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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

Facilities Staffing Requirements
for the Veterans Health Administration—
Resource Planning and Methodology for the Future

Committee on Facilities Staffing Requirements for
Veterans Health Administration

Board on Infrastructure and the Constructed Environment
Division on Engineering and Physical Sciences

Board on Human-Systems Integration
Division of Behavioral and Social Sciences and Education

A Consensus Study Report of

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THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by contracts between the National Academy of Sciences and the U.S. Department of Veterans Affairs. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-49291-1
International Standard Book Number-10: 0-309-49291-2
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration—Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. https://doi.org/10.17226/25454.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

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Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

COMMITTEE ON FACILITIES STAFFING REQUIREMENTS FOR VETERANS HEALTH ADMINISTRATION

COLIN G. DRURY, University at Buffalo (Emeritus), Co-Chair

JAMES B. SMITH, U.S. Ambassador (Retired), Co-Chair

ROBERT ANSELMI, Engineering Department, Veterans Hospital Administration (Retired)

ALBERTO J. GALUÉ, Talent Acquisition and Development, Dallas/Fort Worth International Airport

ROBERT GOODMAN, The Innova Group, Austin, Texas

WESLEY L. HARRIS, NAE,1 Department of Aeronautics and Astronautics, Massachusetts Institute of Technology

GENE HUBBARD, Human Capital Division, RiVidium, Inc., Manassas, Virginia

WILLIAM S. MARRAS, NAE, Department of Integrated Systems Engineering and Spine Research Institute, Ohio State University

KIMBERLY O’KEEFE, Office of the Assistant Chief of Staff for Installation Management, Department of the Army (Retired)

CHERYL PAULLIN, Talent Management and Analytics Division, Human Resources Research Organization, Alexandria, Virginia

FRED S. SWITZER III, College of Behavioral, Social, and Health Sciences, Clemson University

BRIAN YOLITZ, Associate Vice Chancellor for Facilities, Minnesota State College and University System

Staff

CAMERON C. OSKVIG, Director

DANIEL TALMAGE, Program Officer

KELLY ARRINGTON, Senior Program Assistant (until May 31, 2019)

HEATHER KREIDLER, Associate Program Officer (until July 5, 2019)

JOSEPH PALMER, Senior Program Assistant

ERIC SVEDBERG, Senior Program Officer

___________________

1 Member, National Academy of Engineering.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

BOARD ON INFRASTRUCTURE AND THE CONSTRUCTED ENVIRONMENT

JAMES P. WHITTAKER, Facility Engineering Associates, P.C., Fairfax, Chair

WAYNE ARNY, Wayne Arny & Associates, Virginia Beach, Virginia

PATRICIA GALLOWAY, Pegasus Global Holdings, Inc., McLean, Virginia

SANJIV GOKHALE, School of Engineering, Vanderbilt University

CHRIS T. HENDRICKSON, NAE,1 Carnegie Mellon University

CHRIS POLAND, Chris D. Poland Consulting Engineer, Canyon Lake, California

Staff

CAMERON C. OSKVIG, Director

___________________

1 Member, National Academy of Engineering.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

BOARD ON HUMAN-SYSTEMS INTEGRATION

PASCALE CARAYON, College of Engineering, University of Wisconsin–Madison, Chair

JAMES BAGIAN, NAE1/NAM,2 Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor

DIANA BURLEY, Graduate School of Education and Human Development, George Washington University

BARBARA DOSHER, NAS,3 School of Social Sciences, University of California, Irvine

MICA ENDSLEY, SA Technologies, Mesa, Arizona

EDMOND ISRAELSKI, AbbVie, North Chicago, Illinois

NAJMEDIN MESHKATI, Viterbi School of Engineering, University of Southern California

FREDERICK OSWALD, Department of Psychology, Rice University

EMILIE ROTH, Roth Cognitive Engineering, Stanford, California

WILLIAM J. STRICKLAND, Human Resources Research Organization, Alexandria, Virginia

