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In 2014, the Department of Veterans Affairs (VA) endured a high-profile scandal that broke the trust between Veterans and the agency. Investigations revealed wide-spread negligence of Veterans waiting to receive medical care and systemic manipulation of the scheduling system to appear to meet VA’s access to care standards.  To make systematic improvements, in 2016, the agency began a journey to understand how Veterans experience care at VA medical centers using a human centered design approach.  How do Veterans experience outpatient care?  What are the most meaningful improvement possibilities in the eyes of patients' and their families? 


Design Research Lead​

Design Strategy

Photos: Aaron Steinstra, Han Wang, Renee Anderson, Jaryn Miller, Jen Kaczor, Corinne Vizzacchero, Sarah Brooks, Renee Anderson, Jane NewmandJen Kaczor, Julia Kim, Gabrielle Kellner, Roseann Stempinski, Ana Monroe,

Veronica Vela, Eulani Labay

Due to scandals erupting on television and differences of opinions among VA leaders on the VA's ability to deliver care, we wanted to uncover the truth. What were veteran's outpatient care experience at VA medical centers and clinics?

  • What are the moments that matter to Veterans and their families?

  • What are the bright spots in service that should be reinforced across the system?

  • What are the pain points in service that require improvement to enhance their experience?


This project the largest single human centered design (HCD) undertaking at VA to date and set the standard for future HCD efforts at VA. The project:


  • Visited 9 cities across the United States

  • Had a core planning team of 7

  • Conducted 84 in-depth, face to face interviews

  • Met with 40+ stakeholder groups at the national, regional and local levels to garner buy in for the work

  • Led an expanded field team of 80+ to support research, recruitment and on the ground logistics


I lost my insurance. I didn’t know what was going to happen. When I woke up, there were doctors around my bed. They handed me a letter… it was from the VA and it said that the VA was ‘going to take care of one of their own.

Veteran Patient & Former Marine

Seattle, WA

​VA is a jigsaw, I need someone like Paul to help me navigate.

Veteran Patient & Former Soldier

Gainesville, FL

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We conducted synthesis daily, weekly and at the end of the study. This allowed us to distill and refine findings throughout the process and compare what we learned across sites. We also took time to adjust research protocols. 

Incorporating VA staff members and leaders was paramount to the synthesis process to make sure they were learning with us. They were involved in all aspects of synthesis, including:

  • Daily in-person synthesis at local field sites 

  • Weekly remote synthesis to share across field teams 

  • Cumulative in-person synthesis at the conclusion 


The study confirmed access to care issues that plagued the news. It also uncovered great care experiences with VA staff who truly showed they care. We learned that there are 5 key improvement areas for veterans and their families:

  1. Scheduling is a barrier to address urgent needs

  2. Poor clinic navigation causes stress and frustration

  3. Trusted, long term relationships make veterans feel cared for

  4. Long pharmacy wait times prevents medication pick up

  5. Supportive follow up is essential to understand next steps

By focusing on these issues, the VA can create an emotionally resonant experience for veterans.

Visual Design: Deloitte Doblin


  • VA Outpatient Experience Storybook

  • VA Outpatient Experience Journey Map

  • Cumulative Snapshots from the Field


Visual Design: Deloitte Doblin, Aaron Steinstra, Veronica Vela

Visual Design: Corinne Vizzachero, Aaron Steinstra


This project led to the development of VA’s Patient Experience initiative, a national program to improve how Veterans experience care across VA's 152 health care systems and over 1,000 medical facilities in the United States. 

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