Why does the Spokane VA hospital have one of the longest waiting lists in the nation?
Why does it have one of the country’s longest-of-the-longest waiting lists – new patients who can’t be scheduled within 120 days?
Why is it falling short of the national standard for scheduling new patients, and – in an environment where most other VA hospitals are falling short of that standard, as well, why is the Spokane hospital’s record even worse?
No good answer to any of those questions is coming from the administration of Director Linda Reynolds at the Mann-Grandstaff VA Medical Center. Worse, it is incredibly difficult and time-consuming to get the VA to offer up even the least useful kinds of answers – the vaguest drivel. It probably goes without saying that Reynolds has not been willing to simply answer questions directly herself, unaided by a phalanx of mouthpieces and 48 hours to massage promotional copy.
It ought to embarrass Reynolds, as someone who is ostensibly accountable to the public whose payroll she dwells on. This is not just a reporter’s lament. Reynolds and the Spokane VA hospital owe veterans and the public more. Instead, one gets the sense of frantic and manipulative responses to basic questions.
Employees report similar complaints. In May, both of the major unions at the hospital said they had lost trust and confidence in Reynolds’ administration and called for “new leadership with accountability.”
The locals for the American Federation of Government Employees and the National Federation of Federal Employees went public in May with a wide range of assertions about management accountability, dismissal of employee complaints, punishment of union members who complain, and failures of communication by Reynolds’ administration. Their complaints also included an assertion that there was “talk of scrubbing the wait lists for colonoscopies.”
Here’s an example of the style of public communication now operating at the hospital: Last week, for a column about a new batch of audits by the nationwide VA system, I attempted to get an answer from the hospital about its performance on scheduling new patients. The VA strives to schedule new patients within 30 days, and the national average for reaching that goal has been about 90 percent in recent audits.
At the Spokane hospital, it’s 86 percent. Is this a huge deal? Does it reflect a big problem? Why is it lower than the national average? Are local officials concerned about it, and are they attempting to do better? Or, in the alternative, is this less of a concern than it might appear for some reason?
The VA spent two days pondering this and emailed a response that I will quote in full: “Appointments for medical care are scheduled based on an assessment of a patient’s medical need.”
Probably the chief area of concern – at least judging by audit reports – is the hospital’s Electronic Waiting List, which tallies patients who cannot be scheduled for appointments within 90 days. Spokane’s EWL is among the longest in the nation. More veterans here have been on the EWL for more than 120 days than virtually any other hospital as well.
Why might that be?
Again, here’s the answer the VA cooked up after two days: “We are experiencing staff vacancies in some programs. However, through the accelerated care initiative, we have made tremendous progress having patients on the EWL seen sooner.”
The hospital audits – now conducted every two weeks following the nationwide VA scandal – do indeed show the hospital has made progress. It shaved its EWL from 1,543 to 1,210 between two audits in June. Still, only 10 of 153 VA hospitals had a larger EWL. And 373 patients had been on the list for more than 120 days; just four hospitals had more veterans waiting that long.
Decide for yourself if this is “tremendous.”
Further requests asking the VA to expand upon these answers and to have an interview with Reynolds were met with utter silence.
As the national VA scandal has grown, a particular focus on poor administration has emerged. If waiting lists were gamed, there is little doubt as to who had the incentive to do so – top managers were rewarded with bonuses for meeting statistical measures. The former head of the Spokane VA hospital, Sharon Helman, oversaw the Phoenix hospital that was ground zero for the current scandal. Top officials there alleged that her administration kept two sets of books, to hide unconscionable and sometimes fatal wait times.
Two former employees of the Spokane VA have come forward alleging that similar manipulations of wait-time statistics occurred here – under Helman’s watch and before.
All of which means that current efforts to closely audit and publicly release wait times will be greeted with skepticism. It also means that VA leaders should take up the public burden of their job and speak to their communities, instead of hiding behind closed doors and faceless, empty statements.
Reynolds owes this not to me – plenty of people don’t talk to me – but to the thousands of veterans the hospital treats and to those it has kept waiting. She owes it to them to come out and talk frankly about the situation. To express some sense of commitment. To explain and own the problems and not pretend there aren’t any.
She owes this to everyone else in the community, too. You know – the ones who pay her $141,000 salary.