BUSINESS PLAN Review

Veteran Health Administration (VHA) is the largest integrated healthcare system in America. It offers a variety of care services with nine million enrolled Veterans each year, 1063 outpatient sites providing care of varying complexity and 170 medical centers (Griffin, 2015). VHA offers healthcare to meet the requirements of the U.S armed services. The organization offers eligible veterans with medical care that includes inpatient care, behavioral health, outpatient clinics and community living centers. It also offers training for the various categories of medical professionals.

Remember you are writing this for the leadership team. They know all about the organization so only give information that is relevant to your plan.

This project aims at ensuring that all veterans in all veterans’ hospitals receive timely medication through the reduction of wait time before the veterans can receive care. There have been criticisms towards the organization concerning the systems delays in treatment where veterans have died as they await treatment (Griffin, 2015). Therefore, the project will mainly focus on the weaknesses analyzed and by solving them the veterans will have timely access to medical care

This is confusing. Keep it simple. Are you wanting decrease the wait time for medications or the wait times to receive care? Be very specific. I want to decrease the wait time to receive care.

Keys to Success

Increasing medical care professionals will reduce the workload on the current professionals. This will ensure that the ratio of professionals to veterans is effective and workable to enhance easy access to quality care. Patient’s information will be handled with care and put in computerized storage where the managers will be required to ensure that it has been validated to enhance adequacy and availability of patient’s information. Another key to success will be through holding all the healthcare professionals accountable and responsible in processing the needs of veterans in a timely manner (Institute For Health Care Improvement, 2018). Proper management of resources especially in the training services will put the organization in a better position in ensuring smooth running of activities and improvement in credibility.

VAH has dramatically reduced the waiting times for veterans since 1999 and the average system appointments waiting times have been on the decline. According to Institute for Healthcare Improvement (2018), the national waiting time in primary care has dropped by 53% from approximately 60 days to 28 days. Teams from 134 sites were enrolled in an IHI Collaborative in order to learn strategies that could be implemented to reduce the waiting times and through the implementation of advanced clinical access principles, appointment average wait time in the clinics dropped to 54% in 1999. The improvement was significant in the system with 21 Veterans Integrated Service Networks and other numerous locations. However, enhancing the success in the whole VAH system posed a significant challenge (Institute For Health Care Improvement, 2018)

Figure 1: Total Number of Veterans Waiting

Source: Institute for Healthcare Improvement

The graph indicates reduction in Veterans waiting time trend and an approximate of 15% of the whole project an indication that there is a long way to go. Backlog has been an issue at the VAH and in a research conducted by Department of Veterans Affairs Office of Inspector General (2018) the absence of data before October 2014 challenges the determination of when the backlog period began. The system managers had not been verifying the release of information data as staff reported that backlog existed even before the October 2014. An analysis conducted between October 2014 and February 2017 for the systems combined 1st and 3rdparty requests backlog data indicated that backlog peaked in April 2016 with 3423.

Table 1: Combined First- and Third-party Requests Backlog

Source: VA OIG analysis of facility-reported data *Partial quarterly facility

Data was provided in response to OIG update request.

Q2 2016 FY from the table above indicated highest backlog requests by first party and also highest backlog by third party requests and from the research findings the table indicates the trend of backlogs challenges affecting the VAH system and thus the managers need to actively address the release of information backlog (Department of Veterans Affairs, 2018).

VAH beneficiary population is of veterans who actively served in the military service or those who are discharged for various reasons other than being dishonorable. The market analysis will mainly focus on the demographics, the target market, market needs, and trends in the market, market growth and competitive advantage.

The beneficiaries of VAH typically consists of demographic, geographical and behavior factors.

Demographic factors

-Population of veterans is mainly comprised of males

-Veterans population is estimated to decline by the current projections

-In the next two decades, the female population from the currents trends indicates significant increase and also a rise in the percentage of minorities.

Figure 2: Projected veteran population 17 years and older: 2000 -2036 Source: Department of Veteran Affairs

Figure 3: Projected Female Veteran Population17 years and older: 2000-2036

Source: Department of Veteran Affairs

Figure 4: Projected Minority Veteran Population 17 years and older: 2000-2036

Target market

The main target market will consist of the aging veterans in the areas where there are VAH facilities and also target on more enrollments of female beneficiaries.

The specific market needs that have been identified include optimum accessibility to medical care with reduced wait time and at the same time ensuring quality care, improving the patient- record system by the staff and the management to enhance the effectiveness of the electronic health record system and finally ensuring patients satisfaction with the treatment and other services offered in the VAH facilities. Advancements in technology and the necessity to control the increasing healthcare costs and therefore these trends have resulted in VHA to take and continue taking measure to enhance organizational transformation (Department of Veterans Affairs, 2018).

Generally, the veteran population is expected to be on the decrease for the next few decades and therefore targeting a lot of veterans now into the beneficiary lot of VHA will be of importance to transform the organization. It is therefore important to enhance patient experience by improving on the weaknesses and reduce medical care delays and enhance the quality of care offered. VHA is the largest integrated healthcare system in the United States with veterans as the unique consumer base. The organization has made a national impact through medical research, training professionals in healthcare and offering assistance to homeless veterans among others (U.S Department of Veterans Affairs, 2018). However, the private healthcare market has less variation in quality, quicker healthcare access and adapts easily to the changing environment in healthcare. On the other hand, the bureaucracy in VHA is cumbersome, slower healthcare access

VHA is dedicated to offer excellent services to the veterans who courageously defended the nation. The goals are therefore a description of what the Veterans expect from VAH. The goals will, therefore, be to offer easy access, variety of choices and clear information relevant to enable veterans make informed decisions. Ensuring that veterans receive integrated care that is timely and ensuring that the organization is accountable and transparent in all its dealings to gain the veterans trust (U.S Department of Veterans Affairs, 2018). By focusing more efficiently on resources and modernizing systems will ensure its competitive advantage and provide veterans and employees with world-class capabilities.

