The US Veterans Administration (VA) has faced many challenges in the past decade. For example, in 2015, the VA Office of Inspector General (OIG) found extensive, protracted delays and mismanagement at VA hospitals and clinics (Richardson 2015). The OIG (2015)

also published a call for the VA’s managers to make “mission-driven decisions,” stating:

VHA’s [Veterans Health Administration] primary mission is, and should be, the delivery of high quality health care. VHA has a number of critical missions that include: (1) the provision of quality healthcare, (2) the training of tomorrow’s healthcare providers, (3) the provision of healthcare to all citizens in a time of national disaster, and (4) the advancement of medical research. VA must consistently make decisions to ensure that veteran’s healthcare is always the highest priority mission. Within VHA, the first test of a management decision should be an assessment of its impact upon the delivery of quality health care.

This mission is complicated by the vast number of care sites—

more than 1,500—across the United States and its territories. In addition, the VA is subject to seemingly constantly changing laws.

Read page 4 of the OIG’s (2015) report at www.va.gov/oig/

pubs/VAOIG-2015-MMC.pdf. Write about the factors that impede the ability of the VA to make mission-based decisions. Why might these decisions and influences have caused the patient-related problems the VA has experienced?