Management of the veterans medical center in Walla Walla has moved up a notch, according to recently released numbers from the Department of Veterans Affairs.
In the second quarter of this year, the Jonathan M. Wainwright VA Medical Center was one of 10 VA medical centers in the U.S. in the one-star, “high risk” category on a scale of five stars. Since then, it has earned another star, joining 95 others nationwide that have improved in the past year.
“(The one-star rating) was a big black eye for us and I think it was a wake-up call as well,” said Keith Allen, the medical center’s acting director. “I told staff we need to celebrate but we need to get back to work because that third star is on the horizon.”
While two out of five stars may not seem particularly good, Allen said those ratings are for comparing VA medical centers with each other,
The metrics do not draw a direct parallel to the private sectors, he added, but “when you compare us to the UWs, the Virginia Masons, the Harborviews, we are right there, if not better than our counterparts on the private side.”
Allen traced the rating change to the VA’s efforts in identifying areas for improvement, rather than punishing facilities that did not meet benchmarks. He compared it to navigating an unfamiliar room in the dark. They were bumping into things they did not know were there, but concrete measurements brought to light what needed to change.
Since 2015, the VA has worked to improve oversight of quality management by tracking data more closely, offering the medical center a more comprehensive view of the its progress.
Improving communication across the entire facility was one of the biggest improvements, Allen said. Additionally, the amount of people returning the hospital after a recent visit has fallen and employees reported being more satisfied with their jobs.
Still, the medical center has about a 28-percent job vacancy rate, he said. With about 600 employees, Walla Walla is relatively small facility, so those shortages hit the remaining staff harder than at larger facilities.
It is also more difficult to attract and retain primary care providers, Allen said. Many choose to take jobs in the private sector, which often pay more, and some would simply prefer to live in a bigger city. And once they are in the job, many providers show signs of burnout.
Allen said the medical center is showing improvement in this area as it focuses more on training and mentorship. The medical center has also recently hired a chief of staff for primary care, a position that has been vacant for a while, he said.
The medical center is filling positions in its Patient Aligned Care Teams — groups of employees who bring care to the patients all at once rather than, for example, sending them to a doctor, then a specialist, and then a pharmacist. The teams still have vacancies, Allen said, but the pace of hiring is picking up.
Suzanne Gordon, author of “Wounds of War: How the VA Delivers Health, Healing and Hope to the Nation’s Veterans,” said a variety of forces beyond an individual hospital’s influence affect veterans’ health care.
The shortages at Walla Walla’s medical center mirror those at others around the country. Gordon said the VA has about 45,000 job vacancies nationwide and there have been efforts to reduce retirement plans and bonuses for federal employees, including those working in the VA, which further makes moving to the private sector more attractive.
As a government agency, the VA can be caught in the crossfire of the politicians that control its budget and policies, she said.
The nature of the care needed also poses a challenge, Gordon said. In general, veterans are less likely to show up to their appointments, but are more likely to have needs specific to their population.
She said there is a lot of stigma among veterans when it comes to mental health care although they are more likely to need it.
Despite all the shortages, Gordon said it is important to recognize how the VA health care system compares to the private sector.
While there are thousands of private hospitals, the VA is an integrated network that can benefit veterans no matter their location.
According to the third quarter measurements, almost 75 percent of VA medical centers nationwide have shown improvements since this time last year.
“Better things are out there and we just need to go get them,” said Allen. “There are a lot of people here that pour their heart and soul in the facility.”