One thing that Thomas Lynch has learned is that “change requires a burning platform. I don’t think that anybody would disagree that we have a burning platform” at the Department of Veterans Affairs, and “I think we have a compelling case for change in the VA.”
Lynch, assistant deputy under secretary for health for clinical operations at the Veterans Health Administration, was a guest speaker at an Aug. 23 health-care panel, “Restoring Veterans Trust,” conducted by The American Legion’s Veterans Affairs & Rehabilitation Commission during the organization’s 96th annual national convention in Charlotte, N.C.
“I want to clearly acknowledge that we have problems,” said Lynch to a roomful of Legionnaires. “And I want to talk a little bit about why the VA is a system worth saving – your words as well as mine.”
With more the 65 million health-care appointments per year and more than 25 million requests for consultation, Lynch said the health care VA delivers to about 6.5 million veterans “has been recognized as being good-quality care … but the problem is it’s taking veterans too long to get that care.”
In addition, Lynch said, VA has a scheduling system that is “antiquated and cumbersome,” and it has metrics “that have been misused. Our metrics, our performance measures, became goals. We lost sight of what was our primary goal, which is treating veterans, providing quality care to veterans, and we began focusing on indicators: How quickly can we see somebody? How many people are on the wait list? Our focus and our goals were lost.”
One thing the current crisis has made very clear, Lynch said, is that “we can’t do it alone in VA. We have to work with partners … We have to work with The American Legion, (which has) already stepped up, has already stepped forward. They have, for a long time, been running their System Worth Saving (SWS) process and reviews.”
Lynch worked with several teams from the Legion’s SWS program when he was in Omaha, Neb., and found it to be a positive experience with good feedback. “We have to be careful that we do use that feedback. It’s where we got in trouble before," he said. "We looked at our numbers, we said, ‘Gosh! Aren’t we a good system?' But we weren’t listening to the other side of the story, the people that were telling us, ‘We can’t get to that care.’”
After the VA scandal broke, the department conducted a system-wide access audit that revealed, according to Lynch, an “overly complicated scheduling process” and that the 14-day target goal for appointment wait times at VA facilities “was not attainable, we did not have the resources to get there and it represented an organizational failure,” Lynch said.
That audit, Lynch said, showed that 13 percent of VA’s scheduling staff received instructions to enter incorrect information into their systems and 8 percent were not using electronic wait lists appropriately. Since then, VA has been focusing on increasing its capacity to see veterans.
In the meantime, until VA can expand its access capacity, “we have to provide services,” Lynch said. VA has started an initiative to accelerate the delivery of medical care. “We have reached out to over 240,000 veterans, we’ve given 26,000 veterans accelerated appointments (and) the number of non-VA care appointments has increased by 43 percent since May of this year.
“We are working hard to eliminate our backlog. We’re doing that by increasing our own efficiency and by using private-sector resources when it’s appropriate.”
Fernando Rivera, director of VA Veterans Integrated Service Network 5, recognized The American Legion’s contribution in helping veterans and family members with its Veterans Crisis Command Centers (VCCCs).
“We hosted one (VCCC) in Baltimore,” Rivera said. “Our approach was to have every medical center director and myself at the (Legion’s) town hall meeting. Our approach was to have representation from every one of our medical centers, throughout the entire week at the crisis center.”
Rivera said that 60 VA employees from VISN 5 supported the Legion’s VCCC in Baltimore. “It’s all about partnering, it’s all about working together," he said. "We could not open our doors without your support, without your advocacy. Everybody understands that – your advocacy is critical.”