The Roudebush VA Medical Center is under active investigation for its patient scheduling and wait times, according to a new report released by the U.S. Department of Veterans Affairs.
“We’re shocked,” said Roudebush VA public affairs officer Julie Webb. “When we were audited in May, we weren’t told there were any issues, so when we found out we’re on the list for a follow up review, it was a surprise. We don’t know why.”
Roudebush and other VA medical centers are being reviewed after revelations that the VA medical center in Phoenix maintained a secret wait list of veterans who had to wait months or even years to see a VA doctor. Some of the patients on the wait list died before they received medical care.
Monday, the VA released a comprehensive report showing patient wait times – including those on electronic wait lists – for VA centers nationwide.
It shows 253 veterans on the wait list in Indianapolis, and another 20 on a wait list for the VA healthcare system in northern Indiana. Patients are added to the list if they are new to the VA healthcare system and cannot get an initial appointment with a primary care doctor within 90 days. VA guidelines state that all new patients should be scheduled for an initial appointment within 14 days.
Officials at the Roudebush VA center are not surprised by the audit’s wait list findings.
“We are aware of it and we've been working on it aggressively,” said Webb. “Everyone on the wait list has been contacted. We are instituting additional Saturday clinics, extended hours and we've asked our other staff to provide more time in primary care. The wait list should essentially be down to zero within the next week or two.”
Most existing patients who receive services at the Indianapolis VA facility are scheduled to see a doctor within 2 or 3 days, well within the system’s target goals. But that's not always the case. According to the new audit, investigators found 3460 veterans had recently been forced to wait 30 days, 60 days, even 120 days or more to see a doctor.
Webb points out some of those patients chose to schedule their appointments for later dates to accommodate personal conflicts, but admits access to some specialists – such as gastroenterologists for an colonoscopy – can require long wait times for veterans.
Other findings of the VA access audit:
- A complicated scheduling process resulted in confusion among scheduling clerks and front-line supervisors in a number of locations.
- A 14 day wait-time performance target for new appointments was not only inconsistently deployed throughout the health care system but was not attainable given growing demand for services and lack of planning for resource requirements.
- Overall, 13% of scheduling staff interviewed indicated they received instruction (from supervisors or others) to enter a date different than what the Veteran had requested in the appointment scheduling system.
- 8% of scheduling staff indicated they used alternatives to the official Electronic Wait List. In some cases, pressures were placed on schedulers to utilize unofficial lists or engage in inappropriate practices in order to make waiting times appear more favorable.
The Department of Veterans Affairs says there are currently more than 57,000 veterans nationwide waiting for initial appointments within its system. The problems discovered as part of its audit are widespread and require the VA to re-examine its entire system, according to the report.
And the VA investigations are not over.
Some VA medical centers are still under investigation for auditors to gather more information and to determine if VA staff engaged in willful misconduct. The Roudebush VA Medical Center is one of those that has been flagged for further scrutiny. Any suspected wrongdoing will be reported to the VA Inspector General.
In the meantime, the VA says it will take the following immediate actions:
- VA is offering accelerated care for veterans currently waiting for health care services, and it is contacting in excess of 90,000 veterans during the first phase of VA's "Accelerating Access to Care Initiative"
- VA will provide veterans who do not currently have an appointment, or are waiting for additional care or services longer than 30 days, the option to be rescheduled sooner if VA capacity exists, keep their scheduled appointment, or be referred to non-VA providers in the community
- VA has suspended all VHA Senior Executive Performance Awards for 2014
- VHA will remove 14-day performance goal from employee performance plans
- VHA will revise, enhance and deploy Scheduling Training
- VHA will implement a site inspection process
