VA Medical Center

VA Medical Center

Introduction

In 2014, the Phoenix Arizona VA Medical Center was entangled in an embarrassment of hitting the national news over a scheme that was put in place purposely to avoid the internal rules of VA.  The internal rules required healthcare to be provided to veterans by VA promptly, normally within fourteen to thirty days. The scheme involved a development of a secret list, shredding evidence that was meant to hide the long list of veterans that was waiting for appointments and healthcare with their primary health care specialist. Unfortunately, the employees at this facility were instructed by the administrators not to make veterans any doctor appointments within the computer system. Contrary to this when the veterans came in for any appointment, the employees entered the health information or records to the computer and did a hard copy printout through capturing the screen. The employees did not save what was put into the computer, so the veteran’s records of attendance were not traced. The veteran’s health records were collected on electronic list that were put a secret and then the all the records showing the actual time the veterans appointment waiting began were destroyed (Black, Bronstein & Griffin, 2014).

According to one of the whistle-blowers and a local physician who worked at this VA (Dr. Foote) stated the hard copy that had the veteran’s demographic information on it was taken and recorded on a secret electronic list, and later the data contained on the paper was shredded. Therefore, the secret list was the only list showing that the veteran had ever been there and the staff would not delete the veteran’s names from the list until they had a 14 days or less appointment time. This gave the appearance that this VA was improving greatly on their time for waiting while this was contrary to the real situation (Black, Bronstein & Griffin, 2014).

In the repercussions, the Phoenix VA has won the attention from the VA Office of Inspector General (OIG), the U.S. House Veterans Affairs Committee and Congress in Washington and they needed to find a solution to change this unethical practice quickly. After a formal investigation, the executives at the Phoenix VA Medical Center were blamed for keeping a secret list of appointments on a rundown of several veterans who were looking for healthcare services. This summary was kept up beyond anyone’s ability to see of government regulators, who were rather sent documentation that incomprehensibly underreported to what extent it took for veterans to see a primary physician. Therefore, the following paper will express how the Phoenix’s VA Medical Center can execute and adapt to change by using Kotter’s 8-Step model (Cohen & Kotter, 2012).

Sense of Urgency

Based on the VA medical center, in the sense of urgency point, one is required to develop the need for change by informing all stakeholders of the benefits of the change. This is because for evolution to effectively take effect the whole community must acknowledge that there is need to change. The sense of urgency for change at the Phoenix VA is obviously to lower the fatalities experienced in the healthcare center and to save more lives of our veterans. Many veterans use the VA healthcare due to financial constraints, and it is apparent the immoral scheme the Phoenix VA conducted with its secret list, definitely needs to be addressed quickly not to mention the lack of funding issues of the hospital.

As mentioned before, the secret list kept veteran’s on hold of an average of 115 days if not long before they could have been seen by their essential care specialist. Those long hold up times may have had dramatic critical results. According to Wagner (2014), an employee who worked at the Phoenix VA went public as a whistle-blower and stated: she was the secret list keeper for the veterans who waited for months to receive any medical care. She also went ahead to accuse others for making health records alterations after breaking of the scandal as a way of hiding the death of seven veterans who lost their lives while awaiting for medical care. One of the supervisors had ordered this employee to go ahead in gathering appointments requests for new patients every week and place it on her desk. Unfortunately, her estimation was that more than one thousand veterans were sidetracked onto the secret list, which led to them being ignored for several weeks or months as their appointments could not be scheduled within less than 14 days as this was the set time by the administrators in VA. This VA Medical Center therefore had a difficult time when it came to meeting the increased demand for medical appointments.

