VA Desert Pacific Healthcare Network

2015 Annual Report

Fiscal Year 2015

VA Desert Pacific Healthcare Network is proud to present a review of Fiscal Year (FY) 2015.

We have delivered on our commitment and achieved goals set forth by the Veterans Health Administration in the Blueprint For Excellence in FY15. We remain steadfast in providing Veterans with a seamless, integrated, and excellent VA experience. VA Desert Pacific Healthcare Network (VISN 22) is one of 21 regional Veteran Integrated Service Networks (VISNs) operated nationwide by the United States Department of Veterans Affairs (VA). VISN 22 is comprised of five healthcare systems and 32 community clinics serving 1.2 million Veterans, residing in Southern California and Southern Nevada.

In FY15, VISN 22 was comprised of five healthcare systems:

1.      VA Loma Linda Healthcare System (VALLHS)

2.      VA Long Beach Healthcare System (VALBHS

3.      VA Greater Los Angeles Healthcare System (VAGLAHS)

4.      VA San Diego Healthcare System (VASDHS)

5.      VA Southern Nevada Healthcare System (VASNHS)

VHA Mission Statement

Honor America’s Veterans by providing exceptional health care that improves their health and well-being.

VHA Vision Statement

VHA will continue to be the benchmark of excellence and value in health care and benefits by providing exemplary services that are both patient centered and evidence based. This care will be delivered by engaged, collaborative teams in an integrated environment that supports learning, discovery and continuous improvement. It will emphasize prevention and population health and contribute to the Nation’s well- being through education, research and service in National emergencies.

MyVA

The MyVA vision is to provide a seamless, unified Veteran Experience across the entire organization and throughout the county.

MyVA is what we are calling our transformation from VA's current way of doing business to one that puts the Veterans in control of how, when, and where they wish to be served. It is a catalyst to make VA a world-class service provider. It will modernize VA's culture, processes, and capabilities to put the needs, expectations, and interests of Veterans and their families first. MyVA represents an opportunity to affect fundamental changes in VA's systems and structures to align with our mission and values.

MyVA is focused on five areas of improvement:

1.      Improving the Veteran experience

2.      Improving the employee experience so they can better serve Veterans

3.      Improving internal support services

4.      Establishing a culture of continuous improvement, and

5.      Enhancing strategic partnerships.

2015 Year In Review

Health Care Provided: 343,643 Total Patients Treated

Academic: $75.6 million Research Funding

Dollars and Cents: $2,664 million Medical Care Budget

Workforce: 17,238 Total Employees

By the Numbers

Inpatient Bed Days of Care: 468,996

Outpatient Visits: 4.6 million

Prescriptions Filled: 6.58 million

Veterans Provided Orthotic or Prosthetic Equipment: 154,000

Telehealth Visits (All Virtual Care Modalities): 82,526

Medical Students: 2,326

Nursing Students: 1,640

Clinical Student Trainees: 1,196

Medical Residents: 3,312

Dental Residents: 83

First and Third Party Payments Collected: $134.8 million

Medication Costs: $424.3 million

Donations Accepted: $3.5 million

Non VA Care Provided: $260.7 million

Physicians: 1,634

Nurses: 3,563

Veteran Workforce: 32.8%

Volunteers: 9,675

Volunteer Hours: 902,274

Medical Centers: 5

Outpatient Clinics: 32

Square Miles: 104,220

States: 2

Congressional Districts: 34

Total Veteran Population Within Network: 1,170,725

Enrolled Veterans: 506,892

Veteran Users: 310,547

Women Veterans: 31,008

Veterans in Rural Areas: 47,950

OEF/OIF/OND Veterans: 131,950

OEF/OIF/OND VA Users: 86,992

Army Veteran Users: 29.8%

Navy Veteran Users: 32%

Marine Corps Veteran Users: 24.9%

Air Force Veteran Users: 12.8%

Coast Guard Veteran Users: .05%

 

VA Greater Los Angeles Healthcare System (VAGLAHS)

