Excellent Care Starts with Access
Healthcare does not have to be elusive.
The new leadership team at the James E. Van Zandt VA Medical Center (VAMC) in Altoona, Pennsylvania, has made it their goal to provide access to care at the time and place that suits the Veteran’s health care needs and focuses on being a world-class, patient-centered health care organization for Veterans.
This has not always been the standard for the medical center; but a re-focus on access to care is one of the biggest reasons why Altoona VAMC jumped from a 3-star rating in 2016 to a 5-star rating in 2017.
The new emphasis has resulted in high levels of patient satisfaction as shown by the Strategic Analytics for Improvement and Learning Value (SAIL). SAIL assesses 25 quality measures in areas such overall efficiency, patient experience, complications and mortality rates at individual VAMCs. The metrics are then organized within 9 quality domains and one efficiency and capacity domain. Based on the results, each hospital is given a star rating (1-5). The report is updated quarterly to allow medical centers to more closely monitor the quality and efficiency of the care delivered to Veterans.
Improvement trends at Altoona VAMC noted by SAIL are patients’ overall experience with their primary care provider (PCP) and specialty care providers. Out of a score of 1-100, patients reporting a good to great experience with their PCP rose from 74 percent in 2016 to 76 percent in 2017, and for specialty providers the ratings rose from 70 percent in 2016 to 71 percent in 2017. Early data for 2018 indicates these statistics are still current. However, an additional upsurge for overall patient experience rose to 69 percent for the first quarter of 2018 from 67 percent in 2017.
Reduced wait-times for appointments is another way the Altoona VAMC has improved access to care. In 2017, nearly 85 percent of all new PCP appointments were scheduled within 30 days, new specialty care appointments were scheduled within 30 days around 72 percent of the time, and new mental health appointments scheduled within 30 days hit a high mark of 91 percent.
What does not show in the SAIL report are behind the scenes changes and best-practices that Altoona VAMC has taken to increase access and quality of care to Veterans.
Addressing demands for greater access and timeliness of care, primary care teams have created the RN Wave Clinic for scheduling appointments that fit the Veteran’s schedule and needs. The patient sees the Registered Nurse (RN) on the day desired, even same day appointments. The RN will then confer with the physician on duty to seek concurrence or recommendations prior to the patient leaving the clinic. During 2017, over 2,000 RN Wave appointments were completed and a total of 91 percent of Veterans surveyed answered always or usually when asked if they received their appointments as soon as needed.
There has been a large expansion of services at the medical center just within the last six months. Altoona VAMC now offers chemotherapy, colonoscopy, upper endoscopy services, and wound care. They have expanded radiology and added podiatry in their Community Based Outpatient Clinics. Additionally, high demand has led to the addition of Lumbar Epidural Steroid Injections (LESI) and pain management clinics.
Altoona VAMC is part of a diverse healthcare community which includes partnerships with non-VA medical facilities and is looking at ways to attract new talent through this community so they can continue their expansion. They recently added over 100 new personnel to their team and have added a chiropractor who is also an acupuncturist. Additionally, they expanded full practice authority to nurse practitioners.
“It is because of the hard work from our employees and their dedication to our Veterans that we are able to keep improving across all standards” said Sigrid Andrew, James E. Van Zandt VAMC Director. Ms. Andrew also noted that while their services for Veterans keeps improving, the recent AES survey showed a more than 50 facility jump in employee satisfaction when compared to the rest of the nation.
According to the Public Affairs Officer, Shaun Shenk, Altoona VAMC’s current director, “Sigrid Andrew and her leadership team are expanding services at lightning speed to meet growing demands. As an RN by trade, the director has a patient-focused mentality and believes in seeing the medical center and care through the patient’s eyes.”
Continuing their great strides, Altoona VAMC has shown they are gaining momentum as they prove excellent care starts with access.
Note: This blog was authored by Kristin Atkinson, Rating Veterans Service Representative for VBA in Maine.