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Introduction
A look at the current issues regarding health care delivery services in the United States shows the preference of different quality-related problems, which call for immediate interventions. Here, it is worth noting that many health care facilities have not failed to deliver quality services just because they lack funds, knowledge, goodwill or effort, but because these institutions encounter many shortcomings when organizing care services (Institute of Medicine, 2001, p. 3). As a result, studies note that the health care system in the U.S. is characterized by lack of favorable environments, adequate processes, and the capabilities, which should guide the process of delivering quality, equitable, safe, patient-centered, efficient, effective, and timely care services.
Further, other studies show the existence of four major issues that underlie the current quality-related problems in care delivery. Here, lack of the willingness to explore different aspects of the IT revolution, the complex issues regarding science and technology, the increasing number of chronic complications, and the poor organization of care delivery systems form part of the factors that either indirectly or directly play a role in occasioning the quality problems in the health care sector (Institute of Medicine, 2001). To this end, the Institute of Medicine (IOM) suggests the restructuring of health care systems in line with ten major rules aimed at improving care services relative to patient needs. This essay assesses the effectiveness or ineffectiveness of the services offered by Ralph H. Johnson VA Medical Center relative to the ten new IOM rules. Additionally, the paper identifies various gaps, which may need future improvement to attain the standards of the 21st Century healthcare system in this VAMC. Finally, this paper will look at various ways in which the VAMC involves its stakeholders besides collaborating with other institutions to achieve various goals.
Ralph H. Johnson VAMC and the 21st Century Healthcare system
The Ralph H. Johnson VAMC is ranked 7th among the VA network medical facilities, and it serves over 40,000 veterans in about 15 counties across south Carolina and Georgia (Department of Veteran’s Affairs, 2011). The main medical facility is located in Charleston while four other community-based out-patient clinics help to supplement the medical services elsewhere. Accordingly, this medical facility strives to attain the requirements of the new IOM rules in different ways. For instance, in accordance with the first rule, which states that care should be provided through creating continuous healing relationships between clinicians and patients, the facility offers primary, specialty, and long-term care or social services to the veteran population through the Emergency Response and Information desk. And in order to customize care services relative to the client’s needs and values as provided by the second rule, the VAMC’s vision statement has it that the facility adheres to the provisions of continuous quality improvement aimed at meeting the needs and values of the clients (Department of Veteran’s Affairs, 2011; Institute of Medicine, 2001, p. 60).
Furthermore, patients should form the source of control in any medical facility as given in the third IOM healthcare rules. Here, the Emergency Response and Information desk at the VAMC offers clients the opportunity to reach emergency services, access 24-Hour nursing personnel, secure and change appointments, make inquiries, obtain pharmacy refills and locate hospital staff through various hotline services. Conversely, relative to the fourth rule, the VAMC gives the patients the chance to access shared knowledge through ensuring that there is free flow of clinical information between the patients and clinicians. This is achieved through patient education services, the public affairs department, and prompt customer care services in the medical facility. Further, through partnership with other VA institutions and academia, the VAMC strives to offer evidence-based services through research that informs decision-making among the clinicians (Department of Veteran’s Affairs, 2011; Institute of Medicine, 2001, p. 61).
However, despite the VAMC lacking a clearly outlined system for safety provision relative to the sixth rule, there is evidence to show that the facility has an integrated healthcare system that ensures the safety of its patients. Conversely, transparency regarding the information required by the patients is held with high esteem in this VAMC. As a result, the facility’s staff members help patients to access information particularly medical records on request. And in accordance with the eighth IOM rule, which calls for the healthcare facilities to anticipate patient needs before hand, the VAMC has not provided a clear statement on how this is achieved. Moreover, the VAMC is committed to saving resources and time relative to the ninth rule through providing various online services that enable patients to access information in a timely manner, and thus eliminating paperwork and unnecessary patient visits. Finally, cooperation among the clinicians and management processes as provided by the tenth rule is achieved through the public affairs department, which provides prompt information regarding recent developments within and without the facility (Department of Veteran’s Affairs, 2011; Institute of Medicine, 2001, p. 61).
Room for Improvement
The fact that the expansion and consolidation of hospital systems or facilities offers greater positive benefits in terms of improving the quality of care services and system efficiency cannot be overlooked in this context (Cuellar & Gertler, 2005). Therefore, there is the paramount need for the Ralph H. Johnson VAMC to re-evaluate the current systems for care delivery to align its services with the 21st century healthcare systems. Here, the facility should expand its relationships with various organizations and institutions particularly medical schools in different universities. This approach can enable the facility to share medical services in an integrated manner that achieves the desired quality of services. However, care should be taken when developing these partnerships since all the stakeholders should actively participate in identifying benefits and the costs implicated in the joint venture or considering different options while maintaining the integrity of the current medical facilities (Committee on Veteran’s Affairs, 2005).
The role of stakeholders and other institutions in the VAMC
The stakeholders in the VAMC include patients and their families, clinicians, the management, government agencies such as VA, and academia among others. Accordingly, the VAMC strives to provide patient-centered care services through initiatives such as Patient-Aligned Care Teams (PACTs) whose aim is to create partnerships between clinicians and patients, improve access to care delivery systems, coordinate team members in care delivery, and provide team-based care services focused on Veterans (Department of Veteran’s Affairs, 2011). On the other hand, the VAMC in conjunction with VA has entered into a joint venture with the Medical University of South Carolina (MUSC) with the aim of improving the quality of services offered in the current facility and considering the possibility of constructing a new facility to offer training and education to residents. As a result, by 2004, there were many physicians drawn from MUSC who were working in the current VAMC as medical residents (Committee on Veteran’s Affairs, 2005, p. 66).
Conclusions
The paper presents a review of the extent to which the Ralph H. Johnson VAMC aligns its services and systems towards the requirements of the ten IOM rules. Subsequently, the paper highlights the possible gaps and room for future improvement of the VAMC services. And finally, the paper looks at the way the VAMC involves its stakeholders and collaborates with other agencies and organizations in order to offer quality services to Veterans. From the foregoing discussions, it is notable that the current healthcare system in the U.S. is in need of changes aimed at improving the quality of care services. Moreover, despite that the Ralph H. Johnson VAMC has attained a considerable standard of care delivery relative to the provisions of IOM healthcare rules; there is the need for continuous improvement in service delivery to maintain the current status besides standardizing other aspects of care.
Reference list
Committee on Veteran’s Affairs. (2005). Field hearing: Collaborative opportunity for the Ralph H. Johnson VA Medical Center and the Medical University of South Carolina to share facilities and resources (First Session). Washington, DC: U.S. Government Printing Office.
Cuellar, E. & Gertler, P.J. (2005). How the expansion of hospital systems as affected consumers. Health Affairs, 24(1), 213-219.
Department of Veteran’s Affairs. (2011). Ralph H. Johnson VA Medical Center. Washington, DC: U.S. Department of Veteran Affairs.
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st Century. Washington, DC: National Academies Press.
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