WASHINGTON (AP) — Here are highlights from an internal audit by the Department of Veterans Affairs that was ordered by Eric Shinseki, who resigned Friday as head of the agency:
— Meeting a 14-day wait-time target "for new appointments was simply not attainable" given the number of medical workers and growing patient demand.
—Imposing this expectation out in the field without determining what resources would be needed represents "an organizational leadership failure."
—The target also created an overly complicated scheduling process in which schedulers "in some cases" were pressured to make wait times seem better than they were.
— 13 percent of the scheduling staffers interviewed for the audit said they were instructed to enter a different desired appointment date than the one requested by the veteran, a practice that then concealed the real waiting time. But it said there could have been instances where such an entry was appropriate, as when a doctor overrode the date specified by a patient.
—7 percent to 8 percent of scheduling staff interviewed indicated they had used alternate lists to log appointments instead of the department's electronic wait list, as required.
—Interviews with front-line VA staffers found that the most common problem cited was lack of appointment slots for health care providers. It also indicated that the 14-day standard may be too rigid, noting that veterans might have been satisfied with negotiated appointments outside the 14-day window.
—Officials are now removing the 14-day target for performance contracts and this year are suspending executive bonuses that are tied to waiting times.
—Officials are writing new scheduling directives to employees.
—Officials need to compare the capacity to deliver services against health care demands to make sure there are adequate resources.
—Accountability for integrity in scheduling should be strengthened with renewed training and coaching of employees.