OIG Healthcare Leaders Talk VHA Staffing Shortages, Stress on the Workforce
In this episode, Dr. Julie Kroviak and Dr. Beth Winter with our Office of Healthcare Inspections discuss VHA staffing shortages and stress on its workforce based on findings from two published reports. Plus highlights of the OIG's recent oversight work.
Related Reports:
OIG Determination of Veterans Health Administration’s Occupational Staffing Shortages Fiscal Year 2022
Pursuant to the VA Choice and Quality Employment Act of 2017 (VCQEA), the OIG conducted a review to identify clinical and non-clinical occupations experiencing staffing shortages within Veterans Health Administration (VHA). This is the ninth iteration of the staffing report, and the fifth evaluating facility-level data. The OIG evaluated staffing shortages by surveying VHA facilities, and compared this information to the previous four years.
The OIG found that all 139 VHA facilities reported at least one severe occupational staffing shortage. The total number of reported severe shortages was 2,622. Twenty-two occupations were identified as a severe occupational staffing shortage by at least one in five facilities. Every year since 2014, the Medical Officer and Nurse occupations were reported as severe shortages. Practical Nurse was the most frequently identified clinical severe occupational staffing shortage in FY 2022, with 62 percent of facilities reporting this occupation. Custodial Worker was the most frequently reported non-clinical severe occupational shortage in FY 2022, with 69 percent of facilities reported the occupation. Medical Support Assistance was the most frequently reported Hybrid Title 38 severe occupational shortage.
In FY 2022, VHA reported twenty-two percent more severe occupational staffing shortages as compared to FY 2021. FY 2022 is the first year since implementation of VCQEA reporting requirements in which the OIG did not observe a yearly decrease in the overall number of severe occupational staffing shortages; it was also the first time that facilities identified more than 90 occupations as severe shortages. The OIG again determined the ongoing need for Custodial Worker and Medical Support Assistance, noting an increase in the number of facilities identifying these occupations as severe shortages. The OIG emphasizes the importance of VHA’s continued assessment of severe occupational staffing shortages given the increases from FY 2021 to FY 2022.
The Veterans Health Administration Needs to Do More to Promote Emotional Well-Being Supports Amid the COVID-19 Pandemic
The Veterans Health Administration (VHA) Office of Emergency Management issued the initial COVID-19 Response Plan on March 23, 2020, and then an updated version on August 7, 2020. The National Center for Organization Development created a COVID-19 rapid response consultation process for VHA leaders in a supervisory role. The Organizational Health Council developed a team that coordinated with multiple VHA program offices to create a COVID-19 Employee Support Toolkit and other resources. Additionally, several program offices independently created and disseminated employee well-being resources specific to the COVID-19 pandemic, including National Center for Organization Development, Patient Centered Care & Cultural Transformation, Chaplain Service, and the Office of Mental Health and Suicide Prevention.
The VA Office of Inspector General (OIG) identified a generally diminishing awareness of employee emotional well-being supports in relation to organizational hierarchy, low utilization of support resources by leadership and frontline employees, as well as employee perception of inadequate support and responsiveness from leadership.
The OIG conducted a review to assess how the VHA addressed the emotional well-being of employees during the COVID-19 pandemic. The OIG also conducted an overview of VHA programs, including what specialized programs were developed and deployed in response to the unique psychological challenges created by the COVID-19 pandemic for VHA’s staff. The OIG interviewed VA and VHA leaders in multiple offices. The OIG developed and deployed a survey about VHA guidance regarding employees’ emotional well-being during the pandemic, available resources, monitoring of available support programs, and employee engagement with available support programs.
The OIG made one recommendation to the Under Secretary for Health related to increasing leadership and staff awareness of COVID-19 emotional well-being resources for VHA employees and awareness of resources about potential risks and signs of burnout.
OIG Determination of Veterans Health Administration’s Occupational Staffing Shortages Fiscal Year 2022
Pursuant to the VA Choice and Quality Employment Act of 2017 (VCQEA), the OIG conducted a review to identify clinical and non-clinical occupations experiencing staffing shortages within Veterans Health Administration (VHA). This is the ninth iteration of the staffing report, and the fifth evaluating facility-level data. The OIG evaluated staffing shortages by surveying VHA facilities, and compared this information to the previous four years.
The OIG found that all 139 VHA facilities reported at least one severe occupational staffing shortage. The total number of reported severe shortages was 2,622. Twenty-two occupations were identified as a severe occupational staffing shortage by at least one in five facilities. Every year since 2014, the Medical Officer and Nurse occupations were reported as severe shortages. Practical Nurse was the most frequently identified clinical severe occupational staffing shortage in FY 2022, with 62 percent of facilities reporting this occupation. Custodial Worker was the most frequently reported non-clinical severe occupational shortage in FY 2022, with 69 percent of facilities reported the occupation. Medical Support Assistance was the most frequently reported Hybrid Title 38 severe occupational shortage.
In FY 2022, VHA reported twenty-two percent more severe occupational staffing shortages as compared to FY 2021. FY 2022 is the first year since implementation of VCQEA reporting requirements in which the OIG did not observe a yearly decrease in the overall number of severe occupational staffing shortages; it was also the first time that facilities identified more than 90 occupations as severe shortages. The OIG again determined the ongoing need for Custodial Worker and Medical Support Assistance, noting an increase in the number of facilities identifying these occupations as severe shortages. The OIG emphasizes the importance of VHA’s continued assessment of severe occupational staffing shortages given the increases from FY 2021 to FY 2022.
The Veterans Health Administration Needs to Do More to Promote Emotional Well-Being Supports Amid the COVID-19 Pandemic
The Veterans Health Administration (VHA) Office of Emergency Management issued the initial COVID-19 Response Plan on March 23, 2020, and then an updated version on August 7, 2020. The National Center for Organization Development created a COVID-19 rapid response consultation process for VHA leaders in a supervisory role. The Organizational Health Council developed a team that coordinated with multiple VHA program offices to create a COVID-19 Employee Support Toolkit and other resources. Additionally, several program offices independently created and disseminated employee well-being resources specific to the COVID-19 pandemic, including National Center for Organization Development, Patient Centered Care & Cultural Transformation, Chaplain Service, and the Office of Mental Health and Suicide Prevention.
The VA Office of Inspector General (OIG) identified a generally diminishing awareness of employee emotional well-being supports in relation to organizational hierarchy, low utilization of support resources by leadership and frontline employees, as well as employee perception of inadequate support and responsiveness from leadership.
The OIG conducted a review to assess how the VHA addressed the emotional well-being of employees during the COVID-19 pandemic. The OIG also conducted an overview of VHA programs, including what specialized programs were developed and deployed in response to the unique psychological challenges created by the COVID-19 pandemic for VHA’s staff. The OIG interviewed VA and VHA leaders in multiple offices. The OIG developed and deployed a survey about VHA guidance regarding employees’ emotional well-being during the pandemic, available resources, monitoring of available support programs, and employee engagement with available support programs.
The OIG made one recommendation to the Under Secretary for Health related to increasing leadership and staff awareness of COVID-19 emotional well-being resources for VHA employees and awareness of resources about potential risks and signs of burnout.