According to Bronstein & Griffin (2016), CNN revealed that more than of 40 veterans passed on while waiting for medical appointments at the Phoenix, and an official investigation found the “secret waiting list” added to deaths VA authorities could have, obviously, detailed those long hold up times to the federal government, yet that could have implied missing out on bonus pays medical facilities get keeping hold up times short. What’s outrageous about the conduct at the Phoenix VA Medical Center is that as opposed to making the long hold up times open with expectations of settling the issue, executives endeavored to influence it to resemble the problems did not exist by any means. If change is implemented efficiently, there would not be an extreme loss of life at the VA medical center as experienced in the past.

Build the Guiding Team

Effective change implementation calls for effective leadership to oversee see the implementation process as well as govern the formulation of the primary objectives of the plan. As a result, the building team towards the VA Medical Center change would be best sorted if the most affected parties would have direct representation to express their recommendations. The representatives of the involved parties would be sources from the legal representatives of lawyers, executives working at the facility, military personnel, local community, healthcare professionals, FBI, and political leaders in Washington (such as the House Committee on Veteran’s Affairs, Inspector General Office, the President’s VA Secretary of Veterans Affairs). The team building process would be on a voluntary platform. This is because the change intended requires self-motivated and high willpower from all members involved.

Get the Vision Right

The Veteran Medical Center’s mission statement states “To care for him who shall have borne the battle, and for his widow, and his orphan.” Whereas the vision statement is bared the responsibility of taking care of its American Veterans, where it stated that it would provide world-class healthcare with commitment and quality service, for example, U.S. Department of Veterans Affairs, 2015). However, the Medical Center failed to meet its primary objectives in offering quality service to their American Veterans. Based on the driving team towards change, developed in stage three, a lot of ideas would be generated, but the challenge is to choose the best approach to implement it. At this point, the best method is to increase oversight from the management of the medical center with the additional support from the officials in Washington. This can be done by firing executives of wrongdoing, performing continual audits, increase more funding to discourage corruption and increase the accessibility levels of the veterans by hiring more healthcare professionals and opening up more off-site clinics to meet their demands.

Communicate for Buy-In

With regards to the VA medical center, the main point at this stage is to gather support from as many stakeholders as possible. The advocacy for change would be built on a marketing basis, where the social platform would be used to address the need for change and its benefits. It would be most appropriate to disclose all the change requirements to the official government agencies and the VA representatives in Washington as well as the Inspector General Office. This can be achieved through frequent meetings, conference calls, and letters as communication channels. Additionally, the agenda would be the advantages of implementing the medical changes in the healthcare centers as a whole within the community.

Empower Action

The VA medical center should have sufficient amount of staff members and state of the art technological equipment to improve service delivery and the speed at which it is delivered. Additional funding and constant auditing of the veteran medical center also needs to be developed and implemented. This can be achieved through appointing financial experts from other governmental agencies from Washington to help guide them in the right direction. Also, the financial department from this VA needs to be responsible for delegating a commission to audit and oversee all financial matters and provide an accurate report to Washington. Moreover, providing a feedback platform from the patient would also help improve on the intended changes for a better future of the medical center. For example, implementing suggestion boxes and online platforms where feedback can be sourced.

Create Short-Term Wins

A rewarding strategic system is to be implemented for the employee who displays improvements toward the intended objective of the VA medical center, such as incentives and wage increment. For instance, providing inexpensive gifts for the most performing medical staff members in specific departments and also particular commissions for the staffs based on their performance with regards to output. On the other hand, the change would be divided into a module with specific time frames sets to help monitor progress. For example, the number of patients treated in a particular month.

Don’t Let Up

The VA medical center’s change implementation process, are to be made constant or else improve more at the healthcare organization. This is to be achieved through constant training of the staff members, motivating them through rewarding as well as punishing the wrongs done. For example the veteran center every new employee should have an induction of the organization’s goals, values and the culture expected from them. Additionally, the VA medical center they should have the continuous training of being informed and briefed on new technologies and how to use them effectively to improve service delivery.

