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.
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