The expected outcomes are that the veteran well-being will be enhanced through the collaborative aspect and delivery networks that are integrated. Accountability will be enhanced and therefore patients will be offered utmost care to reduce the rising levels of mortality rate within the system. Another major anticipated outcome will be ensuring that veterans are satisfactorily served and reduce lengthy periods before they can access healthcare. The veterans who are at risk will experience reduction in the rates of poverty, homelessness, and suicide. Improved credibility will result in veterans understanding the organizations care, benefits and services where they can avail themselves (U.S Department of Veterans Affairs, 2018)

Veterans Administration Health Management Summary

Figure 5: Veterans Organizational chart

Source: Department of Veterans Affairs

The above chart indicates the type of organization in the Veteran administration system. The management team is at the top with a hierarchical form of organization. Re-organization will be relevant to ensure managers are effective and accountable. Existing management gaps require to be filled with effective and efficient managers to ensure that the veterans are satisfied with the leadership flow and the services obtained.

Contracts such as Veterans Affairs Patient-Centered community care are relevant as they enable the Veterans to access healthcare services by ensuring availability of quality care network provider near to the veteran’s home. Alliances with other healthcare providers are encouraged to improve veteran’s healthcare services (Wpsic.com, 2016).

The organization is determined to recruit, develop and also maintain a diverse workforce that will offer the veterans and their families’ quality care and attention. This plan is focused to ensure that the current and the new additional workforce will improve the processes of the business through proper alignment to the strategic plan, enhance a result-oriented performance culture with increased accountability. Effectiveness and efficiency will be enhanced through offering adequate training to the workforce while the available resources will be managed appropriately.

What will your plan cost?

Guided by the financial position for the fiscal year 2015 1nd 2016 where the total liabilities increased by $3m from 2015. The net position in the FY 2016 decreased by $9m and the funds net cost experienced a net loss of $24m. In the fiscal year 2017, the net position is higher than that of 2016 (Department of Veterans Affairs-FY2017, 2017). Implementation of the financial plan will result in higher projections for the FY 2018 as compared to FY2017 to enhance affordable veteran’s services and profitability.

Figure 6: Consolidated Financial Statements

Source: Department of Veterans Affairs FY-2016

The desired changes in reduction of wait time for veterans will be implemented nationwide in all facilities to ensure a wider reach. Professional staff will be recruited from the organizations training points and other national institutes for an estimated period of four years where employee development will be key to ensure quality care and other services to the veterans. Electronic health record system will be monitored for a period of two years to ensure availability and consistency of patient’s data. Financial reporting will also be enhanced on quarterly basis to ensure proper usage and credibility.

U.S Department of Veterans Affairs. (2017). Partners and Stakeholders. Retrieved 02 28, 2018, from Office of Health Equity: https://www.va.gov/HEALTHEQUITY/Partners_Stakeholders.asp

Chinman, M. O. (2015). A cluster randomized trial of adding peer specialists to intensive case- management teams in the Veterans Health Administration. The journal of behavioral- health services & research, 42(1), 109-121.

Department of Veterans Affairs. (2018). Healthcare Inspection: Delays in Processing Release of Information requests by Pines VA Healthcare SystemBay Pines, Florida. Florida Office of the Inspector General.

Department of Veterans Affairs-FY2017. (2017). Financial Section. https://www.va.gov/finance/docs/afr/2017VAafrSectionII.pdf.

Griffin, S. B. (2015). A fatal wait: Veterans languish and die on a VA hospital's secret list. Retrieved 02 27, 2018, from CNN Investigations: https://edition.cnn.com/2014/04/23/health/veterans-dying-health-care-delays/

Institute For Health Care Improvement. (2018). Reducing Waiting Times: Veterans Health Administration. Retrieved 02 27, 2018, from Institute For Health Care Improvement: http://www.ihi.org/resources/Pages/ImprovementStories/.aspx

Nelson, K. M. (2014). Implementation of the patient-centered medical home in the Veterans Health Administration: associations with patient satisfaction, quality of care, burnout, and hospital and emergency department use. JAMA internal medicine, 174(8), 1350-1358.

Siu, A. L.-D. (2016). Screening for depression in adults: US Preventive Services Task Force- recommendation statement. Jama, 315(4), 380-387.

Thompson, R. (2016). Stakeholder Analysis. Retrieved 02 28, 2018, from MindTools.com: https://www.mindtools.com/pages/article/newPPM_07.htm#Interactive

U.S Department of Veterans Affairs. (2018). Department of Veterans Affairs FY 2018-2024 Strategic Plan.

Wpsic.com. (2016). Veteran's Affairs Patient-Centered Community Care. Retrieved 27 27, 2018 from Millitary and Veterans Health: www.wpsic.com/edi/edi-news/wps-department-of- veterans-affairs-program.shtml

you have excellent information, but this sounds more like a paper for class than a quality project you are proposing. I think you can easily turn this into your business plan. You mentioned several goals, ideas, etc. Stick to one. Once you write your goal which should say something like, “Our goal is to decrease the wait times to get an appointment in my clinic from 50 days to 28 days” Now go back and rewrite your paper with that in mind. You can change the goal, but I was just giving you an example of keeping it simple and focused. Be sure to read the Final Business Plan I posted and use the headings that I listed in the outline. You will be writing it in paragraph format and you can use charts, tables etc. if you like. If you have any questions, please let me know.