Improving patient check-in for Veterans

Using surveys and feedback to improve patient experience


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Since 2017, more than 4 million Veterans have given VA feedback on their customer experience. These surveys are usually sent to VA customers within a few days of their appointment. Recently, 88.5% of Veterans have responded that they agree or strongly agree with the statement, “I trust VA for my health care needs.” That trust question is what VA’s trust rating is based on, but the other questions in the Veterans Signals program survey helps VA pin point opportunities for improvement.

Check-in process problems

In 2018, the Lexington, Ky., VA Medical Center (VAMC) noticed a key customer experience falling short of expectations. When Veterans were asked “After I checked in for my appointment, I knew what to expect,” the satisfaction score was 82%. This alerted the Lexington VA’s Veterans Experience Officer that their patients did not understand what to expect next when checking in to appointments.

After a deep dive look at the check-in process and using a few secret shoppers (sending a few Veterans or VA employees through the process who would document their experience), the Lexington VA saw the problem. The check-in process was not the same in every office and that was confusing patients.

Creating a solution

The Lexington VA then developed standard scripts and other communication aid materials to help VA employees standardize the check-in process and expectation. Also, employing a Lean Six Sigma technique called GEMBA (Japanese term meaning “the real place”) identified some key meeting places such as clinic lobbies or hallways. It then placed display boards and signs in these high traffic spots between the check-in and provider appointment locations to help patients navigate.

The results

The results pointed to an 8-point increase from 82% to 90% from the end of fiscal 2018 to the end of fiscal 2019 for the same patient satisfaction question, “After I checked in for my appointment, I knew what to expect.”

These results aren’t isolated to the Lexington VA. Improvements based on customer experience feedback are underway across the country. Customer feedback data and patient experience programs pair perfectly to improve VA’s effectiveness, ease, and empathy for Veterans, their families, caregivers and survivors.


This story is part of the Secretary’s Priorities series, which was outlined to the House Committee on Appropriations, Subcommittee on Military Constructions, Veterans Affairs, and Related Agencies on Feb. 26, 2019, by VA Secretary Wilkie. The Secretary’s Priorities are Customer Service, MISSION Act, Electronic Health Record, Transforming Business Systems, and Suicide Prevention. These stories are designed to give a closer look at the improvements VA is making in how we relate to, interact with, and ultimately serve our Veterans, their families, caregivers and survivors.


Amanda Clark is a Veteran Experience Officer at the Lexington VA Health Care System. 

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Sharon Pasowicz    

    Talk about bad experiences. I asked my PCP about a spot on my face and she told me it was nothing to worry about. Me being a retired nurse and already having been seen in dermatology, I went to the Derm Clinic to talk to one of the nurses. I did speak to the nurse and she to stand fast, she’s going to get a doctor (Chief of Derm). He looked at the spot, told the nurse to schedule me for surgery within 10 days’ asked me who the doctor was that “blew off” the spot then told me it was skin cancer.the other incident was the clerkin the Women’s Health Clinic Whenever I called and asked and asked to speak orleave a message for the nurse, he would try to ,get this, triage me like a nurse. SHE IS ONLY A CLERK!! This all happened at the VA in Madison, WI but I do have to say except for some idiots,the care here is good.

  2. James Allen Beheler    

    The dermatology department at the John Dingell VA Medical Center in Detroit is the worst at making and recording appointments as scheduled. I visit there once a year (melanoma) and only once in some 12 years have I been called in proper sequence. I was given an appointment this past visit to have stitches removed at 1:15 pm. At check-in, which can’t be done from the Kiosk on the first floor because Dermatology is on the second floor, I was informed that my appointment was for 3:00pm. I have two documents with the same handwriting and can confirm that it was for 1:15pm.
    I have complained numerous times and find the same incompetent employee behind the reception counter. Once, when I wasn’t called, I approached the Dr. who was calling someone after my scheduled time, a questioned him. He stopped the other patient and went to check on my status. He was told by this same person that sometimes the computer doesn’t print out the check-in document. It isn’t the computers fault. I could go on, but what’s the point of complaining to a wall.
    James Beheler

  3. Mark G. Davis    

    I have a problem using the kiosk because there is another veteran with my same last name and last four. I always have to go to the counter and tell the person my first name even though the other person is not even seen at my clinic…or even in my state. We do not have the same birthday so I am wondering why I can’t use any kiosk to check in…..anywhere.

