PRESS RELEASE
What the VA Eastern Kansas Health Care System (EKHCS) is doing to ensure transparency and commitment to our veterans in echoing Dr. Shulkin’s “State of the VA” Address
Secretary of the VA, Dr. David Shulkin states: “…the President is so committed to fixing issues for veterans that what he has told me is, is that it is important that we be open and candid and transparent about where the problems are; that as a businessman, the only way to fix the issues in an organization is if you come out and you talk about what those problems are.” With any organization, there will always be an opportunity for improvement. Dr. Shulkin shares the priorities to ensure improvement are; to provide a greater choice for veterans under the choice program, focus resources more effectively, increase timeliness and access to care as well as veteran suicide prevention. As VA shares its priorities with the nation, VA EKHCS shares its alignment with these priories locally.
In efforts to provide greater choice to veterans, VA will continue to increase the network of Choice providers – from the program inception to March 2017, there has been a 147% increase in the number of Choice providers. We are making progress, but more can be done. Nationally there are 14 medical centers have been identified with a 1 Star Rating, meaning they are below the standard of care VA is striving for. Currently, both the Topeka and Leavenworth VA facilities are identified with a 4 Star Rating and amongst some of the best in VA. One way in ensuring our high rating has been to developed a large network of community agencies that have entered a Provider Agreement with VA so that when care is not able to be coordinated through TriWest via the Choice Program, VA can work directly with these enrolled community partners to directly coordinate care for Veterans and directly process billing claims related to those community referrals.
Marian Paulsen, VA EKHCS’ Associate Chief Nurse for Care in the Community (CitC) mentioned, “with the recent expansion of the types of care that can be authorized related to a Veteran experiencing an Unusual or Excessive Burden (UEXB) in receiving care at the VA facility where the care is available, an increasing number of veterans can be authorized to receive care within the community closer to their home that were previously not eligible under the former guidelines.” Along this line, VA EKHCS continues to make progress in efforts to obtain medical documents from community providers in a timely manner, so that health care information is communicated between the VA and Community provider efficiently and additional care needs may be coordinated timely. VA EKHCS is taking strategic actions to specifically obtain records for multiple high-risk categories of care, such as oncology, cardiology, etc, as well as medical records from aged referrals.
Dr. Shulkin commented that despite limitations within the existing law, VA is holding its employees accountable and making accountability a priority. Director of the VA EKHCS, Mr. Rudy Klopfer states: “When we hear of misconduct, action is taken. We at the VA Eastern Kansas Health Care system expect nothing less than a full commitment from every employee when it comes to accountability and living the ICARE values while caring for our veterans.” In addition to accountability, VA is focusing its efforts into staffing positions and initiatives are being made to focus resources more efficiently. Local staffing concerns are being addressed by VA EKHCS through holding Annual Job Fairs to fill critical and hard to recruit positions. This has shown to greatly expedite onboarding time frames. The onboarding time frames for nurses at the most recent job fair at VAEKHCS has been significantly improved with the goal of bringing them onboard within 30 days, whereas the national average for VA remains about 120 days to hire a nurse. Another highlight is the turnover rates for Medical Support Assistant positions within the VA EKHCS. This rate has decreased from 18.06% (2015) to 7.65% (2016) and thus far in 2017 we are at 1.67%.
Kristen Wells, acting Chief for the Human Resource Department at VA EKHCS said, “at a recently conducted local job fair at VA EKHCS, over 250 applicants were in attendance. Supervisors were on-site at the job fair to conduct on-the-spot interviewing. If a candidate was selected, the credentialing and background process was initiated, and a time for a pre-employment physical was established. Completing these initial steps before the candidate left the facility greatly decreased the timeframe for hire.” The credentialing process, while vital to the hiring process, is still very time-consuming both to the applicant and our current staff.
Another priority is to improve timeliness of services. While we’ve made a lot of progress in reducing wait times we still have more work to do. The Access to Care website now posts wait time data for clinical appointments for all to see. No other health system in America does this. From September 2016 to December 2016 the average wait for MH in EK was about 21 days. From January 2017 to April 2017 that wait time was dropped to an average of 16 days. In primary care over 2,000 same day appointments have been completed this year since implementing same day access for Primary Care, which is an increase of 115 compared to this time last year. Group Practice Manager, Brian Stephens says that, “VA EKHCS experiences some of the same difficulties in recruiting and retaining physicians as found in the civilian sector, which has led to slightly increased wait times for established patients in primary care (currently a 5 day wait time average) and specialty care (currently a 6 day wait time average). However, initiatives are being made to actively recruit physicians.”
Suicide Prevention is a top priority for VA. 20 veterans a day are dying by suicide. This is unacceptable to all of us. Plans are being made to add more mental health provider and utilize telehealth more efficiently. In addition, emergency mental health services for those that were other than honorably discharged are now authorized. When veterans call the Veterans Crisis Line (800-273-8255, press 1 for veterans), they are immediately connected with a trained responder, who will provide support, connection to resources, and emergent care, if necessary. If requested by the veteran, the next working day, a member of the local Suicide Prevention team outreaches the veteran by phone. VA Eastern Kansas is proud of our ability to provide quick access to necessary care. However not all individuals who call the Veterans Crisis Line are enrolled in our system, and recognized that as a potential barrier was our initial enrollment process. Therefore, we improved our ability to quickly upload the data of veterans who contact the Crisis Line to streamline access to care. Of the 20 veterans who die each day by suicide, 14 are not receiving care through the VA. We realize that we cannot fight this battle alone; therefore, VA Eastern Kansas is working to increase our collaboration with community partners. Suicide prevention and other hospital staff recently presented information on mental illness and suicide prevention to local and surrounding law enforcement officers through Crisis Intervention training. VA EKHCS’ Suicide Prevention Coordinator, Dr. Stephanie Davis states: “The goal of Crisis Intervention is to help law enforcement recognize the difference between a mental health emergency and a legal issue, develop strategies to deescalate intense situations, and provide access to resources in a mental health crisis. In addition, we are preparing for our annual Mental Health Summit in September, at which we aim to improve our understanding of the mission, goals, and practices of our Veteran-centered community partners and develop structured processes for collaboration.”
Additional information from the Secretary’s “State of the VA” Address, with Fact Sheet, can be found at:
https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2911
The VA Eastern Kansas Health Care System (VAEKHCS) includes two medical centers and nine rural based clinics spread throughout Eastern Kansas and Western Missouri. VAEKHCS has nearly 1800 employees serving the healthcare needs of nearly 36,000 veterans. We stand on the motto of “Honoring our Veterans – Healing our Heroes”