VA Health Care

Pursuant to a congressional request, GAO reviewed veterans' concerns about health care services at the Department of Veterans Affairs' (VA) medical center in Wilmington, Delaware.

GAO found that veterans alleged that: (1) they had to wait 6 months for orthopedic services because the center referred orthopedic patients to another center; (2) the center had excessive pharmacy service times; (3) the center had excessive waiting times for outpatient services; and (4) the center had unsanitary bathrooms and floors in some wards. GAO found that: (1) although the center examined the veterans before referring them, lack of coordination between the centers delayed some veterans' care from 26 to 67 days; (2) 13 of the 27 veterans reviewed encountered delays and had to reschedule follow-up appointments which occurred from 27 to 128 days later; and (3) the center agreed to establish a formal log to track each orthopedic referral and to improve communications with the other center. GAO also found that: (1) many of the pharmacy delays resulted from inadequate staffing, a personality conflict between the pharmacy chief and the chief of staff, and inadequate space; and (2) the center awarded a contract to expand the pharmacy and implemented a plan to increase mail-out prescriptions to reduce the number of veterans waiting for prescriptions. In addition, GAO found that: (1) although the center implemented actions to reduce waiting times, the waiting times had increased; (2) the center planned to conduct a study to identify ways to improve patient flow; (3) staff reductions contributed to the center's cleanliness problems; and (4) although the housekeeping staff did heavy-duty cleaning less frequently, the center did not believe that it needed corrective actions, since there were no increases in infection rates.