Veterans Healthcare System Term Paper

Pages: 7 (1969 words)  ·  Bibliography Sources: 5  ·  File: .docx  ·  Topic: Healthcare

Veterans Healthcare System (VHA)

The objective of this work is to examine the Veterans Healthcare System (VHA) the largest fully integrated system in the United States in a systematic assessment. This work will first, identify the organization's mission and conduct assessments as follows: (1) Environmental assessment; (2) Organizational assessment; (3) Human resources assessment; and (4) Political process assessment. Following these assessments, a SWOT will be conducted for making a determination of the organization's strengths, weaknesses, opportunities and threats and to ensure the organization is capable of remaining viable in the future. This work will identify key implementation issues and suggestion evaluation of strategic effectiveness in a conceptualization of the overall strategic planning-process, which intends to identify and analyze alternate strategies.

INTRODUCTION

The Department of Veterans Affairs (VA) was established under the Presidential Executive Order 5398 on the 21st of July, 1930 as an independent agency in an order that was elevated to the Cabinet level on March 15, 1989(Public Law No. 100-527). The Veterans Health Administration is one of three organizations that comprise the Central Office (VACO) in Washington, D.C. with the other two organizations being the Veterans Benefits Administration (VBA) and National Cemetery Association (NCA).

I. MISSION

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The stated mission of the Veterans Administration is "to serve America's veterans and their families with dignity and compassion and to be their principal advocate in ensuring that they receive medical care, benefits, social support and lasting memorials promoting the health, welfare, and dignity of all veterans in recognition of their service to this Nation."

Services and benefits are made available to veterans through "a nationwide network of 155 hospitals, 881 outpatient clinics, 135 nursing homes, 46 residential rehabilitation treatment programs, 207 readjustment counseling centers, 57 veterans benefits regional. offices, and 125 national cemeteries."

TOPIC: Term Paper on Veterans Healthcare System Assignment

The five broad strategic goals stated by VA are what forms the components of the VA Strategic Plan: (1) Restore the capability of veterans with disabilities to the greatest extent possible and improve the quality of their lives and that of their families; (2) Ensure a smooth transition for veterans from active military service to civilian life; (3) Honor and serve veterans in life and memorialize them in death for their sacrifices on behalf of the Nation; (4) Contribute to the public health, emergency management, socioeconomic well-being, and history of the Nation; (5) Deliver world-class service to veterans and their families by applying sound principles that result in effective management of people, communications, technology, and governance.

II. ENVIRONMENTAL ANALYSIS

The number of veterans presently total approximately 23,977,000 as of the Veterans Administration September 2006 estimation. (Department of Veterans Affairs, 2007 Organizational Briefing Book) However, today's veterans tends to be older, sicker and poorer and "more likely to have social problems and mental illnesses..." (Oliver, 2007) Oliver (2007) additionally relates that the number of patients seen by the VHA has risen "from 2.5 million patients in 1995 to 5.3 million patients in 2005." Oliver relates as well that the VHA "seems to have improved its performance as measured by various indicators of process quality, but it is important that a continued focus on quality improvements measured through health services research does not draw attention away from concerns regarding access to services, concerns that may be better addressed by political analysis." (Oliver, 2007)

Today's healthcare industry faces greater challenges than ever before in the provision of healthcare and this is true for Veterans Healthcare Administration as well. Exposures of individuals and most particularly those in the armed services to chemical warfare weapons and other hazards is increasingly a risk. As well, the many diseases that are rampant throughout the world today are a risk for any individual who travels across the globe as do servicemen and women. Delivery of healthcare is extremely difficult at this particular time in history due to the heavy demand of needed services by those who are in need of healthcare provisions. When viewing the patient ratings in the performance rating report for the year 2007 it is clear that the Veterans Health Administration is extremely backed up as the target was to have only 7,500 new enrollees waiting to be scheduled for their first appointment (electronic waiting list) while in actuality there were 117,000. However approximately 97.2% of patients in primary care were scheduled within thirty days of the desired appointment date which was in excess of the goal of 96% which had been stated. In fact when looking at the goals stated for other areas such as specialty care appointments it is clear that the Veterans Health Administration is meeting or exceeding many of the goals, which have been set for performance. Of those who are severely injured or ill OEF/OIF servicemembers/veterans, 90% are contacted within 7 calendar days by their assigned VA case manager of their notification of transfer to the VA system as an inpatient or outpatient. (FY 2007 VA Performance and Accountability Report)