  4. Nicholas Engel    

    Check in has not been a problem at Lexington. I’ve been going to the VA for years and been to so many appointments that I’ve lost count. Between the infusion room for rounds of chemo to the OR for surgery. I’ve been through cardiology and many other departments. I have never had a problem with check in. I also do every survey that comes my way. Addressing checking in is something that was never a problem. The biggest problem is the pharmacy. That’s what needs to be addressed. STOP with the stuff that doesnt exist. If people didnt know how to check in, then educate them. It’s not rocket science to check in!

  5. Billy J Pinion    

    Have always been pleased with the check in process at Salem Va, people are friendly and always helpful

  6. John D Milton    

    I think there should be a better way to submit a complaint. I live in South Louisiana and had a problem with a dr. I had to voice my complaint 100 miles away via phone. Plus, if a veteran is going through a crisis, we only have the Suicide hotline. If we are having an emotional situation, we have no recourse. I suggest setting up a hotline with less numbers to remember ie. 333. Rather than 10 numbers, then press 1, then a 5 digit number. That is way too much to remember or go to if you are in a crisis situation.

  7. judy Roberts/Teddy Roberts    

    IN almost 10 years as a VA patient, at no time whatsoever have we EVER had ANY problem with ANYTHING! My husband has had a dozen different doctors(specialty). Constant appts..outstanding personnel/excellent care choice of VA as well as Local Hospital choice for broken neck surgery! I Also believe MTN. HOME VA TN.is a top of the tier FACILITY!

  8. craig keefner    

    It is good to see reporting on usability at VA. Having said that, we’ve (the KMA) had multiple disabled veteran groups report the Vetlink kiosks are practically unusable. Perhaps they know what to expect but that doesn’t mean room for improvement. I manage a kiosk association and work with the U.S. Access board on ADA and accessibility and generally, the VA needs to be embarrassed by their lack of compliance.

    There is a new RFI issued for next generation and we have seen it and responded to it. They need some serious help in accessibility I will say that.

    Too often now website guidelines are becoming baselines for kiosk applications. While it may be easy for them to rattle WCAG 2.1 notations, they do nothing to help the quadraplegic and others.

    I would be interested in disability breakdown of Lexington VA patients over a year. Which disabilities and how many. Is that information available?

    Thanks!

  9. Don Thomas    

    Sorry…the VA sucks!!!! Begining with the REDUNDANT message for suicides or ” if this is an emergency , hang up and call 911 ” . If you have to tell some dumbass to call 911 , then I need that idiot to die. I dont need to keep hearing the suicide hotline number. HOW ABOUT A HOTLINE FOR MY HEALTHCARE PROVIDER !!!!

  10. Jerry Ernest Butler    

    I have some bad experiences with some check in clerks either in person or calling to make appt.it seems it’s always been Male clerks.I’ve had appts.and called way ahead of time if the clerk would just relay a question or notify someone that I other need for DR.and clerk wanted to tell this that and other,all I wanted was to just relay a question to DR.or Dr.’s nurse,the clerk just want to argue.Another time one Male clerk I ask a question and what he said had nothing to do with my question and I replied that not what I ask and you could just see the anger in his face I said I ask question and you (clerk) did not answer question I ask clerk got angry and said I was trying to argue with him and like I did not understand and I was questioning him,he did not answer my question and that’s what I told him he just wanted to argue and we had words.I do not trust the VA in Memphis TN.The clinics I do not feel I get the proper care is Cardiology,Dermatolgy,Neurology and Dental have had no luck with these clinics with proper care.

    1. Dale Beaty    

      Most of the checkin clerks are great. Recently had one of the exceptions. Male on gray team in Alex La. decided it appropriate to disclose all of my personal info to the entire waiting room because I requested he check me in on his term instead of me using my shaking hands on the kiosk. He did this standing in front of the kiosk with other patients 2-3 feet away. We are talking my full name, DOB, last four, home address, home tel # and my next of kin name and relationship. After my visit he then disclosed the amount of travel pay to me half way across the waiting room. He has only been there a few months and hopefully won’t remain long!!!!!!!!!!!!! VA is a great org and most of the emps do a wonderful job.

  11. James Donald Barton    

    Just keep up the good work, a very satisfied veteran.

  12. James Donald Barton    

    I have coming to the VA for my medical needs for many years. All can say is I don’t see how it could get any better. I have never had problem of any kind. God bless them all.

Comments are closed.