Case Study - Change Readiness and Management - Continuous Process Improvement - Findings Analysis and Insights - Performance Optimization - Policy Analysis, Implementation and Compliance - Program and Project Management - Program Evaluation and Measurement - Research Design and Execution - Veteran Health

Optimizing Policy Development for the Veterans Health Administration

Posted on 03.31.25

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Improving internal policy processes to reduce risk and increase consistency across VA medical centers

In 2015, the U.S. Government Accountability Office (GAO) placed the Department of Veterans Affairs (VA) on its high-risk list, citing ambiguous policies and inconsistent processes. These issues led to uneven implementation across VA medical facilities, increasing the risk to Veteran care. A backlog of outdated policies further complicated matters. With limited internal resources, the Veterans Health Administration (VHA) required a streamlined, expert-driven approach to reduce policy inventory, improve clarity and modernize its national policy framework.

The Aptive Advantage

Precision policy analysis
Public health and legal expertise
Process optimization experts

Results at a Glance

Cut average policy development time from 334 days in 2015 to 190 days in 2021
Reduced national policy inventory from 805 in 2015 to 454 in 2022
Lowered percentage of overdue national policies by 28%
Implemented new processes for policy development and concurrence management

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Challenge

Lengthy policy development processes, a backlog of overdue policies and inconsistent guidance created operational risk

In 2015, 59% of VHA’s national policy inventory was overdue for recertification. Delays in updating guidance posed risks to Veteran safety and care quality. On average, publishing a single policy took nearly a year. Limited staffing compounded the issue, creating a need for a scalable, expert-led solution to overhaul the process.

Solutions

Redesigning the policy review system to reduce backlog and improve clarity

Aptive partnered with VHA’s Office of Regulations, Appeals and Policy (10BRAP) to modernize its policy infrastructure. A team of lawyers, public health specialists and VA experts supported content review, timeline management and policy alignment across VHA facilities.

Policy review and streamlining

Aptive and 10BRAP redesigned the national policy review workflow to shorten development timelines and improve clarity. Aptive led content reviews for each document, supported policy owners in aligning language with VA standards and implemented structured timelines for every phase of policy development.

Field analysis and local support

To align facility-level policies with national guidance, Aptive conducted structured interviews and site visits across VA medical centers. Policy experts reviewed facility-level inventories and provided tailored recommendations to reduce duplicative or outdated local policies.

Operational feedback and concurrence

Aptive built structured channels for field staff to provide input, ensuring policies were clear and implementable. The team compiled feedback, updated policies with program offices and coordinated the concurrence process with senior leaders, unions and legal experts. Aptive also supported the development of the new 10BRAP website, offering centralized access to policy templates, FAQs and guidance tools.

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RESULTS

Improved performance and reduced risk through updated policy governance

With Aptive’s support, VHA reduced average policy development time by 43% and decreased its national policy inventory by 44%. The proportion of overdue policies fell from 59% in 2015 to 31% by the end of 2022. These improvements created a stronger foundation for delivering consistent care and guidance across VA facilities. Aptive supported VHA in its drive toward functional zero overdue national policies and lasting process improvements.