well and they gave him a pill and sent him home. Two weeks later he is in the hospital for cancer on both lungs and his kidney. This does not show that the VA is improving. It’s shows that no matter what happens us veterans are going to be given the bare minimum treatment until it’s too late. The VA has a long way to go before veterans believe they are actually there for us.

  12. Carmen Cambian    

    My comment is as follows: How can you make such statements about progress with VA issues when my husband, Raul Cambian, served 18 months based in Sicily, Catania, Italy, in the 1970’s in the Navy, discharged Honorably and now that he is suffering from Diabetes and due to a misdiagnosis by one of YOUR Attending Physician, had to have his left foot amputated and no one cares about him? I’m his wife, Carmen Cambian, and I have exhausted all means of notifying the Dept. of Veterans Affairs/Administration for help in placing him in a Veterans Assisted Living Facility and no one, I mean not one, from the Veterans Administration has bothered to address this situation except for passing the buck or putting me through a revolving door?

    I have kept a diary since Oct. 2014 with dates, Dr’s names, VA Hospital address, phone number, procedures, incidents, medications. I’ve written to politicians because I’ve gotten to help from the VA and not even them have tried to help me. Same replies, too many faxes or emails to take care of or asking for donations but no mention of acknowledgement of my situation with a Veteran. The only one that I am proud of that has tried to help is Governor Andrew Cuomo, God Bless Him. He is a true, politician, who finds time to help a Veteran in is in dire need. But he could only but so much. Here, you proudly brag about PROGRESS, how can you, when I know that there has to be more Veterans with situations similar to my husband’s.

    I have written to Channel 11, WPIX to see if they can help me.

  13. W T Sholley    

    Where are the RESULTS of Evaluations submitted by Veterans regarding THEIR Quality of TREATMENT ?
    What is the PERCENT of evaluation REPORTS to Total Veterans Treated at that SAME Facility ?

  14. Stan Lightner    

    My experiences with Tri-West were anything but positive. The biggest bunch of incompetents I’ve encountered since I was discharged. The VA should put this money into increasing the number of health care providers in the VA Medical Care System instead of companies with the primary/sole interest of making a profit.

    If necessary the VA could utilize mobile buildings like the ones used by schools to expand and/or set up clinics.

    I’m adamantly opposed to “privatizing” or issuing vouchers to those using VA Medical care as this would only exacerbate the situation. Could you imagine a vet who needs open heart surgery due to type 2 diabetes contracted by Agent Orange exposure being given vouchers which would not cover his/her costs?

    Get the profit motive out of medical care for Vets and keep it out.

  15. Tom Reynolds    

    What ever happened to The Choice Program. I have the card that is worth nothing as my Local Clinic were I can only get Shots and See my Primary Care Dr. If I need anything as simple as an X-ray. I need to got to Oklahoma City VA Hospital that is over 120 Miles from here. The Choice Program says 40 miles. I have been turned down 3 times to use local care to get a Sonogram and x-rays. Was also refused by my local clinic to be refereed to The Choice Program each time.

  16. robledo aquino    

    If the VA is really making progress, how come that the waiting time for prescription eyeglasses is eight weeks now ? Two years ago, the waiting time was only three weeks, now it’s almost three times. My prescription eyeglasses was ordered last
    June 7, 2016 and it’s Aug 5, 2016 already but I haven’t received it yet.

  17. Heather .E. Fitzpatrick    

    That is so wrong the VA in Maine is terrible. They do not read pashent records from different state. I go to the ER in Togus Maine for my tooth n get put in inpatient psychiatric ward. My tooth was crack in half and they didn’t do anything for my tooth. I thought I was getting moved to a room in the hospital not the psychiatric ward, they did nothing to help me in any way. I have night mares and can’t sleep good . I will never again go to that place , I do not feel safe there. It’s all wrong what is in his report.

  18. David Rush    

    I think the VA is great, I have had zero problems getting the care that I need. All of the Staff has been excellent and I have been treated with respect. I am proud to be a veteran and supported by the VA Medical Center in Leavenworth Ks.

  19. Ricky Sousley    

    The study is lame again. my wait times have increased at the Atlanta Va ( Blairseveille ) Dental care has been very sorry appointments run over 3 months. If you use Vet Choice and need transportation there is none available. ( need upper gi and can’t drive after procedure ) PLEASE WAKE UP AND HELP THE VET’S.

  20. Charles Vroman    

    This article provides a bit of a mis conception in areas. I would like to address one in particular.

    “Choice Act: Early discussions with Veterans indicated a strong preference, and even a loyalty, for their “own” VHA organization, even if it would mean waiting longer to be seen. VHA facilities and Veterans also report that many times appointments in the community could not be made any earlier than would have been possible inside VA.”

    What is missing from this statement is the fact that the Veterans now understand that, if they opt to participate in the Choice Act for a particular problem, they can not come back to the VA for treatment of that problem. This is one of the “loopholes” in the program that is not advertised or explained. I found out about this through a discussion with the hospital Patient Advocate about my options due to problems with treatment with my Primary Care and certain clinics.

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