Here & Now

Madison VA Hospital Responds to Federal Audit

Frederica Freyberg:

A nationwide audit of VA hospitals across the country and here in Wisconsin showed the VA in Madison had the longest wait times of the three major facilities in the state. According to the audit, the new patient wait time for primary care was 51 days in Madison. At the Milwaukee VA that wait time was about 24 days, and in Tomah, 17 days. Additionally, the Madison facility has been flagged for further review by the Veterans Administration. We asked Tim Donovan, chief of public affairs at the Madison VA, why wait times so far exceeded the 14-day target.

Tim Donovan:

A couple things to know about that figure. First, the 14-day standard is viewed now by the VA, and by everybody who’s looked at it, as an unattainable goal. But still 50.82 days is longer than we’d like it to be. The number may be flawed. There’s a possibility, we’re told, that that number did not take into account a certain number of our patients who were in fact seen. But it’s still too big a number, and it’s something we’re working very hard to reduce. The number is that high because we had a surge of new patients. At the same time, we had some vacancies among our primary care provider team. So in a typical month, when we would have between 125 to the low 200s in new patients, we’ve more recently been seeing a new patient demand of nearly 350. So the new patients have increased a lot. And we had some temporary vacancies among our team of providers for primary care, and we’re working on filling those.

Frederica Freyberg:

Is that what essentially the VA here is doing to try to shorten those wait times, hiring new docs?

Tim Donovan:

Well, we’re filling those vacancies. We’ve also established a new primary care clinic on Saturdays to cut into that wait list a bit. We directed some providers who don’t have assigned clinical duties to work with the patients until we get those vacancies filled, and we’re contacting the patients to do what we can to expedite their care. So we’ve been attacking this issue since, quite frankly, well before the numbers were released on Monday when we saw a surge in patients, so beginning at the beginning of the year.

Frederica Freyberg:

Now, I understand that there’s been congressional action to authorize some $35 billion to put toward these issues in the VA. How might that help the circumstance here?

Tim Donovan:

Well, we might use additional resources to buy health care services in the community for veterans that we’re not able to see as timely as they need to be seen.

Frederica Freyberg:

And so that means that– It had been happening before where people could go outside this facility for care, if needed. But now you might just be able to do more of that.

Tim Donovan:

We might be able to do more of that.

Frederica Freyberg:

Now, the VA says that this facility here in Madison is among those in the region requiring further review. Reasons for that additional scrutiny, according to the VA audit, include concerns that indicated undesired scheduling practices or because staff said they had received instruction to modify scheduling dates. Now, something like that happened in Phoenix, which included secret waiting lists to cover up the amount of time it took for veterans to get appointments. Did that happen here in Madison?

Tim Donovan:

I can tell you there are no secret waiting lists here in Madison. This further review, we’ll find out more about what it means when the further review actually takes place. It could be something as insignificant as a single scheduler not receiving consistent training on how to handle the scheduling system. So we’re working on making sure that the training for the people who are involved in patient scheduling are trained to standard, and only allowing those who are to have access to the scheduling system.

Frederica Freyberg:

How concerning is it that this facility has been flagged for further review?

Tim Donovan:

Well, it really surprised us because we had an in-person audit on May 15, and at the out-briefing, all of the comments about our hospital were positive. So on Monday when this data was released nationally from the Department of Veterans Affairs, we were quite surprised to see our hospital listed as among those that will be subject to a further review. But we’re always interested in improving our processes here, and if there’s something to be found in the further review that we can do a better job with, we’re happy to do it.

Frederica Freyberg:

Did any deaths happen at the Madison VA due to delayed care? I know that the VA has designated some 23 people across the country died as a result of delayed care.

Tim Donovan:

We’re not aware of any veteran who’s had an adverse event, certainly not a death, as a result of any delays.

Frederica Freyberg:

What the public is left with, kind of, is a sense that the VA medical care is stretched way beyond capacity and not able to care for its patients. How would you respond to that on behalf of this facility?

Tim Donovan:

This facility has a well-deserved reputation as among the very best VA medical centers in the country. We’re proud of the quality of care we provide. Are we stretched? Perhaps we’re challenged by resources not always being in perfect balance with demand. But that’s what it takes, a balance of resources against the demands placed on the hospital for resources. And when patient surges come and go, we need to have the right resources available, the right number of providers in the right specialty areas. And we do a pretty good job, and we’re proud of what we do at this hospital.

Frederica Freyberg:

US senator Ron Johnson was among three senators who voted against legislation that would add billions of dollars to the VA budget to hire more doctors and allow more veterans to see private doctors. Johnson says the funding would spend more money to expand a broken system. Senator Tammy Baldwin voted in favor of the funding.