Date of Conferral

4-27-2026

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Sciences

Advisor

Cheryl Anderson

Abstract

The Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States, providing care to millions of veterans annually. Diagnostic service wait times affect veteran access to timely diagnoses and subsequent eligibility for disability benefits, vocational rehabilitation, and social services. The purpose of this integrative review was to identify evidence-based strategies to reduce diagnostic wait time within the VHA. The guiding review question addressed what strategies VA medical centers can use to reduce diagnostic wait times. Guided by Donabedian’s structure-process-outcome framework, a comprehensive literature search initially identified 487 sources across multiple databases. Subsequently, systematic screening and application of inclusion and exclusion criteria, the John Hopkins Evidence-Based Practice Research Appraisal Tool was used to evaluate 20 articles included in this analysis. The findings revealed three primary themes and six subthemes. The primary themes included (a) addressing structural barriers affecting diagnostic access, (b) standardizing diagnostic ordering and coordination processes, and (c) improving patient navigation and prioritization of care. Key subthemes included improving referral workflows, reducing unnecessary diagnostic actions, strengthening scheduling capacity, and prioritizing veterans based on urgency. A key practical implication is that healthcare administrators can improve diagnostic access by implementing coordinated strategies to address workflow inefficiencies, optimize resource allocation, and strengthen patient navigation systems. Recommendations included expanding diagnostic capacity, standardizing workflows, and implementing risk-based prioritization systems. These findings have implications for social change, improving healthcare access, outcomes, and the well-being of veterans and their families.

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