Hiring and keeping qualified nurses and physicians remain a persistent challenge among VA health-care facilities across the country, according to findings reported in the newly released 2018 System Worth Saving report by The American Legion’s Veterans Affairs & Rehabilitation Commission.
“VA must address labor shortages that have left the department understaffed and created patient access and benefit issues,” American Legion National Commander Denise H. Rohan stated in the introduction of the report. The report identifies challenges and The American Legion’s recommendations on how to address them, along with best practices at 11 VA facilities nationwide. VA’s ability to properly recruit physicians and nurses at its health-care facilities was a top priority when the national commander testified before Congress last February.
Moreover, the report recommends that VA implement more efficient “onboarding processes” so that candidates can begin caring for patients sooner rather than risk defection to another employer. Competition with other medical facilities – who are also recruiting doctors and nurses amid a nationwide shortage – makes it difficult for VA to avoid losing prospective medical and nursing talent, due to red tape. Additionally, the 2018 SWS report recommends VA and Congress explore enhanced education debt relief as at least one incentive for doctors and nurses, especially in underserved rural areas.
The Memphis VA Medical Center reported 396 open positions, with every department facing shortages of personnel, during the Jan. 9-11, 2018, SWS site visit. The medical center also reported a best practice in the area of VA staff taking the lead in assistance and support for veterans using the Choice program (use of community providers when wait times are too long in the VA system, or distance to the facility is too great).
The VA Eastern Colorado Health Care System reported 816 unfilled positions – a 24 percent vacancy rate – raising concerns about adequate staffing of a new VA medical center opening in Aurora this summer. Meanwhile, the Denver-area system has made substantial strides in the provision of women’s health services, including a “maternity coordinator within the women veterans program responsible for organizing expectant mothers’ care inside and outside the health-care system.”
Ralph Bozella, chairman of the Legion’s national Veterans Affairs & Rehabilitation Commission, explained in the executive summary of the report that adequate staffing is not the only problem VA and The American Legion are working together to solve. “As The American Legion travels across the country to VA health-care facilities in urban and rural areas, in addition to the lengthy (human resources) onboarding processes, we continue to see space constraints and failures of the Choice program, including the absence of timely payment of services, scheduling challenges and lack of patients’ medical records transference.”
Yet, many facilities reported strides in such areas as alternative treatment programs for post-traumatic stress disorder and traumatic brain injury and in women’s health care.
The report, which helps shape American Legion policy and legislative testimony, is shared with members of Congress, the White House, and the Department of Veteran Affairs.
The American Legion System Worth Saving site visits in the report include facilities at Saginaw, Mich.; Iowa City, Iowa; Milwaukee; Columbus, Ohio; Ft. Harrison, Mont.; Manchester, N.H.; Memphis; Muskogee, Okla.; Denver; Little Rock, Ark.; and Durham, N.C., with one special-purpose visit to the Lee County VA Health Care Center in Cape Coral, Fla.
Closely aligned with SWS inquiries have been seven American Legion Regional Office Action Review (ROAR) visits in 2017 and 2018.
Ten more SWS and seven more ROAR visits have been planned for the months ahead.