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    Results:

    Subject Term: "Medical education"

    4 publications with a total of 8 open recommendations including 4 priority recommendations
    Director: Kathleen M. King
    Phone: (202) 512-7114

    1 open recommendations
    Recommendation: To ensure that HHS workforce efforts meet national needs, the Secretary of Health and Human Services should develop a comprehensive and coordinated planning approach to guide HHS's health care workforce development programs--including education, training, and payment programs--that (1) includes performance measures to more clearly determine the extent to which these programs are meeting the department's strategic goal of strengthening health care; (2) identifies and communicates to stakeholders any gaps between existing programs and future health care workforce needs identified in the Health Resources and Services Administration's workforce projection reports; (3) identifies actions needed to address identified gaps; and (4) identifies and communicates to Congress the legislative authority, if any, the Department needs to implement the identified actions.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: In December 2016, HHS indicated that the agency had not yet taken steps to implement a comprehensive workforce planning effort. Officials said that for the FY2018 cycle, HHS had planned to expand its group developing legislative proposals to include budget issues and gaps that warrant attention. While it did not do so during that cycle, officials indicated that they would recommend this broader approach to workforce planning for future budget and legislative cycles.
    Director: Debra Draper
    Phone: (202) 512-7114

    2 open recommendations
    including 1 priority recommendation
    Recommendation: To help ensure the effective recruitment and retention of nurses across VA medical centers, the Secretary of Veterans Affairs should direct the Under Secretary for Health to develop a periodic reporting process to help monitor VA medical center compliance with the policies and procedures for each of its key recruitment and retention initiatives.

    Agency: Department of Veterans Affairs
    Status: Open

    Comments: VHA convened a taskforce with accompanying charter to address all three of GAO's recommendations, including medical center compliance with policies and procedures for the key recruitment and retention initiatives. The taskforce consists of workgroups that are charged with reviewing current processes for reporting on compliance for the eight recruitment and retention initiatives we identified in our report, identifying opportunities for improvement, and developing recommendations to optimize medical centers' reporting on compliance. Based on the workgroup recommendations, VHA will generate and implement program-specific approaches for reporting on compliance of the initiatives. As of March 2017, the workgroups have reviewed, or are in the process of reviewing, compliance reporting processes for all eight initiatives. VHA anticipates implementing compliance reporting processes by October 2017.
    Recommendation: To help ensure the effective recruitment and retention of nurses across VA medical centers, the Secretary of Veterans Affairs should direct the Under Secretary for Health to conduct a system-wide evaluation of VHA's key nurse recruitment and retention initiatives, to determine the overall effectiveness of these initiatives, including any needed improvements, and communicate results and information in a timely manner to relevant stakeholders.

    Agency: Department of Veterans Affairs
    Status: Open
    Priority recommendation

    Comments: VHA convened a taskforce with accompanying charter to address all three of GAO's recommendations, including conducting a system-wide evaluation of VHA's key nurse recruitment and retention initiatives and identifying areas for improvement. The taskforce consists of workgroups that are charged with reviewing current processes for reporting on compliance for the eight recruitment and retention initiatives we identified in our report, identifying opportunities for improvement, and developing recommendations to optimize medical centers' reporting on compliance. Based on the workgroup recommendations, VHA will generate and implement program-specific approaches for reporting on compliance of the initiatives. As of March 2017, taskforce has evaluated, or is in the process of evaluating, the effectiveness of each of the eight initiatives. VHA anticipates completing these evaluations by October 2017. However, VHA did not provide any information on its efforts to evaluate the overall effectiveness of the key initiatives in meeting VHA's system-wide nurse recruitment and retention goals.
    Director: Brenda S. Farrell
    Phone: (202) 512-3604

    3 open recommendations
    including 3 priority recommendations
    Recommendation: To provide decision makers with appropriate and more complete information on the continuing implementation, management, and oversight of the DHA, the Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to develop a comprehensive requirements assessment process that accounts for needed future skills through the consideration of potential organizational changes and helps ensure appropriate consideration of workforce composition through the determination of the final status of military personnel within the DHA.

    Agency: Department of Defense
    Status: Open
    Priority recommendation

    Comments: As of April 2017, DOD has taken some steps to implement this action. According to an April 2017 letter from the Acting Principal Deputy Assistant Secretary of Defense (Health Affairs), DOD has established processes and procedures to create an overall personnel management process which are documented in a draft Administrative Instruction estimated to be finalized and published by July 31, 2017.
    Recommendation: To provide decision makers with appropriate and more complete information on the continuing implementation, management, and oversight of the DHA, the Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to develop a plan for reassessing and revalidating personnel requirements as the missions and needs of the DHA evolve over time.