Facility Statistics

Total Patients Treated: 90,137

Employees: 5,530

Medical Care Budget: $947 million

Total Inpatients Treated: 14,974

Outpatient Visits: 1.3 million

Research Funding Awarded: $40.5 million

Number of Active Research Projects: 777

Number of Research Articles Published: 753

Total Operational Beds: 1,049

Hospital Operating Beds: 316

Skilled Nursing Home Beds: 372

Domiciliary Beds: 296

Veteran Workforce: 27%

Medical Center

·         West Los Angeles

·         Ambulatory Care Centers

·         Los Angeles

·         Sepulveda

Community Clinics

·         Bakersfield

·         East Los Angeles

·         Gardena

·         Lancaster

·         Oxnard

·         San Luis Obispo

·         Santa Barbara

·         Santa Maria

Academic Partners and Affiliations

·         University of California Los Angeles (UCLA) School of Medicine

·         University of Southern California (USC) School of Medicine

·         1,074 medical residents

·         1,028 medical students

·         879 clinical student trainees

·         310 dental students

·         56 dental residents

·         27 advanced fellowships

·         372 nursing students

Specialty Services

·         Automatic Implantable Cardioverter Defibrillator Center

·         Cardiothoracic and Neurologic Surgery

·         Dual Diagnosis Program for Cocaine-Abusing Schizophrenics

·         Geriatric Research Education and Clinical Center

·         Homeless Program Center of Excellence

·         Mental Illness Research Education and Clinical Center

·         Parkinson’s Disease Research Education and Clinical Center

·         Enhancing Community Integration for Homeless Veterans (REAP)

·         VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP)

·         Patient Centered Care Center of Innovation

·         Polytrauma Level II Center

·         Positron Emission Tomography (PET) Scanner

·         Post-Traumatic Stress Disorder Program

·         Radiation Therapy

·         Robotic-Assisted Surgery

 

VA Long Beach Healthcare System (VALBHS)

Facility Statistics

Total Patients Treated: 56,781

Employees: 2,871

Medical Care Budget: $507.8 million

Total Inpatients: Treated 9,729

Outpatient Visits: 735,917

Research Funding Awarded: $7.4 million

Number of Active Research Projects: 334

Number of Research Articles Published: 135

Total Operational Beds: 414

Hospital Operating Beds: 304

Skilled Nursing Home Beds: 110

Veteran Workforce: 30.9%

Medical Center

·         Long Beach

Community Clinics

·         Anaheim

·         Cabrillo

·         Santa Ana

·         Laguna Hills

·         Whittier/Santa Fe Springs

Academic Partners and Affiliations

·         University of California Irvine (UCI) School of Medicine

·         234 medical students

·         731 medical residents

·         435 nursing students

·         73 clinical student trainees

·         9 dental residents

·         46 dental students

Specialty Services

·         Blind Rehabilitation Center

·         Hyperbaric Oxygen Chamber

·         Joint Studies Program with California State University, Dominguez Hills and California State University, Long Beach

·         Million Veteran Program

·         Preservation Amputation Care Treatment Program

·         Prosthetics Center       

·         Radiation Therapy Program

·         Radiofrequency Ablation of Liver Tumors/Metastases

·         Robotic-Assisted Surgery ((Urology, Thoracic, and General Abdominal)

·         Spinal Cord Injury Center

 

VA Loma Linda Healthcare System (VALLHS)

Facility Statistics

Total Patients Treated: 72,204

Employees: 2,944

Medical Care Budget: $555.7 million

Total Inpatients Treated: 9,561

Outpatient Visits: 807,372

Research Funding Awarded: $4.6 million

Number of Active Research Projects: 145

Total Operational Beds: 269

Hospital Operating Beds: 159

Skilled Nursing Home Beds: 110

Veteran Workforce: 34.7%

Medical Center

·         Loma Linda

Community Clinics

·         Blythe Telehealth

·         Corona

·         Murrieta

·         Palm Desert

·         Rancho Cucamonga

·         Victorville

Academic Partners and Affiliations

·         Loma Linda University (LLU) School of Medicine

·         643 medical residents

·         471 medical students

·         424 nursing students

·         10 dental residents

·         28 dental students

·         93 clinical student trainees

Specialty Services

·         Bariatric Surgery

·         Center for Women’s Health

·         Electrophysiology: Pacemakers and Implantable Cardioverter Defibrillators (ICD)

·         Geriatrics Clinic

·         Million Veteran Program

·         Moderate Acuity Cardiac Catheterization Lab

·         Non-Invasive Cardiac Imaging

·         Percutaneous Coronary Intervention (PCI)