III. HUMAN RESOURCES ASSESSMENT

The VA reports that the Veterans Integrated Service Networks (VISN) "provides close and continuing 'hands on' supervision and leadership to local VA providers of care." The goal is stated to "deliver the right care, in the right place and at the right time." (Department of Veterans Affairs, 2007 Organizational Briefing Book) the VA Organizational Briefing Book published in May 2007 additionally states that the system has moved from one that was previously "hospital-based to a predominantly outpatient system, that ratio of outpatient visits to inpatient admissions went from 29:1 in 1995 to more than 100:1 in 2006." (Department of Veterans Affairs, 2007 Organizational Briefing Book) VHA states the systems have undergone a redesign process and include resource allocation systems, information management systems and strategic planning systems. The new structure is stated to be for "planning, budgeting and service delivery" and is the VISN "a network of facilities with a collective responsibility to coordinate care and maximize the health potential of veterans inpatient geographic regions." (Department of Veterans Affairs, 2007 Organizational Briefing Book) the responsibility and accountability been enabled to be realigned "closer to the point of care delivery." (Department of Veterans Affairs, 2007 Organizational Briefing Book) Top managers for VHA are under a contract of performance and a performance measurement system is in place to assure "the alignment of action with the organizational goals and alignment of all levels of the organization toward achievement of the goals." (Department of Veterans Affairs, 2007 Organizational Briefing Book) Other than these changes of a structural nature the VHA relates that "new strategic goals" are in place that "will move it forward within its domains of value: (1) quality; (2) satisfaction; (3) functional status; and (4) cost. (Department of Veterans Affairs, 2007 Organizational Briefing Book) Defined as quality focus areas during the redesign process which ensued in the Veterans Health Administration were the areas of:

Personnel/human resources - hire and keep the top prospects;

Clinical care activities - perform the clinical activities which are necessary for good health;

Performance indicators - establish and keep track of important indicators;

Internal review and improvement - involve all groups across organizations in improvement; and External review and oversight - get an outside opinion of progress. (Mayo, 2006)

IV. POLITICAL PROCESS ASSESSMENT

Health risk assessment is defined as a "subjective, arbitrary and discretionary political process, rather than an objective and scientific activity..." The same can be said to be true in the assessment of the process of healthcare delivery and the provision of healthcare services when assessment is being conducted in terms of the patient satisfaction as contrasted to the findings stated in research study conducted by the agency providing the healthcare. This is because "health risk assessment does not exclude the bias and prejudice of those doing the study." (Risk Assessment, nd) However, because the head of the VHA is a cabinet-level position major political pressure is placed upon the system in its' entirety." (Mayo, 2006) Improvements to the system include the Veterans Health Information and Technology Architecture (VistA) which has been implemented across the organization country-wide composed of: (1) computerized patient records system; (2) VistA Imaging; (3) Bar-code medication administration; and (4) My HealtheVet. This system allows all caregivers "to see any information in the patient's record throughout the hospital Components of this system include registration applications, an order-checking system, notifications for significant changes in a patient's clinical status, and a reminder system. (Dept. Of Veterans Affairs, 2006; as cited in Mayo, 2006) Weaknesses and threats are identified in the work of Mayo (2006) in the interviews with Dr. Woodbridge and Dr. White, both employed with the Veterans Healthcare Administration. Dr. White states that the biggest challenge facing the VA is "the population of Vets is declining. The last WWIII vets are hanging on, and there is no large veteran population to replace them. Dr. Woodbridge expresses that there have been "major losses in productivity associated with the implementation of electronic records." (Mayo, 2006) Dr. Woodbridge states that the major obstacles unique to the VA system is that the VA is "so bureaucratic, it is hard to affect change." (Mayo,… [END OF PREVIEW] . . . READ MORE

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