Va Hospital Finds Cure For Bureaucracy But Not All Workers Happy With Efforts To Streamline Operations, Improve Health Care
The White House is saluting the Spokane Veterans Affairs Medical Center as it strives to transform into a modern hospital.
During the past 18 months, the center has gone from an old-fashioned VA facility into a hospital that handles most of its patients in quicker, cheaper out-patient fashion.
The hospital’s ongoing revolution looks less impressive from the inside, say workers who grumble that patient care is compromised in the dash to save money.
But in June, federal regulators gave the hospital a rare, perfect score on its annual inspection. And the center recently heard it will receive The Hammer Award from Vice President Al Gore.
The award is Gore’s tribute to bureaucracies committed to saving tax dollars, cutting red tape and “reinventing government.”
Despite the accolades, some hospital workers say many of the changes are superficial, and in other cases go too far.
They note that while the center bankrolls a $3 million building renovation, patients sometimes wait two hours for an X-ray because the VA has been slow to buy a new X-ray machine.
“Where are our priorities?” said one worker who asked not to be identified for fear of retaliation. “Everything is cosmetic.”
Others are outraged that laboratory workers have been told that to save money, phlebotomists - technicians who draw blood - might be replaced by people who work in the hospital’s kitchen or janitorial services.
“We just had a salad cutter up yesterday interviewing for a job” as a blood drawer, said one irked lab worker.
Another worker lamented that hospital administration is quick to cut and reshuffle lower level patient care jobs, but is slow to thin mid-level managers.
Administrator Joseph Manley sounded more amused than concerned by the complaints.
Manley arrived two years ago from the Seattle VA medical center with the goal of making Spokane’s center at 4815 N. Assembly more like private-sector hospitals, such as Sacred Heart Medical Center.
“People don’t like change,” he said in response to worker gripes.
He said the X-ray problem will be solved this month with the purchase of a new machine. He said he’s gotten rid of many excess supervisors, and noted he’s unaware of plans to convert kitchen help into lab technicians.
He did say, though, that some contracted lab workers may lose their jobs.
In his pitch for Gore’s Hammer Award, Manley claimed the center’s personality transfusion was needed because the hospital used to be a place designed for the convenience of employees, not veterans.
“Patients rarely saw the same physician twice,” he wrote. “And any serious ailments usually resulted in an admission to a hospital bed.”
Manley’s other points included:
The average length of stay was almost cut in half in the past 18 months while outpatient care was increased by 28 percent.
The medical center now provides a private or semi-private room to every patient, instead of the previous three-to-four beds per room.
The annual pile of soiled laundry has been reduced by 200,000 pounds, and the number of inpatient meals by 30 percent.
The center is juggling 12 percent more patients this year than last, yet managed to cut $714,000 from its inpatient care budget.
Manley also noted an increase in patient satisfaction by as much as 34 percent.
Esther Westlake, service officer for the Disabled American Veterans, said the center’s changes are applauded by most veterans.
“I think there’s been some improvements in the efficiency,” she said. “For years, the VA was this place where guys went, and if they had some minor problem, they spent two weeks out there.”
A center worker critical of Manley’s revolution also admitted that many of the changes were long overdue.
“The joke used to be it was hard to get out of the VA,” she said. “People would just stay here” forever.
Manley said the downsizing and streamlining of center operations is saving money, but that the overall budget of about $35 million a year continues to creep upward.
“The veteran population is aging like crazy,” Manley said. “Every dollar we save gets sucked up pretty quickly in caring for another person.”
Manley said the center will receive Gore’s Hammer Award in the next 45 days.
Billed as Gore’s answer to embarrassing federal boondoggles like $600 hammers, the award has gone to more than 120 different “teams” of federal, state or local employees “working to build a better government.”
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MEMO: This sidebar appeared with the story: Regional center The center provides medical and surgical services to over 11,000 veterans per year from Eastern Washington, North Idaho and Western Montana.