A recent inspector general report on the Veterans Affairs Department’s systematic failure to address problems at the Washington, D.C. medical center is prompting a broader reorganization at the agency.

“The issues that have happened here in Washington and these systems failures are impacting other facilities across the country,” Secretary David Shulkin said Wednesday at a press conference on the findings of the VA IG report. “It’s why we see inspector general reports that identify similar issues across many facilities, as well as reports by the Government Accountability Office that have identified us as a high risk organization and have identified these types of system failures. I’ve directed that we begin to start doing changes at every level of our organization, at the facility, at the network level, and at the central office level.”

First, VA will complete a plan to reorganize the department’s central office by May 1.

“I’ve asked for an immediate plan to restructure our procurement and logistics department,” Shulkin said. “This is a department that every facility relies upon, where there has not been clear enough accountability, there has been duplication and overlap between what happens at the facility, the network and [VA Central Office] VACO. We’re going to be reorganizing that… so the structure is de-layered and is functioning in a way that works better for direct results and accountability.

Second, the department will form a special team to work with its national leadership council to develop a nationwide reorganization plan for its 23 Veterans Integrated Service Networks (VISNs).

That plan is due to the secretary by July 1.

“The VISN model was put in place close to 20 years ago, a very innovative model that has served VA well,” Shulkin said. “But like any business, the times change, the needs change and it’s time for us to look at how we operate our networks differently to get the type of accountability that’s needed to make sure we don’t see the failures that we saw here in the Washington, D.C. VA.”

Shulkin also appointed a  new executive in charge, Bryan Gamble, to oversee three VISNs: the New England Health Care System and the Capitol Health Care Network, which includes Washington, D.C., and parts of Maryland and Virginia, as well as the Desert Pacific Healthcare Network in California, New Mexico and Arizona.

Gamble, who currently serves as deputy chief of staff at the Orlando VA Medical Center in Florida, will administer restructuring efforts at those networks, Shulkin added. He will also help the department design a new reorganization plan for the medical networks.

Shulkin and the department have identified 15 VA facilities that they’ve designated as “low-performing.” The agency has specific action plans with directed goals to improve those facilities, he said.

A private-sector company will visit and perform unannounced checks at all VA hospitals, he added.

The department will also begin hiring and staffing reviews at every facility across the country, Shulkin said.

Though Shulkin didn’t expand on the details of what a “hiring and staffing review” might look like, he noted a 50 percent vacancy rate at one point among logistics services staff members at the D.C. medical center, which contributed to the hospital’s failures.

VA has struggled with vacancies, particularly among health care professionals, in recent years. Shulkin had once told members of Congress the agency had 45,000-to-49,000 vacancies.

The goal of the department’s reorganization efforts, Shulkin said, is to realign resources from administrative functions back to the agency’s facilities in the field, which work more directly with veterans.

Shulkin and other senior officials have discussed this general concept before. The department has been consolidating its human resources offices over the past year. VA closed its human resources function at the VA Central Office in September.

VA Assistant Secretary for Human Resources and Administration Peter Shelby described his plan to set up regional HR centers across the country and shift customer-facing HR services out of the Washington area.

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