MATTHEW WEINGER, Vanderbilt University Medical Center

Staff

TOBY M. WARDEN, Director

___________________

1 Member, National Academy of Engineering.

2 Member, National Academy of Medicine.

3 Member, National Academy of Sciences.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

Preface

This report by the Committee on Facilities Staffing Requirements for Veterans Health Administration is the next piece of the project to prepare a comprehensive resource planning and staffing methodology guidebook for the Facility Management (Engineering) Programs of the Veterans Health Administration (VHA). The committee has held five committee meetings and five workshops so far, and one more feedback workshop is planned after the release of this report. From these activities, the committee has developed both a deep appreciation of the complexities associated with VHA Facilities Management and an understanding of its current methods of staff modeling and planning. The wide-ranging expertise brought to bear on the study challenge through the varying committee investigations has allowed the committee to evaluate existing models from potential analogues of the VHA Facility Management’s situation. An Interim Report has already been written and released to the sponsor and public. As the committee’s target organization knowledge and modeling examples converged, it has developed findings and recommendations to meet the statement of task.

We wish to express our deep appreciation to the members of the committee for their diligent and dedicated contributions to developing and participating in the multiple workshops and meetings. The diverse expertise and experience offered by the members of the committee were indispensable to the formulation of the individual sessions. We also wish to thank, on behalf of the entire committee, the staff of the National Academies of Sciences, Engineering, and Medicine, whose expertise and skill was absolutely essential to our meeting the charge from our sponsor.

Colin G. Drury and James B. Smith, Co-Chairs
Committee on Facilities Staffing Requirements for
Veterans Health Administration

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

Acknowledgment of Reviewers

This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following individuals for their review of this report:

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by Rear Admiral David J. Nash, NAE, Dave Nash & Associates, LLC. He was responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content of the report rests entirely with the authoring committee and the National Academies.

___________________

1 Member, National Academy of Engineering.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×

3 MODELS APPLIED TO STAFFING

Models

Desirable Model Characteristics

Critical Characteristics of Input Data

Models Applied to Staffing

Context

Model Complexity

Staffing Model Inputs

Staffing Model Outputs

Risk, Benchmarks, and a Caution About Metrics

Modeling Techniques

Summary

4 VHA FACILITIES MANAGEMENT (ENGINEERING) STAFFING METHODOLOGY

Linking VHA Facilities Management (Engineering) Staffing with Target Levels of Performance

Defining Target Performance Levels for VHA Facilities Management (Engineering)

Defining Key Performance Indicators that Reflect Target Levels of VHA Facilities Management (Engineering) Performance

Analyzing Links Between VHA Facilities Management (Engineering) Staffing and Performance

Staffing Methodology

Facilities Management (Engineering) Functions Included in the Staffing Methodology

Levels at Which the Staffing Methodology Should Be Built and Applied

Establishing Baseline Facility Management (Engineering) Staffing Requirements

Incorporating Infrastructure Complexity Parameters into a Baseline Staffing Model

Parameters That Could Be Considered in the VHA Engineering Staffing Model

Number of Infrastucture Complexity Parameters to Include in the VHA Facilities Managmeent (Engineering) Staffing Model

Notional Application of the VHA Facilities Management (Engineering) Staffing Methadology

Estimating the Number of Facilities Management (Engineering) FTEs Needed at the VAMC Level

Estimating a Staffing Budget Request at the VAMC Level

Summary

5 DESIGN, IMPLEMENTATION, AND SUSTAINABILITY OF THE VHA FACILITIES MANAGEMENT (ENGINEERING) STAFFING MODEL

Introduction

Key Staff Element Roles

Sponsorship and Oversight

Leadership Champion

Permanent Chief Engineer Facility Advisory Council

Subject-Matter Expert Task Force

Design Process and Timeline

Overview

Phase 1: Design of “Initial Model” (12 Months)

Phase 2: Coordinated Verification of Initial Model (6 Months)

Phase 3: Coordinated Working Model Independent Entity Verification (12 Months) and Validation

