VHA's Priorities for Strategic Action
Spotlight on Access
In September 2015, VA Under Secretary for Health, David Shulkin, MD, announced five critical priorities that will be the focus of VHA's time and energy over the next few years. These priority goals will help support the transformation of VA care and culture, and will have far-reaching impact throughout the VA system. The five priority areas are:
1. Access. The immediate focus of this goal is to resolve the critical issue of appointment wait-times for Veterans. VA also will address other challenges associated with Veterans' access to care.
2. Employee Engagement. VA culture will seek to fully engage employees with the importance and value of its mission: Service to those who have served.
3. Business practices. This goal seeks to ensure consistency of best practices and resource prioritization by focusing on what's working well, ensuring that effective systems are supported appropriately, and ineffective systems are promptly addressed.
4. Building a high-performance healthcare network. This priority goal focuses on creating a culture of high-performance, based on implementation of best practices—from leadership to clinical to operational to support settings.
5. Restore pride, public trust, and confidence in VA.
While the emphasis of the Under Secretary's access priority goal is on the critical need to reduce patient wait-times, improved access encompasses a variety of related issues, which may include:
- how close Veterans live to VA healthcare facilities;
- whether or not they are older, disabled, or chronically ill and so may experience difficulty traveling; and/or
- whether Veterans experience other barriers (e.g., lack of reliable transportation) that may prevent them from getting to a VA facility for care.
Through its comprehensive research portfolio, VA's Health Services Research & Development Service (HSR&D) has—and will continue—to support the Under Secretary's priority goals. In the coming months, the HSR&D website will highlight some of that research, beginning with an overview of HSR&D-funded projects focused on access. This special Access Spotlight features:
- An overview of HSR&D studies surrounding access
- In-depth highlights of HSR&D research into access
- Redefining how we measure access to healthcare in the digital age. John Fortney, PhD, part of HSR&D's Center of Innovation for Veteran-Centered and Value-Driven Care in Seattle, WA, has been working with VA and HSR&D colleagues to rethink how access is measured.
- Improving Access to Care: Telehealth Collaborative Care for Veterans with HIV, Michael Ohl, MD, MSPH, and colleagues at HSR&D's Center for Comprehensive Access and Delivery Research and Evaluation (CADRE) have been working to improve access to high-quality care for Veterans with HIV infection that reside in rural settings.
- Changes in Veteran-Centered Access and Wait Times. A study led by Julia Prentice, PhD, part of HSR&D/QUERI's Evidence-Based Policy Resource Center and Health Care Financing and Economics (HCFE), examined the relationship between wait-time measures and patient satisfaction for 221,540 Veterans who had responded to the 2010 Survey of Healthcare Experiences of Patients (SHEP) - an ongoing nation-wide survey used to obtain patient feedback on VA inpatient and outpatient care.
Over the coming months, the HSR&D website will feature more about how VA HSR&D research supports the Under Secretary's priorities.
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