Veterans Affairs Hospital Utilization Management Program

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Introduction

Health facilities are expected to offer high quality services which is affordable to the target market; with this notion in mind, Veterans Affairs Hospital has adopted a Utilization Management program to continually improve its health service quality. Patients’ safety is a fundamental in health care industry; according to World Health Organization, medical practitioners need to enact policies that ensure quality and safety is maintained in health facilities (Amalberti, Auroy, Berwick & Barach, 2005). This paper analysis Veterans Affairs Hospital Utilization Management program and offers recommendations on areas that the company can improve to ensure that quality is improved.

Utilization Management program

The policy by the company seeks to improve the quality of services offered by the facility as it innovates and invents better, cheaper and efficient method of service delivery. To ensure that patients get the right medication, the company has systems that deploys experts in different areas and provide them with the facilities they would require to offer quality and affordable services. The main agendas of the system are as follows:

Making their services quality through their members (members according to the company include staffs, community, suppliers, experts, and family of the patient; the definition also extends to the patient themselves
Affordability and accessibility: the Veterans Affairs Hospital Utilization Management program aims at improving the affordability of the service to the veteran and their families; the costs of the medication have been extended to other areas like funeral. The facility has established treatment outlets in other hospitals in their efforts to offer services nearer to the patient.
Involvement of families of the patients: the program aims at improving the relationship and role those patients caretakers at home undertake, it seems to emphasis on more home based care if possible to the patients (Milstein, 1997).

Comparison of Veterans Affairs Hospital Utilization Management program and contemporary models

At Veterans Affairs Hospital, the health care facilities has the main objective of offering quality, timely, and affordable medical services; to attain this paramount objective, the facility has a patient safety policy where they ensure that medical personnel make accurate decisions when handling a case. However the nature of the hospitals patients varies that of other facilities thus when it is implementing a management program, the programs tend to focus on improving the lives of the old veterans which it was made to care for. To some extent the issues that veterans suffer from can be known thus the quality product adopted by the company limits itself to such cases. The main difference of Veterans Affairs Hospital Utilization Management program and others in contemporary ones is the nature and extent it goes to implement the programs. It has a management and curative approach where current facilities have more focus on control and prevention.

One case that the facility deals with on almost daily is diabetes cases, dues to the number there have been some complaints that some patients have been kept under medication of the disease instead of looking for other ways of curing the vise (VA Hospital Official Website, 2011).

Areas that needs improvement

Despite the system of Veterans Affairs Hospital Utilization Management program, the program needs to be improved in the following areas:

Enact policies that facilitate electronic access of health data (use of medical chips)
Widen their focus and care for emerging diseases and health conditions (the program is more centralized on veteran diseases control and offering high quality services)

(Kapur, Gresenz, Studdert, & David, 2003).

Recommendations to improve Veterans Affairs Hospital Utilization Management program

In the efforts of improve their service delivery, VA should strategies that address the operating system in the facilities; they should take advantage of new technologies to have policies that can improve their service delivery.

The human resources department should come up with policies that facilitate innovation of better methods of handing issues. VA should enact policies that ensures that its internal processes are well managed and efficiency and effectiveness is the order of the day; one method that the company should adopt alongside its utilization management program is total quality management strategy. Total quality management (TQM) consists of competitive moves and business approaches aimed at producing successful performance; it is management’s “game plan” for running the business, strengthening a firm’s competitive position, satisfying the customers, the stakeholders, shareholders, and the staffs.

References

Amalberti, R. Auroy, Y., Berwick, D., & Barach, P. (2005). System Barriers to Achieving Ultrasafe Health Care. Annals of Internal Medicine, 142 (9), p. 756.

Kapur, K., Gresenz, C., Studdert, & David, M. (2003). Managing care: Utilization review in action at two capitated medical groups. Health Affairs. Chevy Chase. 22 (4), 13

Milstein, A. (1997). Managing utilization management: A purchaser’s view. Health Affairs, 16(3), 87-90.

VA Hospital Offical Website.(2011). Veteran Affairs Hospital. Web.

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Veterans Affairs Hospital Utilization Management Program

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