Bruce Carter Veterans Affairs Medical Center Case Study

A multitude of investigations were conducted in response to the 2014 VA Scandal with reports and audits showing manipulation of records, long wait times, delays in treatment and overwhelmed caseload by VA practitioners (Wikipedia, n.d., para. 3-7). There are also concerns about the VA’s lack of accountability once

In the past few years there has been increasing discussion about how to provide adequate care for the increasing number of veterasn who are eligible for care through the Veterans’ healthcare administration (VHA). There are concerns is that the VHA is not providing the level of access, efficiency, and quality of care that veterans expect. Lee & Begley, (2016) suggest access to care for the veteran population may be resulting in poor health outcomes. In response to these concerns, the Veterans ' Access to Care through Choice, Accountability, and Transparency Act (VACAA) of 2014, also known as the Veterans Choice Act, was created to improve Veterans’ healthcare. The VACAA proposed to do this by expanding the number of options veterans have for receiving healthcare, by providing access for healthcare at non-VA care centers as well as providing for an increase in staffing at VA facilities (U. S. Department of Veterans Affairs, 2016).

The Veterans Health Administration is home to the United States’ largest integrated health care system consisting of 150 medical centers, nearly 1,400 community-based outpatient clinics, community living centers, Vet Centers and Domiciliary. Together these health care facilities and the more than 53,000 independent licensed health care practitioners who work within them provide comprehensive care to more than 8.3 million Veterans each year. VHA Medical Centers provide a wide range of services including traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. In addition, most of the medical centers offer additional medical and surgical specialty services including audiology & speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision

VBA administers a wide variety of benefit programs authorized by Congress including Vocational rehabilitation and employment, Education service and GI Bill, Loan guarantee, Service-connected disability compensation, VA pension and fiduciary services, and VA life insurance. The following organizational chart depicts the current structure of the Veterans Benefits Administration. The Veterans Health Administration (VHA) serves the Veteran population and is responsible for providing a wide range of medical services by providing inpatient and outpatient care to 5.5 million veterans across the United States and its territories. The VHA operates one of the largest networks of health care facilities in the world. It includes 171 medical centers, 800+ outpatient clinics, 127 nursing homes and 196 Vietnam Veterans Outreach Centers. As well as, domiciliary residences, home health services, adult day care, residential care and respite care programs. In addition, the VHA helps support veterans' health care in non-VA hospitals (Choice Program) and is the country’s largest provider of graduate medical education. The following organizational chart depicts the current structure of the Veterans Health Administration. The National Cemetery Administration (NCA) provides burial space for Veterans and their eligible family members; maintains national cemeteries; marks Veterans’ graves with headstones, markers, and medallions; and administers grants for establishing or expanding state and tribal government Veteran cemeteries. The following organizational chart depicts the current structure of the National Cemetery

The Joint Commission is a self-governing, nonprofitmaking organization that accredits and certifies over 21, 000 health care organizations, hospital, and programs in the United States. The body was formed in 1951. Since its creation, the organization has been working relentlessly to augment healthcare for the people of U.S. and have continued inspiring healthcare organizations with an aim to promote and advocate for quality as well as value in the healthcare ("About The Joint Commission | Joint Commission," 2016). Joint Commission creates performance standards for certification and accreditation programs that healthcare organizations and hospital facilities are demanded to pass to get accreditation from the body. These standards are

There are many roles of the Joint Commission in accrediting medical facilities. The Joint Commission was founded in 1951 and is the nation’s largest accrediting body in health care. They evaluate nearly 21,000 health care organizations in the Unites States. (The Joint Comm, 2016) Once an organization earns the accreditation they are re-surveyed every three years unannounced. They are responsible for making sure that healthcare facilities are up to date on all standards, policies, and procedures. “Joint Commission accreditation can be earned by many types of health care organizations, including hospitals, doctor’s offices, nursing homes, office-based surgery centers, behavioral health treatment facilities, and providers of home care services

The Joint Commission is an independent, nonprofit organization. The Joint Commission approves and certifies almost twenty-one thousand health care organizations and programs in the United States. The Joint Commission accreditation and certification is used nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards. The Joint Commission standards are developed with input from healthcare professionals, providers, subject matter experts, consumers, government agencies, and employers; and approved only by the Board of Commissioners. The mission for Joint Commission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care

Any patient that is seen by a physician within the United States is to be protected by the “Health Insurance Portability and Accountability Act” or HIPAA, which was passed into law in 1996 (Jani, 2009). All health care facilities dealing with any protected health information (PHI) are to ensure that all physical/electronic processes are safeguarded from any third party entity or unauthorized personnel according to HIPAA. All health care data to include any medical insurance

As you well mention the Joint Commission not only evaluates the services of the hospitals but also the ones of other centers that offer the care of the patient, whether ambulatory care, home care and mental health institutions. This is good because when the patient is referred to one of these services we can have a piece of mind because if they are accredited we know that the service they provide are of quality. According to Hebda & Czar “the Joint Commission introduced new emergency management standards for hospitals, long-term care facilities, and behavioral health and ambulatory care that focus on the concept of community involvement in the management process” 2013, p.449. The goals of the commission are directed to watch for the care

The Miami VA Healthcare System serves Veterans in Miami-Dade, Broward and Monroe counties and operates a total of 372 hospital beds (US Department of Veterans Affairs, Veterans Health Administration, n.d.). Since the VA system is owned and run by the federal government, audit requirements in order to provide dietary and nutrition care services in the inpatient, outpatient or long term care setting are different compared to private sector hospitals. Hospitals and health care organizations get accreditation from the Joint Commission in order to meet federal requirements and get payment from Medicare and Medicaid programs (The Joint Commission, n.d.). However, since the Miami VA Healthcare System is a government organization and at a higher level is not required to do so (M. De La Cera, personal communication, January 12, 2017). Nevertheless, the Miami VA requests unannounced visits from The Joint Commission every three years to monitor and strengthen their performance excellence as well as keep their ongoing commitment to the safety and quality care of their patients (Office of Public and Intergovernmental Affairs, 2016). Furthermore, the Agency for Health Care Administration (AHCA) conducts unannounced onsite reviews of the Community Living Center (CLC) to review processes and procedures. Inspectors from AHCA seek

This act has a positive impact on hospitals because it improves quality of care and patient safety through collaboration and engagement with the patient, family and care team. The MOON notification process will allow for the patients to build trust and communicate any concerns with the care team regarding treatment and insurance concerns.

Sources of potential participants can be sourced from internal and external to the Veterans Health Administration (VHA). Possible internal VHA sources of participants could be from one or multiple Veterans Integrated Service Networks (VISN), and from VHA Hospitals, Medical Centers, Outpatient Clinics, Community Based Outpatient Clinics, and the VA Healthcare System; and also through the Veterans Benefits Administration (VBA) regional offices. External sources of participants can include Veterans, Private Hospitals, Medical Centers, Clinics and other non-VA Healthcare

JCAHO is an abbreviation for Joint Commission on Accreditation of Healthcare Organizations is a non-for-profit organization that seeks to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations. It is an organization made up of individuals from the private medical sector to develop and maintain standards of quality in medical facilities in the United States. Although JCAHO has no legal enforcement power, and has no official connection to the US Government regulatory agencies, many medical facilities

Many individuals assume fire doors are completely incombustible. This is not the case, as they are only designed to slow the spread of a fire. Each door

Hospitals are among the most regulated of all building types. Like other buildings, they must follow the local and/or state general building codes. However, federal facilities on federal property generally need not comply with state and local codes, but follow federal regulations. To be licensed by the state, design must comply with the individual state