A Quality Improvement Initiative Designed to Increase Veteran Choice and Consult Retention

Introduction:To improve access to care, the Veterans Administration (VA) offers eligible veterans the choice to receive Community Care (CC). Local changes to CC scheduling coincided with a decrease in expected surgical volumes. This project aimed to increase the retention of CC eligible veterans from 66% to 76% by September 2024, while prioritizing veteran autonomy.Methods:The quality improvement team learned CC eligible veterans were not offered a choice between community and VA care during scheduling. A decentralized and individualized scheduling process was developed to ensure veteran choice was respected and to increase consult retention. Consult retention rates were measured as the intervention was progressively scaled across surgical disciplines.Results:With the new scheduling process, retention rate increased from 66.1% to 69.3% and veteran choice was respected for over 5,500 veterans.Conclusions:As both private and VA networks explore strategies to retain patients within their health systems, a decentralized scheduling approach may not significantly affect retention rates. However, this project highlights how easily complex health care processes can lose sight of patient-centered care, which must remain the ultimate goal.