When I took the helm of VHA one year ago, my most urgent priority was to immediately begin improving Veterans’ access to the care they’ve earned and deserve.
I knew that addressing this national crisis in prolonged wait times was Job One. Consequently, on November 14, 2015 we executed a nationwide, single-day ‘Stand Down’ event to ensure that Veterans who were at greatest risk were seen first.
As a result of this effort —which involved all of our 168 medical centers— nearly all of the 56,000-plus urgent care consults that we originally identified have been successfully resolved.
Taking a coordinated, system-wide approach to our Stand Down proved to be a key decision. Working together across 168 sites helped us share and learn from one another and plan for future improvements in our system.
In fact, our access-related Stand Down was a learning experience so valuable that it has already begun to make a profound difference in how we provide healthcare to our Veterans. I believe it was a pivotal moment in this organization’s history that has launched us toward our ultimate objective of making timely access to healthcare a sustainable reality.
The Stand Down also accomplished something else, perhaps even more important. It was designed to be an exercise in empowerment. By initiating the national Stand Down we learned that action is better than inaction. We also learned that bold actions require courage and commitment.
Following is a great example of what happens when employees feel empowered to be agents of change. It comes to us by way of NPR, which recently ran a segment called, ‘To Cut Wait Times, VA Tries MinuteClinics in Northern California.’ Here’s an excerpt:
“Struggling with long wait times, the Veterans Affairs Health Care System is trying something new: a partnership with the CVS Pharmacy chain to offer urgent care services to more than 65,000 veterans. The experiment began Tuesday at the VA’s operations in Palo Alto, Calif.
“Veterans can visit 14 CVS MinuteClinics in the San Francisco Bay Area and Sacramento, where the staff will treat them for conditions such as respiratory infections, order lab tests and prescribe medications that can be filled at CVS pharmacies. The care will be free for veterans, and the VA will reimburse CVS for the treatment and medications.”
This is just one example of the changes that I believe are now occurring throughout the Veterans Health Administration. Empowerment is a powerful thing. And empowered employees aren’t afraid to think ‘out-of-the-box’ when it comes to tackling significant challenges.
Now let’s take a look at another recent headline, one that has exciting implications when it comes to improving access to care: ‘VA Moves to Cut Red Tape and Wait Times…Advanced Care RNs Will be Able to Do More.’ It’s a story from KTVZ (NBC-21) out of Bend, Oregon.
An article from FierceHealthcare on the same subject sums it up nicely: “The Department of Veterans Affairs aims to expand the scope of practice of advanced practice registered nurses (APRNs) who work for the agency in order to provide veterans with greater and timely access to care.
“Under a proposed rule published today in the Federal Register, the VA said it intends to expand the pool of qualified healthcare professionals who are authorized to provide primary healthcare…”
Providing our Veterans with timely access to care means we need all hands on deck, and empowering our talented nurses to do the work they were trained to do (and are very, very good at doing) is a major step in the right direction. Empowerment is a powerful thing.
Finally, let’s step away from the broader picture for a moment and focus in on what our wonderful employees are accomplishing at the local level –where the real work gets done—when it comes to improving access to care.
Someone who knows a little bit about this subject is Maria Beltran, an outreach coordinator at the Phoenix VA. She’s one of six social workers there assigned to search for and make contact with homeless Veterans —in parks, under bridges, in shelters or alleyways — and find them a place to live, a job, counseling, healthcare… whatever it is they are in need of.
In Maria’s world, access means that if the Veteran can’t or won’t come to you for help, then you go to the Veteran.
Maria’s good work was highlighted some time ago via a short piece by Joe Dana of KPNX-TV in Phoenix. He writes: “There is a relentless cheerfulness in the voice of retired Army Staff Sgt. Maria Beltran. Whether describing a veteran in the throes of considering suicide, or lamenting the many veterans who fall into the trap of drug addiction, Beltran never seems to waiver from a smiling demeanor of pure optimism.”
“I enjoy it —being able to help our veterans,” Maria states in the article. “They’re the ones who need our help right now.”
This kind of outreach is occurring not just in Phoenix, but at VA locations throughout the country. It is the quiet, unsung work of many thousands, and it makes me proud.
Maria, thank you for the good work you do, and for that bright light you carry around inside you at all times.
And to all our VHA employees: allow me to thank you as well. Thank you for your perseverance and your resiliency during these challenging times. Thank you for your dedication to America’s Veterans. And thanks for making my first year here the most profound, exciting and inspirational 12 months I could have ever asked for.
DAVID J. SHULKIN, MD