·         Positron Emission Tomography (PET) CT Scanner

·         Post-Traumatic Stress Disorder Program

·         Prevention of Amputation for Veterans Everywhere (PAVE) Program

·         Robotic-Assisted Surgery (Urology, Thoracic, and General Abdominal)

·         Sleep Disorder Clinic

·         Smoking Cessation

·         Women’s Trauma Recovery Program

 

VA San Diego Healthcare System (VASDHS)

Facility Statistics

Total Patients Treated: 82,710

Employees: 3,410

Medical Care Budget: $647 million

Total Inpatients Treated: 10,287

Outpatient Visits: 947,583

Research Funding Awarded: $41.8 million

Number of Active Research Projects: 678

Number of Research Articles Published: 605

Total Operational Beds: 280

Hospital Operating Beds: 172

Skilled Nursing Home Beds: 39

Domiciliary Beds: 69

Veteran Workforce: 37%

Medical Center

·         San Diego

Community Clinics

·         Chula Vista

·         Escondido

·         Imperial Valley

·         Mission Valley

·         Oceanside

·         Sorrento Valley

Academic Partners and Affiliations

·         University of California San Diego (UCSD) School of Medicine

·         864 medical residents

·         593 medical students

·         409 nursing students

·         151 clinical student trainees

·         8 dental residents

·         6 advanced fellowships

Specialty Services

·         Cardiothoracic, Ear, Nose and Throat, Neurologic, Orthopedic and Vascular Surgery Services

·         Center of Excellence for Stress and Mental Health

·         Health Management Platform Beta Site (Next Generation VA Electronic Medical Record)

·         Mental Illness Research Education and Clinical Center

·         Million Veteran Program

·         National Veterans Summer Sports Clinic

·         Robotic-Assisted Surgery (Cardiothoracic, ENT, GYN, Urology)

·         Spinal Cord Injury Unit

·         Substance Abuse Recovery and Rehabilitation Treatment Program

·         Telehealth Services (Dermatology, Endocrine, Mental Health)

·         The Aspire Center (Mental Health Rehabilitation and Recovery Program)

·         VA Cooperative Studies Network of Dedicated Enrollment Sites (NODES)

·         Gordon Mansfield Spinal Cord Injury Consortium

·         VA/DoD Sharing with Navy Medical Center Balboa

·         Virtual Lifetime Electronic Record/Beacon: Electronic Health Record Exchange with Kaiser Permanente and Navy Medical Center, San Diego

 

VA Southern Nevada Healthcare System (VASNHS)*

*Starting in FY16, VASNHS transitioned into the VA Sierra Pacific Network (VISN 21).

Facility Statistics

Total Patients Treated: 57,383

Employees: 2,444

Medical Care Budget: $463.9 million

Total Inpatients Treated: 5,266

Outpatient Visits: 797,804

Number of Active Research Projects: 8

Hospital Operating Beds: 110

Veteran Workforce: 40.8%

Medical Center

·         North Las Vegas

Community Clinics

·         Pahrump

·         4 Primary Care Clinics throughout Southern Nevada

Academic Partners and Affiliations

·         University of Nevada (UN) School of Medicine

·         Touro University Nevada

·         Specialty Services

·         Cardiac Catheterization Lab

·         Gambling Addiction Treatment Program

·         Homeless Veteran Community Resource and Referral Center

·         Interventional Radiology Suite

·         Tomographic Mammography

·         VA/DOD Joint Venture with Nellis Air Force Base

 

2015 Year In Action

Improving the Veteran Experience

VA Long Beach Healthcare System was proud to host a ribbon ceremony for the newly opened Spinal Cord Injury (SCI) Long Term Care Unit on September 9, 2015.

The first SCI Long Term Care Unit to open since 2011, this highly specialized unit is VA’s sixth across the Nation, with Long Beach being the first and only dedicated unit west of the State of Mississippi.

Recognizing the distinct needs for spinal cord injury Veterans, VA Long Beach provides a permanent home for 12 residents with access to highly specialized care and assistance 24 hours a day. Designed and built for non-acute patients, the new center utilizes the latest in high-tech equipment allowing our Veteran residents greater access to entertainment, socialization, and independence. Each resident will have his or her own private space, allowing for a sense of home with the ability to control their environment while still having immediate access to care if needed.

