Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SATURDAY, February 29, 1992 TAG: 9202290203
SECTION: VIRGINIA PAGE: A-3 EDITION: METRO
SOURCE: LESLIE TAYLOR STAFF WRITER
DATELINE: LENGTH: Medium
VA STAFF CHIEF REBUTS CRITICS OF MOVE
Patient care at the Department of Veterans Affairs Medical Center in Salem exceeds required standards and a move to a new facility was organized well in advance, the center's chief of staff said Friday.Edwards countered allegations by a government union that veteran care is suffering and that the move has thrown the center into disarray.
The comments by Dr. Larry Edwards were the first direct ones he made since employees and the president of the American Federation of Government Employees union at the medical center charged that top administrators were creating a chaotic workplace that has caused patient care to deteriorate.
The center had commented only through its public relations officer.
But Thursday, Edwards requested an interview to clarify the administration's position.
The union's allegations were rooted in changes associated with the scheduled April 3 opening of a $50 million facility at the VA center. The union claimed that the move has been poorly planned and that meetings with officials to discuss the move have been largely disjointed.
Employees were upset at what they called a "shoot-from-the-hip" approach that created confusion.
Friday, Edwards said that employees were offered a choice of how they wanted to be informed about the move - either when plans were "laid out in concrete" or monthly, as plans developed.
They opted for the latter, Edwards said. So why the confusion?
"I'm trying to figure that out," he said.
Edwards displayed a detailed, 13-phase plan that specified which unit would move, where it would move and when. Two long-term care wards will close temporarily, allowing those nursing employees to go through mandated retraining, Edwards said.
Eventually, all nursing employees will be retrained, likely within six to eight weeks, Edwards said.
The union had claimed that bed space was being reduced by the move, meaning fewer veterans could receive care.
Not so, says Edwards.
"We'll have 50 more beds," he said. "We're not decreasing care; we're increasing care, quantitatively and qualitatively."
The new facility will consolidate acute-medical and surgical beds into one building. It will require hiring for an additional 120 positions. Eighty-four of them are for direct clinical support, Edwards said.
In part, that would include physicians, nurses, unit coordinators and health aides, he said. Medical-assistant positions are being created in which employees will perform clerical duties, yet be able to do an electroencephalogram and monitor vital signs.
It is part of a "forward thinking" mind-set that has helped bring the center an additional $5 million in federal funding to its $60 million budget, Edwards said.
"If we are avant-garde and going in the direction of the future, we can get these resources," Edwards said. "Growth is part of development. If you stagnate, you die. And anyone who chooses to work in [the health care field] must be prepared to grow and develop."
A rural-health project was an example of the center's effort to think forward and become part of what Edwards calls the "total health-care system." Though killed a week ago by veterans' officials in Washington, D.C., Salem medical center officials defended the project as an effort to provide basic health services to veterans in remote communities who find it difficult to travel to Salem.
The project enraged veterans' groups that argued it would allow some non-veterans to receive care.
The project isn't completely dead, however. Edwards said Clark Graninger, director of the Salem VA Medical Center, has written to veterans' organizations soliciting their support for a rural-health project strictly for veterans.
Ensuring quality patient care has always been the center's purpose, Edwards said. He questioned whether all of the AFGE members agreed with the charges of lack of consistency in patient care.
The medical center is monitored periodically by staff from the Veterans Affairs central office and consistently received good marks, Edwards said. The national accrediting organization for health-care institutions gave the center a good rating three years ago, he said.
Steps have been taken to improve outpatient care with a "primary team" concept, Edwards said. The intent is to keep patients returning to the same doctors and nurses.
Some VA employees in Salem are angered that the union has given the appearance of speaking for all about the level of patient care.
"I feel sort of misrepresented," said Laura Mays, a registered nurse who works in an intensive-care unit. "And I don't like being misrepresented."
Most of the union members are non-professionals and do not represent professionals, Mays said. And as non-professionals, they should not address patient care, a professional issue, she said.
Patient care at the Salem center is better than some facilities in the private sector, at least in terms of staff/patient ratio, Mays said.