Persistent understaffing at VA is raising issues with patient care at its medical centers and contributing to burnout among employees in other short-staffed occupations that in turn leads to higher attrition and still more severe shortfalls, GAO has said.
In testimony before a House Veterans Affairs Committee hearing, the GAO cited “large staffing shortages” at medical centers in positions including physicians, registered nurses, physician assistants, psychologists, and physical therapists, and “high attrition, increased workload, and burnout” among HR positions, for example.
It said that VA suffers a vacancy rate of about 11 percent in its Veterans Health Administration, including vacancies of more than 24,000 medical and dental positions alone. Department-wide, the latest vacancy figure is 49,000.
GAO said that the problems in part reflect the government’s general challenges to recruit, retain, and develop workers, including “outmoded position classification and pay systems, ineffective recruiting and hiring processes and challenges in dealing with poor performers.” However, others relate to VA’s own problems such as a lack of a “modern and effective performance management system.” It added that many recommendations of prior reports still have not been carried out, including that the VA develop a process to accurately count all physicians providing care at each VA medical center.
Meanwhile, the VA inspector general testified that the department has “chronic healthcare professional shortages since at least 2015,” with 138 of 140 facilities reporting they have shortages in the medical officer occupational series and 108 in the nurse occupational series. Noncompetitive salaries are a “particular issue” which the VA is attempting to address with incentive and student debt repayment programs, but there is high turnover among high-performance staff with “follow-on impacts, as remaining staff became burned out from working overtime to cover existing vacancies.”