Veterans Health Administration: Personnel Data Show Losses Increased for Clinical Occupations from Fiscal Year 2011 through 2015, Driven by Voluntary Resignations and Retirements

What GAO Found

GAO found that the Veterans Health Administration (VHA) collects data on the reasons clinical employees leave the agency and uses that data for planning purposes.  VHA collects personnel data on the number of, and reasons for, clinical employee losses, including voluntary resignations, retirements, or removals due to adverse actions, in its human resources databases. VHA also collects more information on the reasons clinical employees leave through a voluntary exit survey. The exit survey response rate varied by occupation; overall the average was about 30 percent across the past 5 years. VHA uses the information from the personnel data and the exit survey to evaluate its workforce needs. For example, VHA reports annually on difficult-to-retain clinical occupations and outlines a plan for targeting retention efforts for these occupations. VHA also makes these data available to leadership and medical directors through web-based tools, such as an internal website that provides access to human resources data.

GAO found annual increases in the number of employees that VHA lost from five occupations identified by the Veterans Affairs Office of Inspector General as shortage occupations in 2015—physicians, registered nurses, physician assistants, psychologists, and physical therapists. (See table.)

Number of Employees, Losses, and Loss Rate for the Five Shortage Occupations and All Clinical Occupations at VHA, Fiscal Year 2011 through 2015

Source: GAO analysis of Veterans Health Administration (VHA) Personnel Data. | GAO-16-666R

Voluntary resignations accounted for an average of 54 percent of losses from the five shortage occupations during this period, while retirements accounted for an average of 36 percent. Removals accounted for a small proportion (5 percent or less) of losses in each of these five occupations. GAO found a similar trend for all clinical occupations across VHA overall. VHA’s exit survey indicated that advancement issues and dissatisfaction with certain aspects of the work were among the primary reasons respondents from the five shortage occupations left VHA.

Why GAO Did This Study

VHA faces ongoing growth in demand for its health care services. To meet demand, VHA has implemented targeted hiring initiatives; however concerns have been raised about VHA’s ability to ensure that it has the appropriate clinical workforce to meet the demand. GAO was asked to examine issues related to clinical employee retention at VHA.  

This report provides information on (1) how VHA collects and uses information on employees’ decisions to leave clinical occupations, and (2) what trends, if any, exist over the last 5 years in the number of, and reasons for, VHA employee losses from the five shortage occupations. GAO reviewed VHA documentation on its processes for collecting and using information from departing employees. GAO also analyzed VHA data on employee losses and reasons for leaving collected from VHA’s Office of Healthcare Talent Management and interviewed VHA officials about how these data are collected and used.