Pattern of Problems with the U.S. Department of Veterans Administration Health Care System
Abstract
The United States Department of Veteran Affairs has established 151 hospitals, 820 community-based outpatient clinics, and 56 regional offices. In addition, it established about 300 well-established veteran care centers in the United States in 2013. It was started to cater to the medical needs of veterans and their families that is wives and children after the World War 1. The federal government established the first residential medical center in 1811 but started no national efforts that were aimed at helping the veterans. The committee is also responsible for providing financial aid to the veterans and their families. The following issues affect veterans: mental health disorders, stress, substance use disorders and brain injury. However, a pattern of problems has emerged, which has impacted the lives of veterans negatively, as the veteran’s affair department progresses. They include increased wait time for patients, outdated technology, financial problems the backlog of services leading to death and disabilities, and scheduling activities at the Phoenix unit. Therefore, the paper covers research that involved these three problems in the U.S. and gives some strategies that can be followed to solve them from the findings. The three problems covered by the paper include increased wait time for patients, the backlog of services leading to death and disabilities, and scheduling activities at the Phoenix.
Introduction
During the American Revolutionary War, veteran support programs were initiated. Around 25,000 soldiers were affected by this war, and the continental congress gave them a pension as an encouragement to continue fighting. The federal government established the first residential medical center in 1811 but started no national efforts that were aimed at helping the veterans. The civil war raised a national concern to cater for the needs of veterans, their widows, and dependents. The department has been progressing over time, but a pattern of problems has emerged. Such problems include; the lack of proper scheduling due to the use of outdated technology, the lack enough clinical officers, increased waiting time, the backlog of activities, shortage of funds, and delays in giving disability benefits among others. The biggest milestone of the problems emerged with the scandals that were experienced in 2014. The research on the issues affecting the U.S. veteran department is important because it provides a vivid picture and precise knowledge on the standards in which veterans live and operate. The biggest problems affecting the veteran health care department are; the increased wait times for patients, the backlog of services leading to death and disabilities and scheduling activities at the Phoenix center.
Literature review
The topic has been researched earlier, in efforts to obtain full knowledge of the problems affecting veteran departments. However, such previous research has not given detailed report or knowledge of the primary challenges and factors that have led to the emergence of such problems. In most types of research, the main challenges are identified, but their causative agents are ignored. Additionally, due to the use of outdated books and materials, which has been one of the main challenges in this research, no current statistics were found in the previous research. Recommendations to the problems were not found as well. Therefore, this research gives up-to-date statistics, recommendations and full knowledge of the major problems that the U.S. veterans face. As earlier mentioned, the dominant pattern of problems includes; increased wait time for patients, the backlog of services leading to death and disabilities, and scheduling activities at the Phoenix center.
Methodology
The research was conducted to identify the main patterns of problems associated with U.S. Department of Veteran administration. Interviews with veterans or the affected people such as their families were held to obtain first-hand information. Documented reports by the selected committee by President Obama in partnership with Shinseki provided relevant information as well. Other documents and materials such as peer-reviewed articles, medical journals, and the internet were used to obtain information. Questionnaires were administered to veterans and other members of the veteran departments.
Findings
Discussion
The biggest problems affecting the veteran health care department are; the increased wait times for patients, the backlog of services leading to death and disabilities and scheduling activities at the Phoenix.
Activities at the Phoenix medical center for veterans. Each of the problems is discussed broadly below:
Increased wait time for patients
Reports show that veterans wait for a long time to obtain an appointment or medical attention. The biggest problem with long wait times is the manipulation of dates by schedulers. Schedulers manipulate and alter appointment dates to mislead people or make them feel that they will not wait for a long time. The standard wait time should be one to six days, but the research shows that veterans wait for an extended time of forty-eight days and sometimes fail to meet their doctors within these days. 1,400 veterans waited to be scheduled for primary care appointment while over 3,500 waited for an appointment in April 2014 (Sandoval, 2015). Veterans, who had secured appointments waited for a much-extended period while others struggled to secure an appointment. Long waiting time has led to deaths and disabilities among veterans, who wait to receive medical attention or secure appointment dates. 40 patients are said to have died at Phoenix due to the lack of proper scheduling and long wait times in 2014. The increased wait times are caused by the lack of enough physicians, nurses, and other personnel. The veteran administration reported to the Congress stating that, around 46,000 vacancies were available in the skilled health system in the U.S. (United States, 2008). The lack of professionals or increase in jobs is caused by wages discrepancies. These positions do not attract competition among doctors as compared to similar positions in the private sectors, where higher salaries are offered.