Make Change Stick

Instituting change is the final step, and it entails formulating strategies laid out on the VA medical center proposals, the factor in the transformation of the organization. For example, the veteran medical center, in general, should develop an organizational culture where new practitioners, administrators among other staff members at the facility are assimilated towards the objectives, morals and ethical practices of the VA Medical Center.

The corporate culture at the medical center should encompass all the highlighted recommendation towards improving the service delivery of the facility to its veterans. The proposed include auditing and improved funding, training of employees, suggestion platforms for the patients as well as an overall agency (such as the Inspector General and the Secretary of Veterans Affairs) to oversee operations of the medical facility in general.

Conclusion/Reflection

In conclusion, the U.S. Department of Veterans Affairs (2017) explains that, like other standard healthcare services, the Medical Benefits Package underscores preventive and essential care, offering a full scope of outpatient and inpatient administrations. Despite the fact that some VA medical centers are incredible on providing quality healthcare, others scarcely meet least quality principles, making an uneven balance of quality care over veterans living all over the nation. Some VA organizations have long held up records while others are staff heavy and discharge. A moment the favorable position of opening up more outpatient specialty clinics, hiring more staff to meet the demand, involve more employee training, and adding more funding, embraces the access of measuring general viability. Right now, the VA is not required to discharge information on quality, well-being, patients’ involvement, taken a toll viability, or timeliness. The absence of straightforwardness is a factor in how awkwardness including abuse of open assets can happen without much notice.

Since the exposure to this epidemic, the VA medical center recently launched a new website with quality tool and access with an aim of helping veterans to make informed decisions. According to U.S. Department of Veteran Affairs (2017), the new tool makes it possible for the caregivers, veterans and the general public to easily have access a transparent and understandable appointment waiting time and quality care in the healthcare industry. This means that all veterans will be in a position to compare easily and quickly the access to quality healthcare from the VA facility to the other VA facilities and make informed decisions on where, how and when to receive their medical care. With the addition of the Obamacare, veterans at some of VA’s have the ability make comparison between the VA medical quality and the private sector healthcare facilities and have the option to use those private-sectors. Therefore, by making the VA medical center work by expanding its programs, tools, and services, it should give measurements that shows its quality by ordinarily acknowledging its benchmarks. As a result, the veteran healthcare and overall well-being crises can be eliminated to a minimum if not at all. This likewise implies restorative records will never again be faxed or hand conveyed as these records will as of now be put away in a shareable database. This will help numerous Veterans who see human services suppliers crosswise over state lines.

References

Black, N., Bronstein, S., & Griffin, D. (2014). VA Deaths Covered up to Make Statistics Look Better, Whistle-Blower Says. Retrieved from http://www.cnn.com/2014/06/23/us/phoenix -via-deaths-new-allegations/index.html

Bronstein, S., & Griffin, D. (2016). A Fatal Wait: Veterans Languish and Die on a VA Hospital’s Secret List. Retrieved from http://www.cnn.com/2014/04/23/health/veterans-dying-healthcare-delays/index.html

Cohen, D. S., & Kotter, J. P. (2012). The heart of change: real-life stories of how people change their organizations. Boston, MA: Harvard Business Review Press.

U.S. Department of Veterans Affairs. (2015). About VA: Mission, Vision, Core Values & Goals. Retrieved from https://www.va.gov/about_va/mission.asp

U.S. Department of Veterans Affairs. (2017). Health Benefits. Retrieved from https://www.va.gov/healthbenefits/access/medical_benefits_package.asp

U.S. Department of Veterans Affairs. (2017). VA’s New Online Tool Helps Veterans Make Informed Health Care Decisions. Retrieved from https://www.blogs.va.gov/VAntage/ 37002/vas-new-online-tool-helps-veterans-make-informed-health-care-decisions/

Wagner, D. (2014). VA employee” I Kept a Secret Phoenix VA List. Retrieved from http://www.pnj.com/story/news/usanow/2014/06/23/phoenix-va-whistleblower/11297069/

 

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