Overview:
When news came out that a Phoenix, Arizona Veterans’ hospital had been falsifying information about patient appointment wait times1, accusations and denials went flying.
How could this have happened? How could it be fixed? Why hadn’t we known sooner?.
While VAs are working to reduce wait times, focusing on ways to turn waiting room experiences into an engagement opportunity can improve the overall experience. Veterans often wait two, three, four hours to receive care. “I get so bored, I read smoking cessation pamphlets even though I don’t even smoke,” says Mr. Hardy. There are three or four televisions on always, with programming that often feels unrelated to the needs and interests of the patient population. Using these screens to share relevant information about the facility or direct them to resources to help them prepare for their appointment is a simple approach to turning wait times into a meaningful engagement.
In the latest Building on Excellence document released by the Department of Veterans Affairs, it states “veteran satisfaction is now our principle index for assessing access.” 4 If that is the case, there needs to be a major shift in perspective from comparing relative length of wait times as a measure of success, to using a comprehensive patient education solution and communication touch points, alongside existing metrics as a benchmark, for patient experience improvement.
Beyond logistical mystification and wait-time frustrations, clinical confusion remains a barrier to patient satisfaction and improved outcomes. Veterans are still being given clinical information in outdated, overwhelming formats. “How am I supposed to understand the side-effects of my new medication when I am given six pages of single-spaced instructions to weed through? I was told to call the number on the handout with any questions, but all I got was a recorded answer.” says a Pittsburg veteran.
Secretary Shulkin promised more responsiveness at his confirmation hearing5, but veterans are still trying to parse out which part of pre-recorded instructions apply to them when calling hotlines for help or clarification. Again, Shulkin’s department has an ambitious plan to improve access to care management, but tangible results to structural change in an organization as massive as the VA are likely still years away. For today’s suffering veterans, how can they understand how their medication works and next steps in their care, when patient instructions continue to be long, often generic and confusing, inventories of possible side effects?
Unfortunately, large gaps in care coordination and management remain.
How can VA administrators engage, assist and support their patients with the tools at their disposal today? A simple-to-implement, cost-effective answer that VA clinics and hospitals have been adopting on their own is patient education. Delivered throughout the continuum of care, patient education consists of simple instructions and educational pieces that can be accessed at any point throughout the patient journey. These user-friendly instructions make a significant impact on the quality of care, and further support existing VA initiatives like SAIL and MyVa and quality measures that VAs strive to align with like HEDIS and ORYX.
