New DC VA medical center director touts turnaround at troubled facility
June 20, 2019
WASHINGTON — The director of the Washington DC Veterans Affairs Medical Center said Thursday that he intends to turn the troubled hospital into the flagship of veterans health care.
In his first testimony before Congress since he became the medical center’s director last October, Michael Heimall told members of the subpanel on government operations of the House Oversight and Reform committee that the findings from a 2018 inspector general’s report about serious problems at the facility with basic medical practices were “symptoms of a systemic leadership failure.”
His team “has been working hard to improve our processes and ensure safe care for our veterans,” he said.
The Washington medical center provides care to nearly 100,000 veterans and operates on a budget of $550 million, according to a congressional memo for the hearing. The facility was given a 1-star performance rating at the end of the 2018 fiscal year, putting it in the bottom 10% of the Veterans Health Administration’s medical centers across the country.
Last March, the VA’s inspector general released a scathing report that detailed widespread problems at the hospital. The IG described a “culture of complacency” that allowed failures to persist for years, putting veterans at risk and weakening core functions of the hospital.
Of the report’s 40 recommendations, 28 have been fully addressed and closed by the inspector general, said Tammy Czarnecki, assistant deputy undersecretary for health for administrative operations at the Veterans Health Administration. She said some of the remaining recommendations involve long-term monitoring of processes to make certain that the corrective actions become sustainable and hopes they will be closed by the end of October.
The D.C. facility has also improved to a 2-star facility, in part due to low hospital mortality rates and a 50% reduction in hospital-acquired infections this year compared to the first six months last year, she said. The performance rating is based on a scale from 1 to 5, with 5 being the best. The rating is calculated by examining areas such as access to care, employee perception, efficiency and capacity, according to the VA.
The Office of the Inspector General published a Comprehensive Healthcare Inspection Program report in January that gave 18 additional recommendations to the facility, of which one is closed, VA Inspector General Michael Missal said.
“Overall, we found important progress being made at the medical center,” he said.
Heimall said they have hired more staff and leadership, expecting to have more than 200 new workers by the end of the year “to ensure that we never repeat the failures highlighted in the OIG report.”
However, the most vacancies are in the human resources department, with only 25 of the 78 positions filled, according to Rep. Gerald Connolly, D-Va., the Oversight subcommittee’s chairman.
“Without effective HR, it is extremely challenging to make sure you have the resources and the staff necessary to do the job,” Missal said.
Another area of concern is the backlog of information technology issues, with about 4,000 work orders at the medical center and its six outlaying clinics, according to Heimall. The department had a significant staffing shortage in the past, he said, but they are now almost fully staffed and are “very engaged.” Heimall said he is concerned about the introduction of the new electronic health records because he wants the IT department working on upgrading infrastructure in the hospital and not a backlog of other issues.
Connolly asked whether there was still fear of retaliation at the facility for people who speak up about problems.
There are still “pockets of that fear across the organization today,” Heimall said. “And the only way that we can really overcome that is by demonstrating that leadership takes those concerns seriously, we’re going to address them and we actually say thank you to the people who bring them to our attention. And recognize them publicly.”