Fiscal Year 2005 Performance and Accountability Report Published November 15, 2005
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Strategic Objective 3.1: Delivering Health Care
Provide high-quality, reliable, accessible, timely, and efficient health care that maximizes the health and functional status for all enrolled veterans, with special focus on veterans with service-connected conditions, those unable to defray the cost, and those statutorily eligible for care.
Performance Trends and Impact of FY 2005 Results
Performance Trend |
FY 2005 Impact |
Key Measure: Clinical Practice Guidelines Index
* Actual data through June 2005. Final data are not yet available. |
| |
2003 |
70% |
2004 |
77% |
2005 Result |
87%* |
2005 Plan |
77% |
2006 Plan |
77% |
Strategic Target |
80% |
|
The 2005 score of 87 percent significantly exceeded the target of 77 percent. The Clinical Practice Guidelines Index demonstrates the degree to which VHA provides evidence-based clinical interventions to veterans seeking care in VA. The measure covers elements of care that are known to have a positive impact on the health of our patients who suffer from commonly occurring acute and chronic illnesses. Providing these interventions has improved the overall health of these veterans. |
Key Measure: Prevention Index II
* Actual data through June 2005. Final data are not yet available. |
| |
2001 |
80% |
2002 |
82% |
2003 |
83% |
2004 |
88% |
2005 Result |
90%* |
2005 Plan |
88% |
2006 Plan |
88% |
Strategic Target |
88% |
|
The 2005 score of 90 percent exceeded the target of 88 percent. The Prevention Index II demonstrates the degree to which VHA provides evidence-based clinical interventions to veterans seeking preventive care in VA. The measure targets elements of preventive care that are known to have a positive impact on the health and well-being of our patients. Providing these interventions has improved the overall health of veterans by preventing conditions from developing. |
Key Measure: Percent of Primary Care Appointments Scheduled within 30 Days of Desired Date
* Actual data through June 2005. Final data are not yet available. |
| |
2001 |
87% |
2002 |
89% |
2003 |
93% |
2004 |
94% |
2005 Result |
97%* |
2005 Plan |
94% |
2006 Plan |
94% |
Strategic Target |
94% |
|
The 2005 attainment of 97 percent exceeded the target of 94 percent. This measure assesses the degree to which primary care appointments are scheduled in a timely manner. It takes into account the timeline that the patient has identified as meeting his or her need. It serves as a measure of timeliness as well as responsiveness to the patient's stated needs. Providing timely care has improved the overall health of veterans by quickly treating existing conditions and preventing conditions from developing. |
Key Measure: Percent of Specialty Care Appointments Scheduled within 30 Days of Desired Date
* Actual data through June 2005. Final data are not yet available. |
| |
2001 |
84% |
2002 |
86% |
2003 |
89% |
2004 |
93% |
2005 Result |
95%* |
2005 Plan |
93% |
2006 Plan |
93% |
Strategic Target |
93% |
|
The 2005 attainment of 95 percent exceeded the target of 93 percent. This measure was designed to assess the degree to which specialty care appointments are scheduled in a timely manner. It takes into account the timeline that the patient has identified as meeting his or her need. It serves as a measure of timeliness as well as responsiveness to the patient's stated needs. Providing timely care has improved the overall health of veterans by quickly treating existing conditions and preventing conditions from developing. |
Key Measure: Percent of Patients Rating VA Inpatient Service as Very Good or Excellent
* Actual data through June 2005. Final data are not yet available. |
| |
2001 |
64% |
2002 |
70% |
2003 |
74% |
2004 |
74% |
2005 Result |
77%* |
2005 Plan |
74% |
2006 Plan |
74% |
Strategic Target |
74% |
|
The 2005 achievement of 77 percent exceeded the target of 74 percent. VHA's continual assessment of patient satisfaction with inpatient treatment provides a valuable feedback mechanism on patient expectations and what dimensions of care concern veterans the most. This also enables VHA to identify its strengths and quickly address areas where patients are less satisfied. |
Key Measure: Percent of Patients Rating VA Outpatient Service as Very Good or Excellent
* Actual data through June 2005. Final data are not yet available. |
| |
2001 |
65% |
2002 |
71% |
2003 |
73% |
2004 |
72% |
2005 Result |
77%* |
2005 Plan |
73% |
2006 Plan |