Backlog of services
Delays have caused the loss of lives and disabilities among veterans and their families. The lack of enough medical personnel in the veteran medical centers such as Phoenix causes services backlogs (Pratt, 2010). Some patients require special attention from cardiologists, psychologists, and urologists among others, who are few. Therefore, patients die, as they wait for appointments. However, the few personnel work under pressure to attend to a large number of patients, thus, offering low-quality services at times. In partnership with Shinseki, President Obama ordered a broad investigation on the issue due to the increased attention on backlogs (Pratt, 2010). The committee discovered that cover-ups are done to hide the backlog and financial mismanagement claims. Cases of arrears were estimated to have risen by 155% and $5.5 million misappropriations in 2011 (Koo, & Maguen, 2014). President Obama ordered the end or completion of delay claims to end the backlog cases. Over a million cases are processed per year, which consumes time and other resources. Thus, due to delays, cost increases profits, and low productivity is observed.
Scheduling activities at the Phoenix unit
The improper programming and manipulation of schedules have been witnessed at the Phoenix center for veterans. Wait times increase deaths and disabilities among patients because of such manipulation. Reviews show that hospitalized patients, patients in emergency departments, and others, who were seeking care had obstacles in obtaining appointments in 2015. Veterans, who were in need of specialized care from a cardiologist, urologists, and general care failed to get appointments and medical care at Phoenix. However, President Obama authorized a committee to look into the matter due to the increased public complaints. The committee report indicated that administrative leaves and the lack of enough medical personnel were the main challenges at Phoenix. For instance, three veteran health officials were sent on administrative leave, and it was speculated that 40 veterans died during this period in 2014 (Sandoval, 2015). However, the list containing the names of the 40 patients has been concealed by the departments. From the report, staffs had been ordered to hide and manipulate appointment dates once, in 64% of the 258 veteran health administration facilities (The United States, 2003). The outdated technology systems are said to have prohibited staffs from tracking patients and preventing veteran directors in the U.S. from accessing accurate data at Phoenix.
Recommendations
The pattern of problems affecting the veteran health department should be dealt with to avoid further complications and adverse effects among the veterans and their families. Some strategies should be identified to reduce the impacts of the problems. The following are some strategies that can be developed; hiring more medical care staff and retaining them through establishing a competitive plan on payments modes and terms that are comparable to the private sector. Hiring more workers will reduce the wait times and backlogs in the departments. Scheduling should be done properly, and patients should have the access to the veteran administration website for consultation. It will help in improving on programming practices, where a verbal agreement between a patient and a clinical officer can take place (The United States, 2006). The agreement will set a date and time for an appointment, which will help in the elimination of alternate forms for record keeping. It will also end the 14-day policy because meeting requests will become outdated. The establishment of long-lasting software updates that will integrate the systems and the department can replace the outdated technology. A good software will help in scheduling the activities, and responding to feedbacks and queries from patients and the public. A better method of response to claims to reduce backlogs should be defined as well.
Conclusion
Veterans are heroes that need to be taken care of properly but that has not been achieved due to a pattern of problems in US. The major problems in the veteran department are three and include increased wait times for patients, the backlog of services leading to death and disabilities and scheduling activities at the Phoenix medical center for veterans. However, to make sure that their medical needs are well taken care of some strategies need to be put in place. Such strategies include establishment of software that will help in proper scheduling. Hiring more workers to reduce long wait times and backlogs.
References
Koo, K. H., & Maguen, S. (2014). Military sexual trauma and mental health diagnoses in female veterans returning from Afghanistan and Iraq: Barriers and facilitators to Veterans Affairs care. Hastings Women's LJ, 25, 27. http://heinonline.org/HOL/LandingPage?handle=hein.journals/haswo25&div=8&id=&page
Pratt, M. (2010). New courts on the block: Specialized criminal courts for veterans in the United States. Appeal: Rev. Current L. & L. Reform, 15, 39. http://heinonline.org/HOL/LandingPage?handle=hein.journals/appeal15&div=7&id=&page
Sandoval, K. N. (2015). Health Care in the US Department Of Veterans Affairs: Critical Issues and Strategic Progress. http://scholarworks.sjsu.edu/etd_theses/4558/
Smith, R. T., & True, G. (2014). Warring Identities Identity Conflict and the Mental Distress of American Veterans of the Wars in Iraq and Afghanistan. Society and mental Health, 2156869313512212. http://smh.sagepub.com/content/early/2014/01/09/2156869313512212.abstract
The United States. (2006). VA health care: Structural problems, partial solutions: hearing before the Subcommittee on National Security, Veterans Affairs, and International Relations of the Committee on Government Reform, House of Representatives, One Hundred Seventh Congress, second session, May 14, 2002. Washington: U.S. G.P.O. http://www.worldcat.org/oclc/52345164
United States. (2008). The challenges facing the U.S. Court of Appeals for Veterans Claims: Hearing before the Subcommittee on Disability Assistance and Memorial Affairs of the Committee on Veterans' Affairs, U.S. House of Representatives, One Hundred Tenth Congress, first session, May 22, 2007. Washington: U.S. G.P.O. http://www.worldcat.org/oclc/237188396
United States. (2007). Battling the backlog part II: Challenges facing the U.S. Court of Appeals for Veterans Claims : hearing before the Committee on Veterans' Affairs, United States Senate, One Hundred Ninth Congress, second session, July 13, 2006. Washington: U.S. G.P.O. http://www.worldcat.org/oclc/83594138
