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WGU D515 Task 2 New System Challenge Latest Update with complete solution

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Prepared by January 18, 2024 1 2 Propose a new integrated delivery system to the Phoenix Veterans Affairs Health Care System (PVAHCS) executive leadership by doing the following: A. Healthcare Delivery Model Comparison Compare your proposed integrated PVAHCS model with the nonintegrated Phoenix Veterans Health Administration (VHA) model, as described in the OIG report. Include each of the following eight points for each system in your comparison: Nonintegrated Phoenix VHA Model Proposed Integrated PVAHCS Model What guidelines are in place for leadership? According to the Veterans Health Administration (2014), there were no specific guidelines in place for leadership. What was in place were goals to meet a scheduled appointment in a 14 day timeframe with a bonus attached to the leadership if the goal was met or exceeded. The proposed integrated PVAHCS Model would not have a financial bonus or goal attached to have patients scheduled in a specific timeframe. The proposed integrated PVAHCS model would include training for all team members, leaders would audit the scheduling practice every month, and leaders from other VA facilities would quarterly edit another VA facility. What guidelines are in place for transparency? There were identified goals to have patients have a scheduled appointment within 14 days, but no guidelines. Also, there was self-reporting for the timeframes scheduled, which were reported. If there were transparency, that would have been based on the individual leader with the understanding that they might miss their goal with the bonus attached. There were no guidelines in place for transparency (Veterans Health Administration, 2014). The proposed integrated PVAHCS model would include a requirement for reporting based on data that could be validated through an electronic medical record or EMR. If there are discrepancies, that leader or team member would be identified and reeducated with the expectation. Each leader would have their data reported to the leader above them for additional accountability. What is the leadership hierarchy structure? There is a leadership hierarchy structure or chain of command at the top is the President of the United States. The next tier is a cabinet level official, the Secretary of Veterans Affairs, who reports to the President. The following tier The proposed integrated PVAHCS model would include a leadership hierarchy structure that validates those in authority below them. This would be done by checking the electronic medical record in 3 is the Executive Team, which reports to the Secretary of Veterans Affairs. The Directors are next in the leadership hierarchy structure and directly report to the Executive Team. The subsequent leader is the Manager, who directly reports to the Directors. Supervisors who report to the Managers are next in the leadership hierarchy structure. The Supervisors oversee the team members. Some employees did report the issues and would be considered silent leaders (Veterans Health Administration, 2014). contrast to the timeframe presented for when patients were scheduled or not scheduled. Accountability is key to a successful leadership structure. Monthly check-ins will also be to see what issues or concerns could be resolved. The leadership hierarchy structure will remain the same as that of the first president of the United States, Secretary of Veterans Affairs, Executive Team, Directors, Managers, Supervisors, and employees. What resources exist for addressing long patient waiting lists? There were no identified resources from the federal government to help address long patient wait times or lists. As shared by the Veterans Health Administration (2014), there were multiple different wait lists, which would shuffle patients around to create the illusion that all patients were seen within the 14-day goal. The proposed integrated PVAHCS model is to have only one true source for wait times: an electronic medical record wait list that can be vetted and validated. Training will be provided to all employees, from the staff members to the Secretary of Veterans Affairs, to share the expectation for integrity in all areas. For staff who schedule patients, there will be additional education with annual reeducation to ensure this does not happen again. How is care coordinated across departments (e.g., emergency, mental health, etc.)? There were delays in the care provided to the patients related to the scheduling process, which delayed the coordination of care across varied or accessory departments. There was no set guideline to ensure that the patients were scheduled in a timely manner. There was also no safeguard to ensure full holistic care was coordinated for the patient. This resulted in some patients being unalive before the coordinated care could be provided, and other services for the patient, like mental health care, were not given to the patients at an alarming deficit of less than 50% from the 14-day goal The proposed integrated PVAHCS model includes a check-in balance built into the electronic medical record, which will flag the patient's chart if something is lacking or close to exceeding the timeframe for the patients. Additionally, there will be audits done to ensure that not only the primary appointment is scheduled but also any other appointments that were previously ordered, such as mental, endocrinology, physical therapy, etc. The audits will be done by the supervisors, the managers, and the directors.

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WGU D515 Task 2 New System Challenge



New System Challenge

Prepared by
January 18, 2024




1

, Propose a new integrated delivery system to the Phoenix Veterans Affairs Health Care System (PVAHCS) executive leadership by
doing the following:


A. Healthcare Delivery Model Comparison
Compare your proposed integrated PVAHCS model with the nonintegrated Phoenix Veterans Health Administration (VHA) model,
as described in the OIG report. Include each of the following eight points for each system in your comparison:


Nonintegrated Phoenix VHA Model Proposed Integrated PVAHCS Model

What guidelines are in place for According to the Veterans Health Administration The proposed integrated PVAHCS Model
leadership? (2014), there were no specific guidelines in would not have a financial bonus or goal
place for leadership. What was in place were attached to have patients scheduled in a
goals to meet a scheduled appointment in a 14- specific timeframe. The proposed
day timeframe with a bonus attached to the integrated PVAHCS model would include
leadership if the goal was met or exceeded. training for all team members, leaders
would audit the scheduling practice
every month, and leaders from other VA
facilities would quarterly edit another VA
facility.

What guidelines are in place for There were identified goals to have patients The proposed integrated PVAHCS model
transparency? have a scheduled appointment within 14 days, would include a requirement for
but no guidelines. Also, there was self-reporting reporting based on data that could be
for the timeframes scheduled, which were validated through an electronic medical
reported. If there were transparency, that would record or EMR. If there are discrepancies,
have been based on the individual leader with that leader or team member would be
the understanding that they might miss their identified and reeducated with the
goal with the bonus attached. There were no expectation. Each leader would have
guidelines in place for transparency (Veterans their data reported to the leader above
Health Administration, 2014). them for additional accountability.

What is the leadership hierarchy There is a leadership hierarchy structure or The proposed integrated PVAHCS model
structure? chain of command at the top is the President of would include a leadership hierarchy
the United States. The next tier is a cabinet- structure that validates those in authority
level official, the Secretary of Veterans Affairs, below them. This would be done by
who reports to the President. The following tier checking the electronic medical record in


2

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