Deputy Secretary of Veteran’s Affairs (VA) Sloan D. Gibson understands the challenges his department faces. Being the largest health care system in the U.S., the manner in which care is delivered is expected to be the very best. And if that doesn’t happen, scrutiny can be intense.

As the AMSUS 2016 conference came to a close Dec. 2, Gibson talked about how the VA can improve the quality of care, and how he believes health care will be delivered in the future.

“At VA, we know how to deliver great care, and we know how to deliver a great care experience,” said Gibson. “The challenge we have is we don’t have the rigor in our systems and processes that ensure we are delivering that great care and great care experience every single time. We’re too reliant on the passion of the front-line clinicians and support staff in ensuring this happens every time. Even if our success rate in delivering great care is 99.5 percent each month that means about 35,000 times a month we don’t get it right. This presents challenges for us as we’re working to build trust. Because it only takes one of those anecdotal stories where we didn’t deliver that great care experience to undermine the trust veterans, taxpayers and elected representatives have in what we do.”

With the number of veterans who require care expected to double within the next 10 years, Gibson stated the VA is working with organizations such the National Association of State Directors of State Directors of Veterans Affairs (NASDVA) to meet this challenge. Gibson stressed the importance of aligning resources to meet this need. “We’ve got to start having this conversation with the incoming administration and congress now,” he said. “Our veterans want and deserve quality care, and having talks with our lawmakers helps to accomplish this.”

A priority of the VA is to improve access to health care. To accomplish this, Gibson cited four issues he believes must continue to be addressed—increase staffing, provide more space for staff to provide quality care, increase productivity and provide better community care. “In the last couple of years, we have completed more than 25 million medical appointments in the community, compared to 16 million in FY 2014,” said Gibson. This is a vital component today, and it’s going to be such moving forward. We also want to make the delivery of care more seamless for veterans—here’s what he/she needs, here’s their location…how do we best deliver care for that veteran?”

During his tenure, Gibson has seen what he described as a “fragmented, ineffective and inefficient” benefit enrollment system move from more than 100 days to get enrolled to one that now takes minutes. “We’re not quite where we want to be with this, but we’re getting much better,” he said.

Gibson also stressed the importance of the Department of Defense and federal health care agencies to continue to work together in a joint effort to improve the quality of care. “We’ve got to figure out how to break down some of the remaining barriers that keep us from attaining a 100 percent success rate,” he said. “It’s right for DoD, it’s right for VA, our service members, their families and taxpayers.”