VA’s top health official’s five ways to transform access to care

As David Shulkin marks eight weeks on the job as the Veterans Affairs Department’s Undersecretary for Health, he said giving veterans better accessibility to healthcare is his main priority.

Shulkin outlined five main ways he wants to transform veteran’s healthcare now that he has taken over the reins as the VA’s top health official.

“If we don’t get [accessibility] fixed and the waiting time issues completely resolved so people can get care when they need it then we are not going to get beyond that” when it comes to solving other problems, Shulkin said during a Sept. 3 event in Washington hosted by the American Council for Technology-Industry Advisory Council.

In order to tackle that goal and others, the VA will be undertaking a number of initiatives such as clinically prioritizing appointments so those in most dire need receive care first. The VA will launch applications that ease the burden of scheduling appointments on veterans.

The VA needs to recruit permanent leaders as well.  The department currently has a 45 percent vacancy rate in its network directors and a 25 percent vacancy rate in its medical directors. Shulkin said he needs to figure out how to retain its leaders.

“How can you possibly make the types of changes that we are doing unless you have the right leadership in place?” Shulkin said. “A lot of our effort now is making VA a place where people want to come to serve.”

Part of the reason the VA is lacking qualified leaders is it has been plagued by scandals such as the patient scheduling errors and others. The department still is reeling from the resignation of former VA Secretary Eric Shinseki after a host of problems with its healthcare system.

But along with finding new recruits, Shulkin wants to inspire the employees who already work for VA.  Another top goal is to increase employee engagement. The VA has the second lowest employee morale engagement of any government organization, ranking just above the Department of

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Homeland Security.

Scott Blackburn, the director of the VA’s task force in charge of culture change, said part of the VA’s morale problem is that the whole department is being dragged down by bad publicity from a few outlying facilities. While a lot of VA facilities function well, the bottom 10 percent receive most of the attention, which makes even good employees feel like they are doing a subpar job, Blackburn said at the ACT-IAC event.

“You can’t be successful at an organizational turn around unless you have the hearts and the minds of the people that work with you,” Shulkin said.

Shulkin said he’s also prioritizing consistency of best practices in the healthcare system, and the development of a high performance network to reduce costs through a redesign of the healthcare processes. Those redesigns may include internal changes or adoption of new technologies.

Shulkin said he finally wants to restore the trust and confidence of the veterans and the public after the failures in the past. Accomplishing that requires a high degree of transparency to root out underlying problems, he said.

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