A one-star rating — out of five, and not for the first time — for its quality of care prompted the Gulf Coast Veterans Health Care System to address the public with steps they will take — and have already begun taking — to improve patient care.
The system, with clinics in Florida, Alabama and Mississippi and its largest based in Biloxi, is one of 14 nationwide with a one-star rating, which puts it below Veterans Affairs standards and below community standards. It does not affect its funding or accreditation.
During an address last week, VA Secretary David Shulkin, a doctor, offered an assessment and diagnosis of the beleaguered system, including ongoing, chronic issues concerning quality of care, access to care, dealing with community providers, processing claims, out-of-date technology, accountability and staffing.
On Wednesday, the interim director of the Gulf Coast Veterans Health Care System, M. Christopher Saslo, focused on access to care, working with community providers and quality of care.
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The one-star quality of care rating, which covers the final three months of 2016, is based on 30 metrics, everything from nurse turnover to infection control. The good news, Saslo said, is those 30 metrics provide a lot of data, and that data allows officials to focus their efforts on areas that can be improved and focus on the most effective methods to improve those metrics.
Officials in Biloxi have already researched best practices at other VA systems and meet regularly with members of the committee that determines the ratings.
“We know we can’t afford to take our eyes off the prize,” Saslo said.
He added the health care system has improved on many of the metrics since the 2016 rating, though the data collected may not yet reflect that.
For several years, the biggest issue among the VA health systems has been access to care and how long it takes veterans to be seen by medical staff. At the Gulf Coast VA, 97 percent of patients requiring primary care are seen within 30 days of a requested appointment. The average wait time is 6.4 days for a new patient and 5.1 days for an established patient.
The system has hired 48 staff so far in behavioral health care and 37 in primary care, its two biggest areas of concern, and expect to soon hire 16 more in behavioral heath and 17 more in primary care.
“We hire aggressively and we hire with intent,” Saslo said. Initiatives to streamline hiring practices and improve incentives have helped with the process. Those providers, in turn, are encouraged to work with each other for a continuum of care.
But often the perception of access to care is different than the reality, and the VA is perceived as being slow to treat veteran— whether because a patient’s desire to be seen does not match up with a doctor’s determination of what is clinically appropriate or because a specialist has a longer wait time than the primary care clinic. And, in some cases, veterans are stuck waiting more than 30 days for care. More providers are also needed in the community to facilitate the Choice Program. Shulkin also said last week the VA needs to improve methods of finding providers and approving claims to pay those providers.
To that end, Saslo said the Gulf Coast VA system has at least two programs aimed at improving veterans’ experiences while in VA care. One is for outpatient while the other is for inpatient veterans, but both aim to make veterans feel welcome and like their doctors are committed to their care.
“Sometimes we become so entrenched in the process we forget about the person,” Saslo said. “So what we’re trying to do is to make sure our veterans understand that we’re here for them and that their vote is with their footprint. They have the right to take their care anywhere but we want them to choose VA.”