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Acronyms

A/E architects and engineers
AHRQ Agency for Healthcare Research and Quality
AI artificial intelligence
APPA APPA (formerly Association of Physical Plant Administrators)
ASHE American Society of Healthcare Engineering
ASHRAE American Society of Heating, Refrigerating, and Air-Conditioning Engineers
ASI Aviation Safety Inspectors
ATSS Airway Transportation Systems Specialists
BDA big data analytics
BIM building information modeling
BV best value
CAI Capital Asset Inventory
CAPRES Capital Resource Survey
CARES Capital Asset Realignment for Enhanced Services
CBOC community-based outpatient clinic(s)
CD construction document
CEFAC Chief Engineer Facility Advisory Council
CI condition index
CM construction manager
CMMS computerized maintenance management systems
CMS Centers for Medicare & Medicaid Services
CP Capital Project(s)
DD design development
DM deferred maintenance
DoD Department of Defense
Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
×
DOE Department of Energy
EA Engineering Administration
EOC Environment of Care
EPA Environmental Protection Agency
FAA Federal Aviation Administration
FCA facility condition assessment(s)
FCI facility condition index
FM Facility/ies Management
FTE full-time equivalent
FTEE full-time equivalent employee
FY fiscal year
GAO Government Accountability Office
GMP guaranteed maximum price
GSA General Services Administration
GSF gross square feet
HCFC Health Care Facilities Code
HHS Department of Health and Human Services
HQ Headquarters
HVAC heating, ventilation, and air conditioning
ICU intensive care unit
IDIQ indefinite-delivery, indefinite-quantity
IFB invitation for bid
IFMA International Facilities Management Association
IG Inspector General
IoT Internet of Things
ISO International Organization for Standardization
IWMS integrated workplace management system
JOC job order contract
KPI key performance indicator
KSAO knowledge, skills, abilities, and other characteristics
LSC Life Safety Code
ML machine learning
NASA National Aeronautics and Space Administration
NDMS National Disaster Medical System
NFPA National Fire Protection Association
NRM nonrecurring maintenance
NTP notice to proceed
O&M Operations and Maintenance
OACSIM Office of the Assistant Chief of Staff for Installation Management
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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OCAMES Office of Capital Asset Management, Engineering, and Support
OI&T Office of Information and Technology
OPES Office of Productivity, Efficiency, and Staffing
OPM Office of Personnel Management
OSHA Occupational Safety and Health Administration
PMTS Predetermimed motion-time system
RFB request for bid
RFI requirement for improvement
RiTMS Risk Identification, Triage, Mitigation, and Sustainment
SCIP Strategic Capital Investment Planning
SD schematic design
SME subject matter expert
TCO total cost of ownership
TF task force
USAF U.S. Air Force
VA Veterans Affairs
VAMC Veterans Administration Medical Center
VAST VA Site Tracking Database
VCP Veterans Choice Program
VERA Veteran’s Equitable Resource Allocation Methodology
VHA Veterans Health Administration
VISN Veterans Integrated Services Network
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2020. Facilities Staffing Requirements for the Veterans Health Administration–Resource Planning and Methodology for the Future. Washington, DC: The National Academies Press. doi: 10.17226/25454.
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The Veterans Health Administration (VHA) is America's largest integrated health care system, providing care at 1,243 health care facilities, including 172 medical centers and 1,063 outpatient sites of care of varying complexity, serving 9 million enrolled Veterans each year. In addition, VHA has opened outpatient clinics and established telemedicine and other services to accommodate a diverse veteran population and continues to cultivate ongoing medical research and innovation. Facilities specific to VHA fulfill clinical, operational, research laboratory, and administrative functions. Each site is designed to serve a geographical location with specific health care needs. VHA's building inventory has sites of different ages, and often there is a mix of building size and age at each site or campus.

At the request of the VHA, this study presents a comprehensive resource planning and staffing methodology guidebook for VHA Facility Management Programs by reviewing the tasks of VHA building facilities staff and recommending actions for the VHA to meet the mission goals of delivering patient care, research, and effective operations.

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