    Agency: Department of Defense
    Status: Open
    Priority recommendation

    Comments: As of April 2017, DOD has taken some steps to implement this action. According to an April 2017 letter from the Acting Principal Deputy Assistant Secretary of Defense (Health Affairs), DOD has established processes and procedures to create an overall personnel management process which are documented in a draft Administrative Instruction estimated to be finalized and published by July 31, 2017.
    Recommendation: To provide decision makers with appropriate and more complete information on the continuing implementation, management, and oversight of the DHA, the Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to determine the future of the Public Health and Medical Education and Training shared services by either identifying common functions to consolidate to achieve cost savings or by developing a justification for the transfer of these functions from the military services to the DHA that is not premised on cost savings.

    Agency: Department of Defense
    Status: Open
    Priority recommendation

    Comments: As of April 2017, DOD has taken some steps to implement this action. According to an April 2017 letter from the Acting Principal Deputy Assistant Secretary of Defense (Health Affairs), DOD has changed the designation of its Public Health function from a shared service to a division. This change recognizes the distinction that we previously highlighted between a shared service, or the consolidation of functions previously performed by the military services, and a transfer of functions from the military services to the DHA. The letter states that DOD is in the process of assessing business case analyses for various efficiency efforts, with one proposal estimated to save $613 million over three years. DOD has not taken similar action with regard to its Medical Education and Training shared service. As we previously reported in our prior update, while DOD cites future cost savings in its modeling and simulation and online learning product lines, we reported in 2014 that these initiatives overlap with the DHA's Contracting and Procurement and Information Technology shared services. For example, while cost savings for Modeling and Simulation are allocated to the Medical Education and Training Directorate, implementation costs are to be incurred by the Contracting and Procurement shared service. This recommendation will remain open until DOD either identifies common functions to consolidate within Medical Education and Training to achieve cost savings or develops a justification for the transfer of these functions from the military services to the DHA that is not premised on cost savings.
    Director: Brenda S. Farrell
    Phone: (202) 512-3604

    2 open recommendations
    Recommendation: To help ensure that DOD has the necessary information to determine the extent to which cost savings result from any future consolidation of training within METC or the Education and Training Directorate, the Assistant Secretary of Defense for Health Affairs should direct the Director of the DHA to develop baseline cost information as part of its metrics to assess achievement of cost savings.

    Agency: Department of Defense: Office of the Assistant Secretary of Defense (Health Affairs)
    Status: Open

    Comments: The House Report Accompanying the National Defense Authorization Act for Fiscal Year 2015, citing our work on this subject, required DOD to submit a report by January 31, 2015 detailing, among other things, an explanation of the purpose and goals of the medical education and training shared service with regard to its role in improving the cost efficiency of delivering training, including the challenges it will address, the practices it will put in place to address these challenges, and the resulting cost savings. However, as of September 2015, DOD has not submitted this report. Until DOD develops baseline cost information as part of its metrics to assess achievement of cost savings, this recommendation should remain open.
    Recommendation: To help realize the reform effort's goal of achieving cost savings, the Assistant Secretary of Defense for Health Affairs should direct the Director of the DHA to conduct a fully developed business case analysis for the Education and Training Directorate's reform effort. In this analysis the Director should (1) identify the cost-related problem that it seeks to address by establishing the Education and Training Directorate, (2) explain how the processes it has identified will address the costrelated problem, and (3) conduct and document an analysis of benefits, costs, and risks.

    Agency: Department of Defense: Office of the Assistant Secretary of Defense (Health Affairs)
    Status: Open

    Comments: The House Report Accompanying the National Defense Authorization Act for Fiscal Year 2015, citing our work on this subject, required DOD to submit a report by January 31, 2015 detailing, among other things, an explanation of the purpose and goals of the medical education and training shared service with regard to its role in improving the cost efficiency of delivering training, including the challenges it will address, the practices it will put in place to address these challenges, and the resulting cost savings. However, as of September 2015, DOD has not submitted this report. We reported in September 2015 that DOD has not yet presented a fully developed business case for its Medical Education and Training shared service. Until DOD addresses these concerns, this recommendation should remain open.