The Department of Veterans Affairs is streamlining its construction department in an effort to make the VA health system more competitive with private providers.
Last week, the VA began organizing its construction department into five interdisciplinary teams that will handle construction projects from the idea stage to completion, said C.V. Yarbrough, the VA's associate chief medical director for construction management.
Each of the teams will be responsible for all the construction projects in a specific geographic region. And each will have technical, engineering and support personnel, giving medical directors a "single point of contact" when they want to upgrade or build a new facility.
That's an advancement, because administrators in the past have had to contact as many as 12 separate offices to construct a new facility.
"I am absolutely convinced that we can do business this way more quickly and with better customer service than when we had so many scattered offices," Mr. Yarbrough said. "I don't know if we will ever be as nimble (as private providers), but I think in getting access to new facilities (the) VA can be absolutely more competitive than we are now."
As part of its effort to prepare to compete with private providers, the VA also will be adding "many hundreds" of new clinics around the country by the end of fiscal year 1996, Mr. Yarbrough said. While no decisions on finances and locations have been made, the clinics likely will range in size from some that can house several medical personnel to those accommodating as many as 12 to 15 providers.
To further reduce the time it takes to build or lease those new clinics, Mr. Yarbrough has given medical center directors more autonomy. Those directors now will be able to decide for themselves if they want to add new clinics of as much as 10,000 square feet in size or up to $300,000 in cost.
"It's that kind of delegation and that kind of flexibility at the medical director level that you need for national healthcare reform," Mr. Yarbrough said.
The VA currently has 43 construction projects under way totaling almost $4 billion. Those projects include hospitals in Detroit; Palo Alto, Calif.; and West Palm Beach, Fla.; and 14 clinics.
Mr. Yarbrough said those three hospitals may be the last of their type built by the VA. "I think we will do much less of building new hospitals and concentrate much more on ambulatory facilities. We will see a lot more leasing and remodeling of existing facilities, including looking at taking over (defense department) facilities that are closed or abandoned."-Eric Weissenstein