201706_03_27 - Columbia VA Health Care System
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Columbia VA Health Care System

 

201706_03_27

June 9, 2017

By Dr. David Omura, DPT, MHA, MS

Medical Center Director, Wm. Jennings Bryan Don VA Medical Center

 

As many of you may have heard, the Secretary of Veterans Affairs Dr. David Shulkin hosted a press briefing on May 31 to discuss the “State of the Veterans Administration.” During this national briefing, he provided a candid assessment of the challenges facing the Department of Veterans Affairs, and what he believes can be done to rectify some, if not all, of these issues with the support of each and every Veterans Affairs facility.

In his briefing, Dr. Shulkin highlighted 13 areas of risk which he believes are significant areas of focus that need to be addressed in order to drive performance, quality of care, and maintain world class services. These areas include:

  • Accountability of all Staff
  • Hire and Retain the most Talented Workforce available
  • Continue to Improve Access for Veterans
  • Ensuring the Appropriate Payment of Community Providers
  • Streamline Community Care Services and partnering with Department of Defense medical facilities
  • Make Quality Metrics on VA healthcare Transparent to the Community
  • Increase the Speed in Addressing Disability and Appeals Claims
  • Improve Information Technology Services
  • Ensuring appropriate Capital Asset Needs are Maintained
  • Obtain Department Funding for Needed Construction
  • Reducing the Bureaucracy in the VA: Improve Communication
  • Further Reduce Waste, Fraud and Abuse
  • Eliminate Veteran Suicide

The staff of the William Jennings Bryan Dorn VA Medical Center stand fully behind the secretary’s vision, and are focused on continuing to improve the care provided to our Veterans each and every day.  A 90-day plan was developed for our Medical Center which provides a focused approach on overall operations and is being used in conjunction with facility’s annual performance plan and strategic plan in driving progress. 

The following are just a few of the measures that highlight the success of the Dorn VA:

  • Continue to Improve Access to Care:

Here at Dorn VA, as the secretary said, “We've done a significant job in improving access to care for clinically urgent veterans, so people with clinically urgent needs are now being addressed in a much more efficient way.”

The average wait time at Dorn for a primary care appointment is only seven days, and at our seven community-based outpatient clinics across the state, the average wait is between five and 10 days compared to 2015, when the average was more than 12 days. Regarding access to mental health care, the average wait time at Dorn is now two days, compared to nearly five days only a year ago. We are also pleased to report that as our access continues to improve our quality remains very high and we meet or exceed the quality of care of our community facilities and are in the top 10 percent in the Healthcare Effectiveness Data and Information Set (HEDIS) and Oryx inpatient measures across the VA.

  • Ensuring the Appropriate Payment of Community Providers:

Another category Dr. Shulkin covered was paying providers when veterans go out into the community. He expressed his understanding that providers are increasingly frustrated with the VA’s inability to make payments in a timely manner; to the point that some of them are actually leaving our network. The Dorn VA is actively engaged in developing, maintaining, and improving our relationships with community providers. Facility leadership meets regularly with our community partners and others involved in the process to evaluate and quickly address any concerns. This regular communication, along with improved staffing and improved processes, has led to improvements in outstanding payments, leading to enhanced community relations and veteran satisfaction.

  • Make Quality Metrics on VA healthcare Transparent to the Community:

According to recent data of what veterans themselves said about their own experience accessing care and the quality of that care, more than 80 percent of them said they were completely satisfied. This is a significant improvement over the last few years in which barely more than 50 percent of the Veterans receiving care here were satisfied with their experiences here.

We expect this number to climb even higher in the weeks, months, and years to come, due in part, to the efforts being made to expand our ability to provide care to veterans by developing new facilities, repurposing and redeveloping some of the old facilities on this campus, and maintaining a focus on hiring staff who are committed to provide the care our veterans deserve.

In terms of transparency to the community, the VA recently deployed a publicly accessible website that shares quality data from community providers and VA facilities, satisfaction scores, and how quickly veterans are able to be seen. www.accesstocare.va.gov

  • Ensuring appropriate Capital Asset Needs are Maintained

Plans are in place for many expansions and new buildings on the Columbia campus and at the Community-Based Outpatient Clinics (CBOCs). Some of these projects include new CBOC facilities in Rock Hill, Orangeburg, Sumter, and Florence, which are currently approved and in the design phase, and will be increasing in size by nearly 100 percent in the next three years or so.

In addition to these enhancements in the CBOCs, at our main campus in Columbia we will have a new parking garage under construction in the next six months. We will also have new buildings including: a mental health center, a Fisher House for patients’ families to stay at for no charge, a prosthetics center, a new perimeter fence, a police headquarters building, and the renovation and restoration of the historic building 10 as a primary care annex. In our current main facility, projects underway include a mental health inpatient unit and the OR suite renovation.

With these exciting improvements, the face of the Columbia campus will change significantly in the near future and will allow us to continue to improve services while also providing a better experience to our Veterans.

  • Further Reduce Waste, Fraud and Abuse

The efficient use of taxpayer funds is a main focus of the medical center, and is taken into consideration with all facility operations. Other areas of focus include productivity reviews, strategic planning with our Department of Defense partners, and prescription diversion prevention measures. As part of the facility’s 90-day plan, along with a national focus on prescription drug diversion, a goal was developed to design and implement an enhanced tracking system to address and prevent drug diversion. Our overall focus is to maintain our operational efficiency and at the Dorn VA all expenditures are closely monitored for the most efficient use possible. We are proud to be in the top 10 percent of efficiency measures for all VA facilities.

  • Eliminate Veterans Suicide

The Dorn VA has a dynamic suicide prevention team that continues to identify ways to address this widespread and tragic problem. Several facility goals to address suicide prevention include developing stronger partnerships with the South Carolina National Guard and the South Carolina Department of Mental Health, hosting suicide awareness summits, and the integration of suicide prevention into the homeless veteran program.

Additionally, the facility has partnered with other VA medical centers to implement a VA Diffusion of Excellence practice called the Home-Based Mental Health Evaluation (HOME) program, which will empower employees to promote continuous improvements in the transition from inpatient mental health care to a Veteran’s home, reducing post treatment suicide rates.

The Dorn VA is also a member of the Midlands Veteran Engagement Council (MVEC) which is made up of community leaders who provide feedback to the Medical Center and are a barometer of how we are performing. We appreciate their input, collaboration, and partnership in our relentless focus on providing the best care possible for our veterans.

As our president has expressed several times, he is committed to fixing the issues veterans face, and Dr. Shulkin is right in line with this message – wanting to fix the problems and lag times within the VA. As for Dorn VA, I am just as committed to taking care of our veterans as the president and the secretary – and so is my staff. And though there may be some who feel otherwise, I would say to them to consider that nearly 40 percent of our staff are veterans themselves and many others have close family members who were or still are in the military and they are committed to our mission. Secondly, I ask those veterans we serve, their families, and their friends, that if you see something at the Dorn VA or one of seven CBOCs that needs to be addressed, to let us know so we can resolve those issues immediately. Together we can all be part of the solution.