Improving the Employee Experience so they can Better Serve Veterans

Culture is the way we act when no one is looking.

VA San Diego Healthcare System’s Culture of Excellence (COE) launch in March 2015 brought an innovative cultural transformation plan to the forefront of its daily activities. The COE is a group’s way of living, believing, perceiving and behaving. It’s a philosophy tailored to improving five pillars of service with the goal of driving improvements to overall care. Those pillars are to be Veteran-centric, use teamwork, respect, and connect with employees and patients, be the difference and to continuously improve.

COE was designed to work with other national cultural transformation agents like MyVA and Blueprint for Excellence. The program relies on all employees to help each other succeed in becoming agents for change.

Currently, VA San Diego Healthcare System is in the process of launching its COE activities and continuing to press for cultural improvements.

Improving Internal Support Services

Improved Customer Service at Call Centers

How many calls do you think a call center receives per year?

For VA Loma Linda Healthcare System only, that number was 393,743 in 2015.

The call center handled 1,640 calls per day on average, and on the busiest day, there were 2,800 calls coming in.

That’s a lot of calls!!

Commendably, call center representatives answered those 393,743 calls within 30 seconds on average. With such minimum waiting time, less than five percent of calls were dropped before reaching the reps. And more importantly – 87 percent of the calls reached resolution without the need of an extra call translating in a much better patient experience for our Veteran.

Not surprisingly, VA Loma Linda call center is the fourth best call center in the Nation and VA Desert Pacific Network recognized it for its best practices.

The call center supports Primary Care, Audiology, Surgical, Neurology, Podiatry, Urology, Orthopedics, and Vascular Services - efficiently and timely.

Establishing a Culture of Continuous Improvement

Medication Safety

Safer Pain Medication Prescribing

Prescription drug overdose is the leading cause of accidental death in the United States today. VISN 22 has developed a strong infrastructure to reduce prescription opioid drug (“painkiller”) doses and lethal combinations with benzodiazepines (“sedatives”). VISN 22 is a national leader in reducing the opioid – benzodiazepine combination, decreasing the number of patients on this combination by 25% in Fiscal Year (FY) 15. The VISN 22 Multidisciplinary Pain Committee, a group of physicians and pharmacists from each site, meets monthly to develop pain management best practices, which are adopted at each medical center to improve prescribing practices and patient safety.

The Academic Detailing service is a group of clinical pharmacists who educate both providers and patients on important new research in medication safety. They train providers to more safely prescribe these medications, and help patients more safely take these medications. Through these efforts, VISN 22 has been able to reduce high doses of opioid medications by 29%, train over 700 patients on overdose education, and provide the life-saving medication naloxone for opioid overdose reversal.

A new education initiative to reduce medication risks in older Veterans

Benzodiazepines are medications that are often used to treat anxiety or insomnia. However, over long periods of time they can contribute to falls, motor vehicle accidents and cognitive problems. These medications are particularly dangerous in patients that are over 65 years old. In FY15, the VISN 22 Academic Detailing Service piloted a project to educate patients about these risks, sending information to their homes. Patients were encouraged to speak with their providers to see if these medications were still right for them. This is the first time clinicians have conducted a widespread patient education effort.

The project is continuing into FY16, but early results show that six months after receiving this educational information, 26% of patients had discontinued their benzodiazepine prescription. They are working with their providers to address their issues like anxiety and insomnia without medications that may cause harm.

·         794 patients with Hepatitis C cured during FY2015 (91% of patients who completed therapy and had follow up lab tests).

·         29% reduction in patients prescribed high dose opioids (down to 874, with continuing reductions).

·         25% reduction in patients prescribed both opioids and benzodiazepines (“sedatives”); down to 1774, with continuing reductions. VISN 22 was the 3rd best in the country.

·         #1 in improving measures for the Psychotropic Drug Safety Initiative (safer prescribing of mental health medications) among all VAs.

2015 Year In Action

Enhancing Strategic Partnerships

Draft Master Plan for West Los Angeles VA Campus

“VA’s intent is to transform the Greater Los Angeles Campus into a vibrant community where all Veterans can receive healthcare, benefits, employment, and other supportive services, which they deserve and to which they are entitled.” – VA Secretary, Bob McDonald.

