Thursday, May 29, 2014

VA did not make providing quality care a primary goal, VA official says

The VA has not made providing quality care a primary goal.

That's not my call, that's a VA official's judgment.

Last night, the House Veterans Affairs Committee held a hearing on the VA's inability to provide the Committee with information in a timely and accurate manner.  US House Rep Jeff Miller is the Committee Chair, US House Rep Mike Michaud is the Ranking Member.

The Committee held from one panel which was comprised of VA's Assistant Deputy Under Secretary for Health for Clinical Operations Dr. Thomas Lynch; the VA's Assistant Secretary for Congressional and Legislative Affairs Joan Mooney; and the VA's Congressional Relations Officer Michael Huff.

The VA scandal isn't going away, it's only getting bigger.

(That's especially true if the press reports on the hearing I'm sitting in right now and they can start with US House Rep Dan Benishek stating, "I can't believe it takes five years to get this going, what's the story with that?"  And they can include his remark, "Why has it taken five years? The entire Second World War only took us four years.")

The VA's own witness made that call.

beto orourke

That's US House Rep Beto O'Rourke, a Democrat from Texas who's serving his first term in Congress.  He sits on the House Veterans Affairs Committee.  We're noting his exchange with Dr. Thomas Lynch of the VA.

US House Rep Beto O'Rourke:  Dr. Lynch, I think one of the important things you have made a commitment to this evening, in your words, is to restore trust in the data that we are receiving.  Some good news that we received from the El Paso VHA was that in March of this year, veterans seeking new medical appointments waited zero days which seems remarkable and exciting except for everything that we're discussing today and our inability to trust what we're hearing.  I already said earlier that we took it upon ourselves to conduct a scientific survey to figure out what the facts were and how long veterans were really waiting in El Paso.  Could the VA not employ that same method?  And in Phoneix, El Paso, everywhere that you're auditing results right now, could there not be not just the one time audit but ongoing, a continuing survey of the veterans, treating veterans as customers, finding out about the quality of their experience and verifying their wait time as they experienced it against what the VA said they waited?

Dr. Thomas Lynch: Congressman, one of the options we have been discussing internally is whether or not we could partner with the Veterans Service  Organizations and use their membership and use their members as, uh, an opportunity to identify the kind of service we're providing and where they're experiencing delays.  I think there is an opportunity there that clearly needs to be explored further.

US House Rep Beto O'Rourke:  I hope you will do that.  Another thing that struck me, you were talking about a failure within the VA that resulted from elevating a performance measure into a goal which could possibly have led to the scandal in Phoenix and other -- perhaps other-other parts of the VA.  If the current performance measures are not working what are some recommendations that you have for how we measure performance at our VHA system?

Dr. Thomas Lynch: I-I -- Don't get me wrong, I think that we need to have performance measures.  I think that they need to be tools that help us understand our system.  And I think we need to focus on our primary goal which is: are we seeing veterans, is our system growing, are we providing quality care?  When those become the goals of the system, then you cannot game performance measures.  Performance measures become a tool.  If you ignore them, then you're actually hurting yourself because you're not growing your system like you're supposed to and as a director or an administrator you will fail.

Back to the hearing I'm at.  They're on the second panel.  As the first panel was ending, a Committee member wanted to correct the impression that the Committee's website is not screen reader friendly.  He declared that Browsealoud is on the website.

That may be, I don't have time to check that.  Browsealoud is really geared towards dyslexics, not towards the blind or those with sight issues.

Veteran Terry Kebble pointed out that the programs more likely to be used by the blind were Freedom Scientific's JAWS Screen Reading.

The Committee is going to speak with the BVA witnesses after the hearing to better address this issue.

US House Rep Mark Takano noted that the information needs to be shared with the House and the Senate so that all the Congressional websites are serving the blind and sight challenged Americans.

And O'Rourke is asking questions right now in this morning's hearing, a sign that I need to get this up at the website.  And Ruth's "VA censors who appears before Congress" went up a little while ago, that's her report on last night's hearing.

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