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Nov 2016

VA Inpatient Psychiatric Hospitals Fall Short on Quality Measures

The Veterans Health Administration is the largest integrated healthcare system in the U.S., serving 8.76 million veterans each year. But as we’ve seen over the last few years, the system is far from perfect, with its fair share of scandals such as long wait times and cover-ups.

Now, a recent study published online in Psychiatric Services has found VA hospitals are falling short on psychiatric care.

So what’s going on?

The study from Harvard found VA hospitals are failing to ask patients important screening questions 39 percent of the time. These are questions related to vets’ trauma history, substance use, violence risk, and strengths (like optimism and stable employment). To compare, other hospitals (for-profit and nonprofit) conduct these screenings nearly all of the time.

The researchers also reported that VA hospitals are discharging patients on multiple anti-psychotics without giving appropriate justification for doing so 61 percent of the time. Additionally, patients are being discharged without a plan for continued care about half the time.

Their recommendation?

Lead study author Morgan Shields said the results “further substantiate the need for VA hospitals to receive greater regulation and financial resources.” She also called for more data to allow researchers and policymakers to improve the mental health care system.

But how?

In a recent editorial, Shields and colleagues called for the establishment of a national surveillance system to go beyond simply monitoring whether or not facilities say they followed protocol. The proposed system would take it a step further and focus on patients’ experiences within the VA system, including any physical and emotional harms they suffer, as well as how satisfied they are with their care.

The goal would be to better understand the quality of care that is being provided so that adjustments can be made.

What do you think?

Do you think this is the right approach for improving mental healthcare within the VA system? If so why, and if not, what would you do differently?

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