The Master Plan

A master plan is a high-level planning process that uses community and stakeholder input to define what is important about a place and how its character, usage, and operations can be improved in the future.

A key purpose of the Master Plan is to help VA determine (based on input from pertinent stakeholders including other Federal agencies, state, city, and local authorities and surrounding counties; legislators; Veterans and Veteran Service Organizations (VSOs); the former Plaintiffs in the Valentini v. McDonald litigation; and the local community), how best to utilize the West Los Angeles (WLA) VA campus in a Veteran-focused manner. That vision includes efficient and dedicated functionality whereby Veterans visiting the campus would be able to experience a “gold standard” of care, support, convenience, and customer service, from VA’s health, benefits, and cemetery administrations.

The WLA Master Plan describes how the physical elements of the campus can be improved, notably for healthcare delivery, housing, recreational, therapeutic, healthcare, benefits, and memorial services for Veterans in the future. It identified potential reuse options, development, and infrastructure improvements needed; ways to improve functionality of the campus amongst the designated zones, including through improved signage and pathways; and opportunities to enhance open space, all while preserving the historic nature and character of the campus.

The Master Plan recognizes and takes into account VA’s unequivocal priority to operate the WLA campus as a vibrant, welcoming, and sustainable community where all Veterans—including homeless Veterans, severely disabled Veterans, women Veterans and elderly Veterans will feel comfortable accessing services, living, interacting, recreating, and socializing with one another and their families, VA personnel, and visitors.

VA published the Preliminary Draft Master Plan in the Federal Register and solicited comments from the public. During the 45-day public comment period, VA received a record setting 1,002 submissions. These comments were carefully reviewed and considered in the revised framework Draft Master Plan now published. This plan is a true reflection of the power of a community coming together to do what is right for Veterans.

Ending Homelessness in Los Angeles

VISN 22 has the highest concentration of Homeless Veterans in the country. VISN 22 continues working diligently to locate and help this vulnerable population.

Specifically, in Los Angeles, VA and the entire VA Greater Los Angeles Healthcare System community have been and continue to work with a sense of urgency and purpose to minimize the time a Veteran experiences homelessness and to ensure they don’t return to homelessness. To accomplish this, VA expanded our capacity to care for homeless and at-risk of homeless Veterans.

·         We provided $30 million in additional funding for Support Services for Veteran Families (SSVF) homeless prevention and rapid rehousing programs. Currently, more than $40 million dollars is available to both prevent and end Veteran homelessness.

·         More than 800 HUD-VASH vouchers have been awarded for Greater Los Angeles in 2015, increasing the total to almost 6,000 vouchers in GLA.

·         325 new short-term beds have been added to provide bridge or emergency housing on and off the VA medical campus.

·         Approximately 1,600 LA area Veterans have been placed into permanent housing since March 2015. On average, almost 280 Veterans are placed into housing per month through VA funded programs.

·         VA has contracted with professional entities to expand homeless outreach and improve housing placement/ landlord relations.

·         VA intensified case management services for HUD-VASH. These case manager will provide direct individualized assistance to homeless Veterans in finding and maintaining permanent housing while also assisting with access to health care, employment, and other services to assist the Veteran.

In June 2015, VAGLAHS officially opened Building 209 which provides long-term therapeutic housing and employment services for up to 65 Veterans, including dedicated housing for female Veterans. Services in Building 209 assist Veterans as they work to fully reintegrate back into the community.

 

Medical Centers

VA GREATER LOS ANGELES HEALTHCARE SYSTEM

11301 Wilshire Boulevard

Los Angeles, CA 90073

310-478-3711

www.losangeles.va.gov

www.facebook.com/losangelesva

www.twitter.com/losangelesva

 

VA LONG BEACH HEALTHCARE SYSTEM

5901 E. 7th Street

Long Beach, CA 90822

562-826-8000

www.longbeach.va.gov

www.facebook.com/VALongBeach

www.twitter.com/VALongBeach

 

VA SAN DIEGO HEALTHCARE SYSTEM

3350 La Jolla Village Drive

San Diego, CA 92161

858-552-8585

www.sandiego.va.gov

www.facebook.com/VASanDiego

www.twitter.com/VASanDiego

 

