Oct 27
Wanda – Thank you very much for the excellent briefing and the tour. This was very helpful and we will be refining our work.
Here are some follow up questions, listed in order of importance:
National Comparison Data
–I think you answered our question for now. I see you guys use this data, which is in a different format than our data. We’ll start plugging through this.
https://www.va.gov/HEALTH/docs/DR80_102017_Pending_and_EWL_Biweekly_Desired_Date_Division.pdf
I could not find the “Patient Access progress Update Release 80 – October 26, 2017”
My search site: www.va.gov “patient access progress” failed to bring it up. It isn’t listed on the OPA site.
–Is there some website url I could check?
Level 2 facilities
–We can’t find a list of the level 2 facilities nationwide. Please send a URL so we can refine our peer comparisons
Loss Rate
–Just to triple check that the loss rate data we have refers to a percentage of FTE (full time equivalent) of the entire staff of that particular occupation.
—Is there any methodology to the Loss Rate data?
SHEP Score
Melinda said there were several questions embedded in the SHEP score and that we don’t have the survey sample (n) size.
Here is the data we used to calculate the SHEP score graphics and the narrative to explain it.
“How we measure access? We measure Access by surveying Veterans using the Consumer Assessment of Health Providers and Systems (CAHPS) Clinician and Group version 3.0. This is an industry standard survey used across healthcare. The numbers we report are the percent of Veterans saying “Always” or “Usually” to the following questions:
Urgent Care: In the last 6 months, when you contacted this provider’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed?
Routine Care: In the last 6 months, when you made an appointment for a check-up or routine care with this provider, how often did you get an appointment as soon as you needed?
Access scores reported here are for clinical encounters between December 2016 and May 2017.”
This is the data we used:
https://www.accesstoshep.va.gov/Main/getRawData?location=*&format=csv
1) Do you have further details about the methodology behind the SHEP score?
Coverage maps for Memphis and Shreveport, Little Rock and Fayetteville.
Facilities in eastern Ark under Memphis (VISN 9, Station ID 614) and southern under Shreveport (VISN 16, station ID 667). Don’t know the dividing lines.
SAIL
1) What happened to bring Fayetteville from a 2 sail rating to a 5?
2) Can we get SAIL data from 2014 and earlier?
3) What is the weighting of the SAIL rating – it includes health and quality measures, but which ones count more (readmission rates?). Melinda gave a good general explanation. Any more detail would be welcome
Thank you again,
Rob
Questions VA Briefing
1) We looked at a lot of wait time data. Can you briefly give us a sense of the process of scheduling an appointment for a veteran and some of the complexity involved?
1) Get photos of VA health providers and patients.
2) Coverage maps for Memphis and Shreveport. Facilities in eastern Ark under Memphis (VISN 9, Station ID 614) and southern under Shreveport (VISN 16, station ID 667). Don’t know the dividing lines.
2) Opioid usage on facility
Alex – Turnover
- What is the actual definition of loss/turnover rate? What do the figures represent?
- What positions need to be back-filled that the VA is lacking? Why are these positions not filled? What will it take to make sure the VA is adequately staffed with what they need to provide care?
- The staffing turnover data we have, have some vague descriptions for some of the positions listed. For example, the data lists nurses but there are different types of nurses that serve different purposes at the VA. Therefore, what is the specific staffing breakdown that the VA has?
Andrea Johnson
- My colleague Alex Nicoll says you have seen a rise in the number of female veterans seeking medical attention. How many female veteran patients has the VA hospital scheduled appointments with each year for the past three to five years? Are you aware of any factors that play into this increase?
- The female veteran population is slowly increasing. In 2016, women made up 9.6 percent of the veteran population, and women are projected to make up 16.3 percent of all living veterans by 2043, according to data released by the Department of Veteran Affairs. How is your hospital preparing for the increase? What women’s services could be improved upon?
- Both women and men can experience Military Sexual Trauma during service. According to the Department of Veteran Affairs’ website, all veterans seen at the VA health facilities are asked about such experiences that might affect their mental or physical health. Do you find reports of this more often from women? How do you think this affects women’s views of the military?
Chase – EWL
What is the Fayetteville VA doing that makes their electronic wait times both longer than average and shorter than average compared to other VAs in the region? Between 2014 and 2017, an average of 56.27 people per year on the electronic wait list waited longer than 120 days for an appointment while an average of 95.78 waited shorter than 30 days. Both of these measurements are higher than Little Rock, Memphis or Shreveports’ numbers.
For what reasons are people at the Fayetteville VA added to the EWL? What services can the Fayetteville VA not offer that require the use of the EWL?
Does the Fayetteville VA treat the EWL as a bad thing, and if so, what are they doing to stop putting people on it?
Erin mcGuinness
Donald Trump initiated a multi-billion dollar budget increase for VA affairs. The fiscal year began Oct. 1, yet Brian McNally, who is in charge of VA housing for the Ozarks, has received no budget allocation information yet. How long will it take before we start seeing the benefits of a budget increase?
Leah Nelson
Questions:
How many veterans are referred to off-site primary care locations each month?
What is the average primary care wait time for off-site primary care locations each month, are they experiencing the same long wait times like the VA?
Why are veterans on average experiencing longer wait times even though the VA’s budget was increased last year?
Taylor Klusman
- Do you see many veterans applying for work at the VA?
- Do you have a system that enables veterans to more easily find work at the VA than civilians might?
- Roughly what percentage of VA employees are veterans themselves?
Veronica Torres
Do veterans have required check ups with time restraints?
Where can we find the SAIL data online for previous years? That is done by the VA.
What is this VA hospital in particular lacking?
What does the VA hospital want to tell the public about? (sort of PR but looking for topics to look into.)
Katie Serrano
- Little Rock has seen strikes and shortages in the nursing department at their VA Hospital over the last 6 months. Do you see any sort of strike occurring in the future in Fayetteville? Why? How does a hospital prepare to combat that issue before it occurs?
- I recently did a story about a new Occupational Therapy degree that will be offered at the University of Arkansas in 2020. The director said she believes VA wait times would go down if OTs were patients primary caregiver instead of a general physician because they are able to help with more day-to-day activities and physical injuries. In your own professional opinion do you agree or disagree with this and why?
- Why do you think there is such a big difference between primary care appointments, mental health appoints, and special care appointment wait times? What factors affect these wait times?
Lindsey Guimont
- Has the Recovery Engagement and Coordination for Health – Veterans Enhanced Treatment (REACH VET) had any effect on suicide rates?
- Is there any data on veterans who have received help from the VA and still die by suicide?
- What steps do you take with suicidal patients?
Define pending wait times and compare pending versus completed wait times
According to the VA website
- Pending: Scheduled appointments at a facility except surgery and procedures.
- Completed: Completed appointments at a facility except surgery and procedures.
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