Step it up. That's the gist of the message acting Secretary of Veterans Affairs Sloan Gibson delivered to regional VA hospital directors yesterday. Gibson, who was appointed after Eric Shinseki's resignation in May, was in Philadelphia for strategic meetings on reducing patient wait times.

"You are directly accountable for the timeliness and quality of care that we deliver — and so my expectation is not only as it relates to wait times but, basically, everything you do. You have to get close enough to that operation to ensure that we're delivering the right healthcare outcomes," he said.

Gibson is touring the country's VA hospital facilities to gain a better understanding of what contributed to long wait times, and to get to the bottom of practices to conceal these waits on records. "I think, frankly, at VA we became very focused on working to meet metrics. And in the course of working to meet these metrics, we lost sight of meeting the needs of patients," he explained.

Gibson said the VA needs to deliver patient-centered care, and one of his immediate goals is to create a better system for patient feedback that would deliver information on patients' experiences in "real time." The system will include on-site feedback, letters and telephone surveys.

Gibson says he is backing his demands on hospital directors with additional resources where needed. The Philadelphia VA hospital has just received an additional $500,000 in funding to increase staff, extend hours to nights and weekends, and to build partnerships with providers in the community to allow vets to seek treatment there if needed.

Gibson says he is not afraid to take politically unpopular steps in his efforts to create a more efficient VA system — which could include closing down underused hospitals.

"I think one of the challenges I see before us is calling it like I see it. And I have committed to Congress that I will do that," he said. "And to the extent that keeping a facility open impairs our ability to meet the needs of veterans, then I'm going to call it like it see it."

Gibson says he is confident that the VA system is going to come out of this experience a "dramatically better organization, because Congress is stepping up support, and most VA employees are passionate about delivering good care to veterans."

The Philadelphia hospital is one of 112 VA centers nationally under further investigation for wait times and tracking practices. Gibson said the "closer look" does not suggest wrongdoing.