VA SOUTHERN NEVADA HEALTHCARE SYSTEM

6900 North Pecos Road

North Las Vegas, NV 89086

702-791-9000

www.lasvegas.va.gov

www.facebook.com/LasVegasVA

www.twitter.com/VALasVegas

 

VA LOMA LINDA HEALTHCARE SYSTEM

11201 Benton Street

Loma Linda, CA 92357

909-825-7084

www.lomalinda.va.gov

www.facebook.com/VALomaLinda

www.twitter.com/VeteransHealth

 

Community Clinics

ANAHEIM

714-763-5300

2569 W. Woodland Drive

Anaheim, CA 92801

 

ANTELOPE VALLEY

661-729-8655

340 East Avenue I, Suite 108

Lancaster, CA 93535

 

BAKERSFIELD

661-632-1800

1801 Westwind Drive

Bakersfield, CA 93301

 

BLYTHE TELEHEALTH

760-921-1224

1273 West Hobsonway

Blythe, CA 92225

 

CABRILLO

562-826-8414

2001 River Avenue

Building 28

Long Beach, CA 90810

 

CHULA VISTA

619-409-1600

835 3rd Avenue, Ste. B

Chula Vista, CA 91910

 

CORONA

951-817-8820

800 Magnolia Avenue, Ste. 101

Corona, CA 92879

 

EAST LOS ANGELES

323-725-7557

5400 E. Olympic Boulevard, Ste. 150

Commerce, CA 90022

 

ESCONDIDO

760-466-7020

815 East Pennsylvania Avenue

Escondido, CA 92025

 

GARDENA

310-851-4705

1251 Redondo Beach Boulevard

3rd Floor

Gardena, CA 90247

 

IMPERIAL VALLEY

760-352-1506

1600 South Imperial Drive

El Centro, CA 92243

 

LAGUNA HILLS

25292 McIntyre Street

Laguna Hills, CA 92653

949-587-3700

 

LAS VEGAS NORTHEAST

702-791-9050

4461 E. Charleston Boulevard

Las Vegas, NV 89104

 

LAS VEGAS NORTHWEST

702-791-9020

3968 N Rancho Drive

Las Vegas, NV 89130

 

LAS VEGAS SOUTHEAST

702-791-9030

1020 S. Boulder Highway

Henderson, NV 89015

 

LAS VEGAS SOUTHWEST

702-791-9040

7235 S. Buffalo Drive

Las Vegas, NV 89113

 

LOS ANGELES

213-253-2677

351 E. Temple Street

Los Angeles, CA 90012

 

MISSION VALLEY

619-400-5000

8810 Rio San Diego Drive

San Diego, CA 92108

 

MURRIETA

951-290-6500

28078 Baxter Road, Ste. 540

Murrieta, CA 92563

 

OCEANSIDE

760-634-2000

1300 Rancho del Oro Drive

Oceanside, CA 92056

 

OXNARD

805-604-6960

2000 Outlet Center Drive, Ste. 225

Oxnard, CA 93036

 

PALM DESERT

760-341-5570

41-990 Cook Street

Building F, Ste. 1004

Palm Desert, CA 92211

 

PAHRUMP

775-727-7535

2100 E. Calvada Boulevard

Pahrump, NV 89048

 

RANCHO CUCAMONGA

909-946-5348

8599 Haven Avenue, Ste. 102

Rancho Cucamonga, CA 9173z0

 

SAN LUIS OBISPO

805-543-1233

1288 Morro Street, Ste. 200

San Luis Obispo, CA 93401

 

SANTA ANA

714-434-4600

1506 Brookhollow Drive, Ste. 100

Santa Ana, CA 92705

 

SANTA BARBARA

805-683-1491

4440 Calle Real

Santa Barbara, CA 93110

 

SANTA MARIA

805-354-6000

1550 East Main Street

Santa Maria, CA 93454

 

SEPULVEDA

818-891-7711

16111 Plummer Street

Sepulveda, CA 91343

 

SORRENTO VALLEY

858-657-1980

10455 Sorrento Valley Road

San Diego, CA 92121

 

VICTORVILLE

760-951-2599

12138 Industrial Boulevard, Ste. 120

Victorville, CA 92395

 

WHITTIER/SANTA FE SPRINGS

562-466-6080

10210 Orr and Day Road

Santa Fe Springs, CA 90670