Closer Look at a New High Risk Area—Managing Risks and Improving VA Health Care

Last week, we issued our 2015 update to our High Risk List. Today, we take a closer look at 1 of the 2 new areas: Managing Risks and Improving VA Health Care.

In the spring and summer of 2014, delays in care at VA medical facilities drew media attention and spurred more than 20 congressional hearings. We have made numerous recommendations to VA to improve the timeliness, cost-effectiveness, quality, and safety of the care it provides to veterans. However, VA has yet to fully implement more than 100 of our recommendations.

Our concerns about VA health care fall into 5 broad areas:

1. Ambiguous policies and inconsistent processes. We’ve found that unclear policies led VA staff to inaccurately record the required dates for appointments, and inconsistently track waiting times for new patients.
2. Inadequate oversight and accountability. VA doesn’t routinely assess how well its facilities implement certain policies, and often relies on facilities’ self-reported data, which are often inaccurate or incomplete.
3. IT challenges. We’ve repeatedly reported on VA’s outdated, inefficient IT systems. For example, for more than a decade we’ve reported on how VA and DOD electronic health record systems don’t work with each other efficiently.
4. Inadequate training for VA staff. VA’s training requirements can be both burdensome to complete and insufficient. For example, we found that training for staff responsible for cleaning and reprocessing reusable medical equipment was lacking, potentially exposing patients to dirty equipment and infection.
5. Unclear resource needs and allocation priorities. VA lacks the data it needs to make important management decisions about where to allocate its resources. For example, VA cannot readily access the data it needs to determine whether its existing nurse workforce matches its clinical needs.

Watch this video for more information about why veterans’ health care was added to our High Risk List.

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