59-day wait for new local VA patients, audit shows

Staff writerJune 9, 2014 

Officials with the VA say complaints of long lines and waiting times for appointments at the Seattle (pictured) and American Lake VA hospitals is emblematic of the challenges they face.

DEAN J. KOEPFLER — Staff photographer

New patients seeking care at Puget Sound veterans hospitals wait an average of 59 days for an appointment ­— more than four times longer than the VA’s performance goal of 14 days, according to a national VA audit published Monday.

 But established patients fare better, usually getting an appointment in six days.

The VA released the report amid a national scandal that emerged from reports of staff in Phoenix covering up delays by falsifying records on patient wait times. Veteran Affairs Secretary Eric Shinseki resigned May 30 in the scandal’s fallout.

So far, VA Puget Sound, with hospitals in Lakewood and Seattle, has not been linked to fabricated wait-time reports.

The new audit does say those hospitals’ scheduling practices should receive “further review.” But that does not necessarily signal wrongdoing because auditors called for another look at nearly every VA hospital in the country.

“VA Puget Sound administrators were unaware, until the report was released, that it had been selected for additional review,” Puget Sound VA spokesman Chad Hutson said in an email Monday.

Nationally, 13 percent of VA schedulers were reportedly told by supervisors to manipulate appointment schedules to make patient waits appear shorter.

Meanwhile, reams of new data released Monday in coordination with the wait-time audit shows the local system’s challenges in coping with patient growth. VA Puget Sound expects to care for roughly 100,000 patients this year, nearly double the number from 2000.

Just 36 percent of new patients calling the VA Puget Sound are able to get appointments within two weeks of making a request, according to the data. Top-performing hospitals in the system are able to meet that 14-day standard for 66 percent of new patients.

The local hospitals were much better at getting established patients in the door to see doctors: a six-day wait, on average.

In the performance rankings for the first three months of 2014, VA Puget Sound scored high marks in some areas. It was among the best in the country at connecting new patients with mental health resources in a timely manner. It’s also far ahead in preventing Methicillin-resistant Staphylococcus aureus (MRS) infections.

But it ranked poorly in performance measures such as:

  • Turnover among registered nurses.
  • Patient survival following acute care.
  • Pneumonia cases for patients receiving mechanical ventilation.
  • Urinary tract infections linked to catheters.

In addition, VA Puget Sound’s call center was backlogged. Call center staffers dropped 15 percent of their calls, compared to the VA standard of no more than 4 percent.

VA Puget Sound’s call center also was slow in picking up the phone. It took staffers an average of 195.6 seconds to respond to calls; the VA goal is 25.3 seconds.

The call center has been a crunch point for VA hospitals in the Northwest for more than a year. Last summer, VA Northwest Chief Medical Director Frank Marre wrote in a newsletter that call centers under his department had the third-worst performance rate in the system.

“This is no small problem,” Marre wrote, noting that veterans of all generations expect reliable customer service.

Marre’s letter also cited problems with pneumonia and other illnesses that should not lead to hospital stays.

“Ideally, a patient with pneumonia should get better with good treatment and not need to go to the hospital,” he wrote.

The VA Puget Sound gave The Daily Olympianperformance measures on patient wait times that showed delays declining for primary care visits as the Seattle and Lakewood hospitals filled staff vacancies this year.

The numbers, included in a May 25 story in the newspaper, showed the local hospitals scheduled primary care appointments within two weeks about 98 percent of the time -- just short of the national goal of 99 percent. Those numbers were bi-weekly snapshots collected over several months ending in March. 

The performance rankings published Monday looked at the first three months of 2014, and found that 80 percent of Puget Sound patients received primary care visits within two weeks of a call.

Hutson on Monday could not explain the disparity between the two sets of numbers.

The VA hospital in Portland has the longest average wait for an appointment. New patients there wait 80 days.

Smaller facilities in Anchorage, Boise and Spokane reported average waits of less than 30 days for new patients.

The VA’s national audit called the system’s goal of scheduling appointments within two weeks of a request “simply not attainable” for a health agency swelling with new patients from the the Iraq and Afghanistan era, mixed with older generations of veterans. 

It called the 2011 decision by senior VA officials to set the target, and then give bonuses to staffers who meet it, “an organizational leadership failure.”

In the 1990s, the VA’s wait time standard was 30 days. If that standard were still in place, the reports released this week showed VA Puget Sound would have met it 95 percent of the time. 

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