United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2001-08-31 monographic deposited born digital GA 1.13:GAO-01-953 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-953 P0b002ee18037fba2 f:d01953 DGPO 2010-08-12 2011-03-28 GAOREPORTS-GAO-01-953 machine generated eng fdlp REPORT GAOREPORTS-GAO-01-953 GAO-01-953 Health centers Health services administration Veterans hospitals Managed health care Veterans benefits Patient care services VA Veterans Health Information Systems and Technology Architecture VA Veterans Integrated Service Network Other Written Product A01678 The Department of Veterans Affairs (VA) operates one of the nation's largest health care systems. In fiscal year 2000, roughly four million patients made about 39 million outpatient visits to more than 700 VA health care facilities nationwide. However, excessive waiting times for outpatient care have been a long-standing problem. To ensure timely access to care, VA established a goal in 1995, that all nonurgent primary and specialty care appointments be scheduled within 30 days of request and that clinics meet this goal by 1998. Yet, three years later, reports of long waiting times persist. Waiting times at the clinics in the ten medical centers GAO visited indicate that meeting VA's 30-day standard is a continuing challenge for many clinics. Although most of the primary care clinics visited (15 of 17) reported meeting VA's standard for nonurgent, outpatient appointments, only one-third of the specialty care clinics visited (18 of 54) met VA's 30-day standard. For the remaining two-thirds, waiting times ranged from 33 days at one urology clinic to 282 days at an optometry clinic. While two-thirds of the specialty clinics GAO visited continued to have long waiting times, some were making noteworthy progress in reducing waiting times, primarily by improving their scheduling processes and making better use of their staff. These successes were often the result of medical centers' and clinics' working collaboratively with the Institute for Healthcare Improvement (IHI)--a private contractor VA retained in July 1999--to develop strategies to reduce patient waiting times. Medical centers and clinics participating in VA's IHI project have received valuable information and strategies for successfully reducing waiting times. However, VA has not provided guidance to its medical centers on how to implement IHI strategies, and has only recently contracted with IHI to disseminate best practices agency-wide. VA also has not developed other national guidance to help clinics reduce waiting times. While clinics that did not have guidelines could have benefited from headquarters' assistance, VA has not established a national set of referral guidelines. Moreover, VA lacks an analytic framework for its medical centers and clinics to use in determining the root causes for long waiting times. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-953/html/GAOREPORTS-GAO-01-953.htm GAO-01-953 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-953 Other Written Product GAO-01-953; VA Health Care: More National Action Needed to Reduce Waiting Times, but Some Clinics Have Made Progress; Health centers Health services administration Veterans hospitals Managed health care Veterans benefits Patient care services VA Veterans Health Information Systems and Technology Architecture VA Veterans Integrated Service Network Public Law 104-262