Improving satisfaction, reducing infections are priorities for VA Pittsburgh director
The Pittsburgh Veterans Affairs Health Care System is taking a closer look at how it compares to other hospitals in the region amid a push from VA leaders to correct highly publicized deficiencies in the national system.
While the Pittsburgh system compares favorably with other VA medical centers, receiving five out of five stars in a comparative quality ranking, it could improve its marks in patient satisfaction and infection prevention, said Karin McGraw, VA Pittsburgh's director.
McGraw talked with the Tribune-Review a week after VA Secretary David Shulkin delivered what he called a “candid assessment” from the White House of problems in the VA and his office encouraged medical centers across the country to embrace transparency.
McGraw took the helm of VA Pittsburgh in January 2016. She became its first permanent director since 2014, when VA leadership fired former director Terry Gerick Wolf over her handling of a deadly Legionnaires' disease outbreak.
Among 40 regional hospitals, VA Pittsburgh had the fifth-highest rate of infections in the tubes doctors place in large veins to administer fluids and medicine and collect blood, according to an online VA comparison tool based on 2015 data. The system had the 10th-highest rate of urinary tract infections, according to the tool.
McGraw said the Pittsburgh system admits more complicated patients than some other regional hospitals — it is the only VA hospital in the state designated to treat the highest-complexity patients, including those who need organ transplants and robotic surgery.
The hospitals that ranked best eliminated the infections. Westmoreland County's Excela Health Frick Hospital reported none of either type of infection, as did Punxsutawney Area Hospital. Hospitals with higher rates of central line infections were West Penn Hospital, Forbes Hospital, Indiana Regional Medical Center and Reynolds Memorial Hospital in West Virginia.
McGraw said she has formed a team of employees to analyze the infections and to make suggestions for improvement. She also has formed teams to study patient satisfaction. In surveys, 69 percent of veterans who received care at VA Pittsburgh's University Drive campus said they would definitely recommend the hospital.
She said she is taking a hands-on approach to patient satisfaction, meeting one-on-one with veterans to address their complaints. She is working on a way to collect veterans' feedback about their care in real time at the hospital, rather than in mailed surveys. She has hosted town hall meetings around the region to hear veterans' concerns.
She is working to address parking problems that rank highly among the complaints, she said — an effort that might require relocating some physicians' offices to a nearby location.
She said one of her first priorities as director was to build trust in the wake of the Legionella outbreak and the string of interim directors that followed. She believes she has made progress.
“I do think I'm building trust with the veterans. ... It doesn't appear to me there was as much hands-on meeting with veterans that have complaints as I would like to do,” she said. “So I have had frequent meetings with veterans who have not been satisfied with their care.”
Veterans Benefits Administration officials attend the meetings as well. Shulkin in his speech addressed the need to speed up benefits claims processing, noting that 90,000 disability claims nationwide are taking more than 125 days to process.
In Pennsylvania, about 3,500 veterans have been waiting more than 125 days for a claim to be processed, said VA Regional Benefits Office Director Jennifer Vandermolen. The average processing time in the state is 126 days, Vandermolen said.
The office has launched a pilot program to try to process claims within 30 days, she said. The program draws on veterans service organizations to help gather evidence, a step that can draw out the claims process, she said.
Data released last month showed that the VA Pittsburgh's University Drive campus had the second-longest wait times among VA treatment centers in the state for a return visit to a doctor.
Michael Stelacio, a Pennsylvania American Legion alternate national executive committeeman, said he would like to see the wait times reduced but otherwise he has been pleased with the new leadership.
“They're really on their toes and have been in Pittsburgh since last year,” Stelacio said.
Shulkin said the nation's VA system needs $18 billion in repairs and upgrades. According to the same report, the H.J. Heinz campus needs $10 million in remediation and the University Drive campus needs $41 million in improvements. Shulkin noted the national estimate could change as the system evaluates its needs.
VA Pittsburgh buildings are up to 91 years old at the H.J. Heinz campus in Aspinwall and up to 63 years old at the University Drive campus, McGraw said. The system has 23 construction projects under way and 31 more in the design phase, she said.
Shulkin recently authorized mental health treatment for veterans who received other-than-honorable discharges. The VA Pittsburgh has traditionally treated that population, McGraw said, and she anticipates about 500 veterans from that group will seek treatment services in the next year.