Introduction
Program evaluation refers to the process of collecting and analyzing information with an aim of assessing programs and projects. The main aim of evaluating programs is to assess their efficiency and effectiveness either in public or private domains. Program evaluation is a vital assessment method for potential funders or sponsors to understand the efficiency or effectiveness of funding a program. The following paper explains how program evaluation done to measure whether Veteran Health administration, a state- run program, is meeting its goals. It clearly gives an outline of the program, stakeholders, goals and objectives, and describes how the program can be evaluated.
Veteran Health Administration Program
Veterans Health Administration is a state- run facility that gives health care to the nation’s service men that fought for the country. It started as a soldier’s home back in the 1800s due to the increasing number of casualties caused by the civil war. In some cases, soldiers would be injured such that they became totally disabled and there was a need to create a home for them 1. Over the years, more hospitals were established in different states to serve more veterans who got affected by the war.
In the 1980s, the president of United States created the department of Veteran affairs, which would oversee all the work of the above institution. Today, the evaluation at the Veteran Health Administration hospital shows that the customer service level is high and even higher than that of private clinics. The hospital seems to offer quality care to patients, and one of the studies done showed that patients with diabetes got more care than in other health care systems. Veterans Health Administration hospital has managed to extend its efforts to give care to veterans whether homeless or not.
It has also assisted in training doctors and other health practitioners with an aim of improving the services. The hospital has ensured growth and improvement through doing research in various fields than concern them 2. This hospital has helped many veterans who suffered various problems during the war. Some soldiers became blind; others became physically disabled while others suffer mental conditions. It has been a significant facility to the veterans since they should be recognized as heroes of their country after fighting in wars such as the Vietnam War.
Stakeholders in Veterans Health administration hospital includes:
- Staff of the hospital that include medical workers, trainees, receptionists, voluntary workers and non-clinical workers.
- The outpatients and inpatients and their families– These refer to patients admitted to the hospital or those visiting the hospital. They could be receiving medical care such as palliative care, receiving regular drugs or undergoing surgery and other specialized treatments.
- Organizations related to veterans of war- There are various organizations related to the caring of veterans, which can be termed as VHA’s external stakeholders.
- Agencies that deal with public health issues.
- Media and press.
VHA consists of various Mission goals and objectives such as:
- Provide excellent Health care value- The Veteran Health administration has an emphasis on value of the health care provided across the facilities.
- Provide excellent in Service as defined by customers- The facility emphasizes on the need to get feedback from clients and patients about the health care provided to them
- Provide excellence in education and research- VHA emphasizes on the need to get extensive research and education with an aim of improving all areas relating to patient care priorities.
- Be an organization that characterized by exceptional accountability- This goal focuses on extensive performance measurement system for the facility by collecting, analyzing and assessing data to ensure accountability.
- Be an employer of choice- This goal comes with the conviction that Veteran health administration values people as the most significant resource.
Evaluation and Measurement
Performance indicators can be used to characterize the areas of health care that concern patients and customers’ experiences. The importance of using performance indicator tool is that they reflect health care recommended by most guidelines, and they are reliable sources of information since they consist of face value validity especially in areas of general expert opinion 3. The methods used to measure and evaluate the program should be qualitative and quantitative in nature.
This is because the mission goals consist of aspects that need to get evaluated using different methods of data collection and analysis 4. Program accountability and effectiveness must be considered by engaging the stakeholders, describing the program, focusing the evaluation, gathering credible evidence and justifying the conclusions. Implementations, effectiveness, efficiency, cost- effectiveness, attribution need to be evaluated in regards to the mission goals and objectives.
To ensure that the first and second goals are evaluated, the most crucial point to consider is domains of value in relation to the two goals (Provision of excellence in health care value and service as defined by Customers). The domains can be termed as the vital factors that contribute to health care value. The domains include technical quality of applications, technologies and techniques used in offering medical attention to clients and the results of such interventions.
Another factor considered in the domains of value is cost of appropriated funds and other prices used in operating the program. Service satisfaction needs to be evaluated thoroughly to come up with the views and opinions of the customers, patients and their families in regards to the health care facility. Access to services also needs to be checked in order to determine the time taken to get medical care; the distance travelled to reach the facility and ease of enjoying the services offered by the program. Functional status has to be scrutinized to express the ability of patients to work normally after getting the medical attention and interventions from VHA.
To evaluate the third, fourth and fifth mission goals, a lot of attention must be given to strategic themes that provide measurements to goals success- factors. In providing excellence in research and education, there needs to be a capitalization of needs and any outstanding opportunities available in the facility. Education and research would also need to be linked to all current and expected requirements of the patients (the veterans).
There must be an enhanced level of external awareness and collaborative tasks so as to achieve the strategic theme of ensuring excellence in education and research. For VHA to be an organization that has exceptional accountability, performance measurements need to be linked with reward, promotion and recognition. In addition, individual accountability must be assessed, and aim at creating a culture of team- based efforts. For VHA to be an employer of choice, the administration must maintain high levels of job satisfaction and safe environment 5. Employment should be offered as an equal opportunity activity, and ones employed, the workers should get continuous quality improvement.
The above points explain the way the evaluation should be carried out to determine if indeed the program meets its stated goals and objectives. If the qualities provided are characterized by the facility, then one can conclude that the program indeed meets its goals.
References
Department of Veterans Affairs Office of Inspector General Healthcare Inspection. Progress in implementing the Veterans Health Administration’s Uniform Mental Health Services Handbook, Washington, DC: VA Office of Inspector General, 2010.
Mayo, Rachel. “Veteran’s Health Administration: The Best Value in Healthcare” (2006): 1-8.
McDavid, James C., and Laura R. L. Hawthorn. Program evaluation & performance measurement: an introduction to practice. Thousand Oaks: SAGE Publications, 2006.
Perlin, Jonathan B., et al. “The Veterans Health Administration: Quality, Value, Accountability, and Information as Transforming Strategies for Patient-Centered Care” The American Journal of Managed Care (2004).
Sorbero, M., et al. Program Evaluation of VHA Mental Health Services: Administrative Data Report .Alexandria, VA: Altarum Institute and RAND-University of Pittsburgh Health Institute, 2010.
Footnotes
- Jonathan Perlin, et al, “The Veterans Health Administration: Quality, Value, Accountability, and Information as Transforming Strategies for Patient-Centered Care” The American Journal of Managed Care (2004).
- Rachel Mayo, “Veteran’s Health Administration: The Best Value in Healthcare” (2006).
- James McDavid C. and Hawthorn, Laura L. Program evaluation & performance measurement: an introduction to practice. (Thousand Oaks: SAGE Publications, 2006).
- M. Sorbero, Program Evaluation of VHA Mental Health Services: Administrative Data Report. (Alexandria, VA: Altarum Institute and RAND-University of Pittsburgh Health Institute).
- Department of Veterans Affairs Office of Inspector General Healthcare Inspection. Progress in implementing the Veterans Health Administration’s Uniform Mental Health Services Handbook, (Washington, DC: VA Office of Inspector General, 2010).