Seven years ago, the Veterans Health Administration (VHA) partnered with VA’s Veterans Experience Office (VEO) to create a standardized patient experience for all Veterans receiving health care at medical centers and outpatient sites of care. This focus was further emphasized after the 2017 Journal of the American Medical Association (JAMA) article showcased the excellent clinical care delivered at VA but highlighted the need for patient experience improvements. According to the article, “VA hospitals performed better than non-VA hospitals for most outcome measures, but VA hospitals performed worse on certain patient experience measures and behavioral health measures” (JAMA Internal Medicine, June 2017).
So, what did we do? We created “The VA Way” and embarked on a six-year journey to improve the culture at VA by focusing on the moments that matter to our customers and employees, building solutions for pain points, and developing mechanisms to highlight and recognize great experiences. We analyzed data from VSignals electronic surveys, measuring trust and moments that mattered.
The VA Way is the department’s customer experience (CX) formula that connects all VA employees to our I CARE values. I CARE Values + OTM principles + WECARE behavior and SALUTE recovery all together capture our shared purpose “to care for those who have served in our nation’s military and for their families, caregivers and survivors,” and that is the VA Way.
At its core, I CARE values hold all employees accountable for integrity, commitment, advocacy, respect and excellence. But how does an employee put these values into action? The guiding principles of VA’s Own the Moment CX employee training helped highlight the actions we expect each employee to deliver. Connect and care, understand and respond to the Veteran’s needs and guide their journey through our VA system. Set the goal to make things easy, effective and emotionally resonate so that Veterans feel valued and honored for their service and sacrifice, and ultimately trust VA to fulfill our country’s commitment to Veterans. In addition to our guiding principles, we expect that all employees will deliver WECARE behaviors to every Veteran at every encounter: welcome, explain your role, connect with the Veteran, actively listen, respond to the need and express gratitude. In the unfortunate instance where we may not deliver exceptional experiences, we then apply SALUTE to apologize and provide service recovery. SALUTE is Saying hello, apologizing, listening to the concerns, understanding their needs, taking action and expressing gratitude.
Over the past several years, VEO and VHA have worked tirelessly to train all VHA employees (almost 400,000 individuals) on the VA Way. Together with VHA leadership, providing a focus on experience and stressing its importance, the Choose VA initiatives, innovations from across the field, a system-wide focus on improving diversity, equity, and inclusion (DE&I), a focus on whole health and wellness, and the discipline of a high reliability organization (HRO), we have created something very special at VA.
Has all this dedication and training paid off? Let the numbers speak for themselves. VA’s trust has improved from 47% to 79% over the past six years. VHA’s trust hit an all-time high of 91% during the COVID pandemic. With the latest Hospital Consumer Assessment of Healthcare Providers & Systems (HCAHPS) patient experience scores from the Centers for Medicare & Medicaid Services (CMS), it is clear that VA is not only the best in the country at providing an excellent patient experience, but we are also outpacing the private sector. As a result, we now have more facilities rated four and five stars than the private sector. We are compared to more than 3,000 hospital systems across the country, which is no small feat. As for employees, employee satisfaction is at its highest in years. Employees regard VA as one of the best places to work in the federal government.
In keeping with our motto, “How we treat Veterans today is the reason they Choose VA tomorrow,” we focus on the whole person through whole health and being a high reliable organization. When asked what VA is doing differently, we respond, it’s the VA Way!
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The Syracuse NY urology team didn’t get the memo. On 4/3/23 I had a cystoscopy at Syracuse. My urologist (Dr.Ferry) allowed an unintroduced resident (Alexander Chartier) to do my procedure. I was told to drop my pants and underwear, lift my shirt and lay on the bed. I asked for a gown and it was refused. I laid there for several minutes exposed before being prepped and having 2% lidocaine administered. I was left exposed for the waiting period too. I was covered with a hand towel very briefly just before the procedure began. The resident removed the towel for the procedure but never replaced it on competition. Immediately the doctor and the resident left the room so quickly they left the door open to the hallway leaving me exposed to anybody walking by. I was left with uncontrollable shaking, still exposed and without any word or care from the staff. My lidocaine was spilled and was essentially worthless for pain. I had excruciating pain during the entire procedure that got worse with each passing minute until the scope was finally removed very abruptly. So abruptly as to cause pain and bleeding for 5 days. The 5th day I passed blood clots and had to go to the ER. Of the 25 minutes in that room I was exposed for 20 minutes unnecessarily. I later found out from Hospital Management that it is common not to give men a drape or gown for privacy, but it was procedure to give a drape or gown to female patients. That was the policy for years as stated by the Chief of Urology (Dr.Imad Nsouli). I brought all this up to Hospital Management and they told me changes would be made but nothing happened to any staff members. For all I know this practice continues today because nobody would show me the changes they said took place. Deputy Chief of Staff (Dr.Pflanz) was helpful to some extent but delayed me the repeated promise for weeks of a meeting with Urology to discuss what happened that day and why. This treatment by Urology was so traumatic to me that I am now seeking and getting help at the mental health clinic to help me deal with the effects of what they all did to me. I would like to know how people like this remain employed at the Syracuse VA Hospital. It seems as though these people can do anything, write in the notes that they did everything right and nobody ever knows the truth until a patient complains. My records were written as though nothing happened that day out of the ordinary and even included false information. My trust in the VA has diminished significantly because of this event and the way Hospital management handled it. Somebody should expose these people and do something about it but I’m betting nothing will ever come of it. The good old boy network of covering everybody’s butt continues from what I’ve experienced, and veterans that were treated there got treated like a piece of meat. We all had our privacy violated and our dignity taken away because of the actions of those in that urology department. I have moved my urology care outside of the VA.
At the Durham NC VA a veteran is subject to any person who wants to can get into the veterans records. In other words there is no doctor patient confidentiality. The police are there to protect the staff and harass the patients. You can not get false information removed from your records. The patient advocate will not answer your calls. Sexual harassment is approved by the administration. I have not seen in the ten years or so of going to this VA any improvement in the way the veteran is treated in a positive way.
V.A. medical patient care (respect, kindness) is hit and miss, you have to always be on your guard for the stupid way some of these people act including security..as a Man of color, the partiality, double standard is blatant… with white people they are treated right, black men once again it’s hit or miss..and too many black men and women working there act stupid also
The VA experience should include a feed back from the veteran. The culture is still wait. How can a civilian chiropractor get you in the week. The VA has a two month waiting list. If tramadol is no longer treatment for pain and chiropractic medicine is the only answer to pain, my question is why not several chiropractors. Just the cost savings of not providing tramadol should allow the hiring of more. But the culture of just wait we are very busy remains. I heard the VA was awarded billions more in budget, but the veteran waits, you have no recourse, no complaint boxes, and surveys like this just extract good numbers to present. Figures lie and liars figures.
Tramadol is an unusual pain med for me and have never had it prescribed by the VA-only the Army(Now, my VA provider does not prescribe pain meds at all). Too many side effects, to long a period for it to kick in and very short lasting. For kidney stones and when my back locks up, it is useless. Suggest you talk with your provider about a different pain med.