Tue August 26, 2014
VA Deputy Secretary On Wait Times: 'We Owe The American People An Apology'
Originally published on Tue August 26, 2014 8:07 pm
MELISSA BLOCK, HOST:
For more on the VA Inspector General's report and the department's response, I am joined now by the Deputy Secretary of Veterans Affairs, Sloan Gibson. Welcome to the program.
SLOAN GIBSON: Melissa, thank you very much. It's good to be here.
BLOCK: Let's start with that conclusion. The reports says it cannot conclusively prove that the absence of timely quality care caused the deaths of these veterans. But even so, it's quite clear that a wait time of seven - eight months for an appointment presented health and safety risks for these patients. Do you acknowledge that the conclusion here is that this shows a widespread failure of care within the VA?
GIBSON: Absolutely, yes. I would say on the one hand I'm relieved that they did not conclude that the delays caused deaths, but they're still unexcusable - inexcusable. We owe our veterans there and around the country, and we owe the American people an apology.
BLOCK: Well, apart from an apology, I want to ask about what action might be taken...
BLOCK: ...Because this of course is not a new problem. The report today says there have been 20 reports on wait times and access to care within the VA since 2005. Here's a quote from the report - "VA has been resistant to change." So why should veterans expect anything to be different now?
GIBSON: Well, I think what veterans should be doing is watching our actions. What you have a new leaders inside the organization. What you've got is an environment of openness and transparency that's being created. We're pushing detailed wait time information out the door twice a month - detailed care quality and patient safety information out the door. So I think what we're trying to do is to - is to be very open and very transparent and demonstrate accountability, but at the end of the day we have to earn that trust back.
BLOCK: When you think about the - the existing system - part of the problem has been with these long wait times - that the VA has not enough doctors, especially in primary care. Under the new reform bill, there is now billions of dollars to spend on private care outside the VA system. Do you see that as a long-term fix, as opposed to bringing more doctors within the VA itself?
GIBSON: I think purchase care is design for extraordinary demand, extraordinary technology or extraordinary geography. But it's not intended to be replacement for a strong and vital and effective veterans healthcare system. In my testimony both to the Senate and to the House, I noted that I thought the greatest risk in the intermediate term was that funding would only be provided to provide more care -to deliver more care in the community and not to make up for the shortfall in clinicians you've mentioned, as well as in space. We - oftentimes when I'm out visiting medical centers, I find that spaces is one of the key constraints for access to care.
BLOCK: When you think about benchmarks for success - you've talked about earning back the trust of veterans - what metrics do you use for that? I mean, when you think about the original 14 day for appointments that led to this whole system of lying about wait times to meet that goal - what's your new measure of success and how do you ensure it doesn't backfire?
GIBSON: Well, I think what we will - we will work towards - we are already building much more robust, continuous measures of patient satisfaction - veteran satisfaction. And I think that becomes the single most important set of metrics that we use to gauge our - our success by. It's - it's the success as viewed from the veteran's perspective.
BLOCK: Is there some benchmark for an appropriate wait time that you have in mind that would tell you we are - we are hitting our target here, we are - we are where we need to be?
GIBSON: Well, one of the things that I've learned - I'm now six months at the VA - one of the things I've learned is - is you won't find a large, integrated healthcare systems are using a single wait time metric as the basis for judging access to care, because there's no clinical relevance for a single wait time. For some veterans that need to be seen today - even the old 14-day standard failed miserably. And so basically that's why I think we get back to looking at - at veteran satisfaction and patient satisfaction. So that - so that we are asking the veteran - did we see you timely? Were you able to get that that appointment scheduled when you wanted to be seen? And so for the veteran that doesn't need to be seen - doesn't care about being seen in three or four weeks - that's fine. For the veteran that needs to be seen today, we see that veteran today.
BLOCK: Sloan Gibson is the Deputy Secretary of Veterans Affairs. Thanks for being with us.
GIBSON: Thank you very much, Melissa. Thanks for the opportunity. Transcript provided by NPR, Copyright NPR.