Health

Mass. Veterans Medical Facilities Fare Well in VA Audit

Jamaica Plain, Massachusetts -- 05/06/2014-- Dr. Daniel Forman (L) takes the blood pressure of his patient, a 91 year old World War II veteran who did not wish to give his name, during a clinical trial with at the JP Campus of the VA Boston Health Care System in Jamaica Plain, Massachusetts May 6, 2014. Jessica Rinaldi/Globe Staff Topic: 12Trialsphoto02
Jamaica Plain, Massachusetts -- 05/06/2014-- Dr. Daniel Forman (L) takes the blood pressure of his patient, a 91 year old World War II veteran who did not wish to give his name, during a clinical trial with at the JP Campus of the VA Boston Health Care System in Jamaica Plain, Massachusetts May 6, 2014. Jessica Rinaldi/Globe StaffThe Boston Globe

On Monday, the Department of Veterans Affairs released their internal audit of health care facilities across the country in which they investigated some of the ongoing scheduling problems that have been highlighted in the recent scandal, all starting with the Pheonix Health Care facility where 18 veterans recently died in the area waiting for an appointment.

In Massachusetts, veterans medical facilities were some of the first to be investigated in the federal department’s audit. At VA hospitals and clinics in the state, fewer than 600 patients are waiting 90 days or more for appointments after requesting them, out of 57,000 patients across the country currently waiting for appointments. To summarize, Massachusetts is faring well with regard to wait times. The shortest wait time nationally was 12 days in Bedford, Mass. at the Edith Nourse Rogers Memorial Veterans Hospital. Honolulu, Hawaii had the longest wait at 145 days.

Two Massachusetts VA facilities however have been highlighted in the internal report as requiring further review because of qualitative responses from the staff during the investigation, according to the audit. The VA Central Western Massachusetts Healthcare System in Leeds and the VA Boston Healthcare System, Brockton Campus were cited in the audit as “Requiring Further Review.” The average wait time at VA Central Western Massachusetts HCS for a specialist is 67 days, which is the tenth longest wait nationally for this category.

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Here’s what that qualification means:

The listing of these sites should be understood as a preliminary step, and further actions will be taken after the determination of the extent of issues related to scheduling and access management practices.

So what’s a qualitative response?

According to the audit, a team of 14 coders from the VA reviewed scheduling practices during their site visits and coded employee responses about scheduling according to the following seven categories:

1. The date the patient wants to be seen is the desired appointment date.

2. The date the provider requests is the desired appointment date.

3. No veteran input sought, available date chosen as desired appointment date.

4. Veteran input routinely disregarded, available date entered as desired appointment date.

5. Desired appointment date changed after it’s been entered for non-clinical reason.

6. Scheduling practices influenced by threats or coercion.

7. Voicing concerns about scheduling met with punishment or retribution.

In Phase One of the audit, the veterans affares investigative team visited the Bedford facility on May 15, the Boston Jamaica Plain facility on May 16, Boston (West Roxbury) facility on May 12, Boston (Brockton) facility on May 13.

In Phase Two of the audit, the investigative team completed site visits at veterans facilities in the following locations: Fitchburg, Greenfield, Pittsfield, Lowell, Gloucester, Lynn, Causeway St. in Boston, Quincy, New Bedford, Oak Bluff, Hyannis, and Plymouth.

The full audit data is available on the Veterans Affair’s website.

Here’s how other New England states fared:

In White River Junction, Vt., 98 percent of patients who scheduled appointments at The Department of Veterans Affairs were seen within 30 days of their requests, but the audit found that 532 patients in Vermont and parts of New Hampshire waited more than a month for an appointment.

In Maine, the audit of the VA hospital in Augusta on May 14 found that 664 veterans had to wait more than a month for an appointment, but 99 percent of the doctor visits occurred in 30 days or less. New patients waited an average of 36 days for an appointment.

Rhode Island has one of the longest wait times in the country. Veterans wait an average of 72 days to schedule their first primary care appointment at The Providence VA Medical Center.

Material from the Associated Press was used in this report.

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