Assessment of Veterans Administration New York Harbor Healthcare System Missed Opportunities

The VA New York Harbor Healthcare (VA NYHHS) system encompasses the veterans' healthcare system for the boroughs of Queens, Manhattan, Brooklyn and Staten Island. The organization consists of campuses throughout the boroughs and provides care to over 52,000 veterans a year. The VA NYHHS uses the VA national standard known as the "missed opportunity" measure to improve services in their outpatient clinics. The system is struggling with a large number of appointments that are not kept or cancelled. The Capstone team assessed the high missed opportunity rates, and created plans for improvement. The team explored six performance measure clinics to identify areas that are leading to missed opportunities, including surveys and interviews with patients, administrators, service chiefs, clerical and centralized scheduling staff, as well as clinic observation. The team evaluated the findings to determine the cause of the poor missed opportunity rates, and made recommendations for reminder system policies.