Adjustments Needed to Improve Qualified VA Nurse Staffing
A new study by the U.S. Government Accountability Office found the VA lacks adequate and qualified nurses.
- A new report from the U.S. Government Accountability Office (GAO) examined seven Department of Veterans Affairs medical centers (VAMC). It examined the Veterans Health Administration’s (VHA) nurse staffing methodology and found that it experienced problems developing and executing the related nurse staffing plans and some reported improvements in nurse staffing. GAO conducted the study because there have been questions raised in the past about the adequacy and qualifications of VHA’s nurse staffing.
The report found that each of the VAMCs reviewed in the report have developed a facility-wide staffing plan, which outlines initiatives needed to ensure appropriate unit-level nurse staffing and skill mix and takes the steps to execute them. However, these plans are creating problems which includes a lack of data resources and training difficulties in both the development and execution of staffing plans. While some VAMCs reported improvements in the qualifications of their units nurses, other stated that the staffing remained inadequate and that nurse unit assignments and the job duties were not always appropriate for their qualifications.
It was discovered that VHA’s oversight of the staffing process and methodology is limited when it comes to ensuring implementation and administration is handled properly. Without proper controls, the VHA is unable to fully meet department goals, like creating a standardized staffing methodology for determining an adequate and qualified nurse workforce at VAMCs that can meet increasingly complex healthcare needs. There are several areas where VHA is limited in its oversight process. These include:
Environment assessment – VHA did not comprehensively assess each VAMC to ensure preparedness for implementing the methodology, including having the necessary technical support and resources, prior to the issuance of the directive requiring each VAMC to implement the methodology.
Monitoring compliance – There is no official plan in place to monitor VAMC compliance with the methodology.
Evaluation – There is only limited evaluations conducted of the methodology and at least one evaluation has been significantly delayed.
Timeliness of communication – The protracted timeline for communicating methodology-related information may have hindered the ability of VAMCs to appropriately develop their staffing plans and to execute the initiatives contained in those plans.
Organizational accountability – There is no defined areas of responsibility or appropriate established line of reporting within VA’s management structure for oversight of the implementation and ongoing administration of the methodology.
The U.S. Government Accountability Office had several recommendations for what the VA needs to do in order to rectify these problems. These include assessing VAMC’s ability to implement the methodology; monitor VAMC’s ongoing compliance with the methodology; complete timely evaluations; improve the timeliness of communication with VAMC; and define areas of responsibility and reporting within VA’s management structure. The VA concurred with the recommendations.