73% |
Strategic Target |
73% |
|
The 2005 achievement of 77 percent exceeded the target of 73 percent. VHA's continual assessment of patient satisfaction with outpatient treatment provides a valuable feedback mechanism on patient expectations and what dimensions of care concern veterans the most. This enables VHA to identify its strengths and quickly address areas where patients are less satisfied. |
Key Measure: Non-institutional Long-Term Care as Expressed by Average Daily Census
* Actual data through June 2005. Final data are not yet available. |
| |
2002 |
24,126 |
2003 |
24,413 |
2004 |
25,523 |
2005 Result |
29,316* |
2005 Plan |
30,118 |
2006 Plan |
35,540 |
Strategic Target |
43,098 |
|
The 2005 attainment of 29,316 was below the target of 30,118. This measure quantifies the degree to which veterans have access to non-institutional care within VHA programs and/or contracted services. Non-institutional care has been deemed to be more desirable and cost efficient for those veterans who need this level of care. The measure drives both expansion of the variety of services and of geographic access, which benefits the veteran who then is able to live in the least restrictive setting possible. |
Related Information
Major Management Challenges
The following major management challenges have been identified for this strategic objective:
OIG
GAO
Program Evaluations
An independent evaluation of VA's cardiac care program was completed in 2003. The study found that heart patients treated at VA hospitals have consistently higher mortality rates than patients of similar age and in roughly similar health who are treated at non-VA institutions. A larger proportion of the veterans die in the first month after suffering a heart attack, and a larger proportion of the survivors die over the next 3 years. The program evaluation also found that VA patients undergo cardiac catheterization-a key step in assessing the seriousness of a person's heart disease-less often than patients treated in non-VA hospitals. In addition, they have only about one-half the likelihood of undergoing angioplasty or bypass surgery, two procedures that can often extend life.
A blue ribbon panel of national experts was commissioned to oversee the quality improvements for VA's cardiac care program. Changes that have been implemented include stricter adherence to national clinical guidelines, hiring more cardiologists, upgrading catheterization lab equipment, reconfiguring access to cardiac care (including expansion of community services), providing reimbursements for emergency care provided in non-VA settings, and conducting additional clinical research to discover the causal effects of VA's higher mortality statistics. All VA hospitals with cardiac care programs have provided detailed plans on how they intend to improve the quality of care at their facilities. VA's Strategic Management Council is monitoring compliance with the national action plan.
In January 2005 VA initiated an independent evaluation of its oncology program. The program evaluation focuses on lung, colorectal, prostate, hematologic, and breast cancers. The results of the program evaluation will help VA determine how well it is meeting the oncology program goals and objectives and will provide a comparison of how VA is performing compared to the private sector.
Program Assessment Rating Tool (PART) Evaluation
In relation to this strategic objective, the Administration conducted a PART evaluation of VA's Medical Care Program during 2003, which resulted in a rating of "Adequate." Please see Summary Table 3 for more information.
New Policies and Procedures
A new directive was issued for Documentation of Kinesiotherapy Services in Department of Veterans Affairs (VA) Nursing Home Care Units that does the following:
- Establishes policy for the documentation of Kinesiotherapy services including applicable treatment time and procedures within VA nursing home care units.
- Defines the interdisciplinary care process in short-term, goal-oriented rehabilitative care programs, formal restorative nursing programs, nursing home care units, and other long-term maintenance programs.
Other Important Results
- The 2005 attainment of 85 percent met the target for outpatient encounters that have electronic progress notes signed within 2 days.
- The 2005 achievement of 73 percent exceeded the target of 67 percent for patients who report being seen within 20 minutes of scheduled appointments at VA health care facilities.
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