The American Legion’s System Worth Saving (SWS) Task Force has issued its report on conditions at a Department of Veterans Affairs (VA) medical center in Fort Wayne, Ind. The Fort Wayne campus, along with one in Marion, Ind., make up the VA Northern Indiana Health Care System.
On Oct. 22, the Fort Wayne campus temporarily closed its acute-care and intensive-care services after a series of problems in critical areas of health care, according to Ginny Creasman, the facility’s acting associate director. The Legion’s SWS Task Force made a site visit to the Fort Wayne hospital after several veterans contacted the Legion worried about their health care and wondered when important quality-of-care services would be restored.
Besides Creasman, the task force interviewed Denise Deitzen, director; Ajay Bhawan, chief of staff; Helen Rhodes, associate director for operations; Audrey Frison, associate director of patient care services; and other key staff members.
The SWS report noted the hospital issued a press release on Oct. 22, announcing it had "temporarily paused inpatient operations on the Intensive Care Unit and Acute Medical Unit at the Fort Wayne campus to afford us the opportunity to review our processes, provide training to our staff, and ensure our continued ability to maintain the most flexible systems and highest standard of care for our veterans."
However, no official VA letter was sent to the facility’s enrollees, which caused much speculation among local veterans as to why the hospital’s critical-care services were being closed. Many enrollees expressed their concerns at a Dec. 5 town hall meeting in New Haven, Ind., hosted by American Legion Post 330.
Ralph Bozella, chairman of the SWS Task Force, and Jacob Gadd, deputy director of health for the Legion’s Veterans Affairs & Rehabilitation Division, facilitated the meeting. Nearly 50 people attended, including Richard Jewell, Department of Indiana commander; John Hickey, department service officer; county service officers; VA employees; and representatives for Sen. Dan Coats, R-Ind., and Rep. Joe Donnelly, D-Ind.
Bozella told hospital administrators that local veterans generally like the care they receive in Fort Wayne, "but there’s not enough of it. Services are going to be restored, but there’s no timeline."
The Legion’s SWS report said that several concerns were identified at the town hall meeting, including fears that the Fort Wayne facility would be completely shut down. Patients now must travel about 50 miles to the VA facility in Marion for treatment.
The Fort Wayne campus has been facing a staffing challenge recently — it’s had three directors in the past 18 months and currently has vacancies for a cardiologists, pulmonologist and chief of mental health. It too has had a turnover of 11 registered nurses and three licensed practical nurses.
While the acute care unit reopened on Dec. 18, the facility still needs to reopen the cardiac telemetry and intensive care unit.
The SWS report made several recommendations for improving external and internal communications, and addressing concerns of the facility’s staff, including:
Director should conduct a town hall meeting with veterans in the local area to explain the reason for the pause in services and steps/phases for reopening them.
Facility leadership should schedule media interviews to discuss progress in the resumption of services.
Quarterly congressional/veterans service organization meetings should be conducted to provide updates and share mutual issues and concerns.
Supervisor training should be instituted for mid-level staff, as there were many challenges between frontline employees and leadership.
Current plans to conduct the National Center for Organizational Development and Transition Briefing/Orientation should be carried out.
Consider adding employee surveys, focus groups, culture training and team building.
Continue to use Rapid Process Improvement Workgroups to empower frontline employees and nurses to more effectively work with doctors to ensure quality and safety for veterans.
Continue to work with VA and private agencies to expedite hiring for the following immediate-need positions: cardiologist, pulmonologist, emergency room director/physician and chief of mental health.
"While the pause of inpatient services was a proactive measure to ensure the quality and safety of medical care to veterans," the Legion report said, "Fort Wayne and other facilities must strive to identify issues and concerns, and follow procedures and hire the right staff to prevent future pauses or interruptions of needed medical services to our nation’s veterans."
The SWS Task Force plans to conduct a follow-up visit to the Fort Wayne facility in six months to determine what corrective actions and improvements have been made.
Read the report here.