Report Summary

Audit of Veterans Health Administration's Efforts to Reduce Unused Outpatient Appointments

Report Number 08-00879-36, 12/4/2008 | Full Report (PDF)

The Office of Inspector General (OIG) conducted an audit to evaluate the effectiveness of Veterans Health Administration’s (VHA) efforts to minimize the number of unused outpatient appointments. The objectives for the audit were to determine if VHA has an effective method to accurately track and report unused outpatient appointments, whether VA medical facilities implemented effective processes for reducing the number of patient no-shows, and whether unused appointments could be used for patients who are waiting for care. VHA did not have an effective method to accurately measure and report unused outpatient appointments, has not implemented effective processes for reducing the number of missed opportunities, and needs to ensure that, where possible, unused appointments are filled with patients currently on lists waiting for care. We projected about 4.9 million (18 percent) of the scheduled 26.5 million annual outpatient appointments in VHA’s 10 performance measure clinics were unused in Fiscal Year (FY) 2008. Minimizing the number of unused outpatient appointments could enable veterans to receive more timely patient care and VHA to make better use of resources valued at about $76 million annually and $380 million over a 5-year period.

We recommended the following actions to improve the use of outpatient appointments: Establish procedures to ensure facilities measure and track all unused outpatient appointments, including those from no shows, patient cancellations, and unscheduled appointment slots. Establish a system to measure the effectiveness of processes employed to reduce the number of missed opportunities and then implement any best practices nationwide. Establish procedures requiring facility directors ensure scheduling personnel offer appointments to patients who are either on the electronic wait list, waiting for appointments with specialists, or currently have appointments more than 30 days past the desired dates of care, when appointments become available and the facility has at least 3 days notice.

The VHA Under Secretary for Health concurred with the audit recommendations and monetary benefits and provided acceptable implementation plans. We consider all issues to be resolved but may follow up on implementation of planned corrective actions.

12/10/08