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VA San Diego Healthcare System
VASDHS Annual Report Dedicated to Five-Star Health Care Excellence 2018
STAFFING STATISTICS (FTE = Full Time Equivalent) Employees (FTE) 3,187
Financial Report & Statistics
PROFILE The VA San Diego Healthcare System (VASDHS) provides a wide range of inpatient and outpatient services at the medical center in La Jolla, and at six community clinics in Chula Vista, Escondido, Imperial Valley, Mission Valley, Oceanside, Sorrento Valley and at the Rio Clinic. We provide medical, surgical, mental health, geriatric, spinal cord injury and advanced rehabilitation services. VASDHS has 296 authorized hospital beds including skilled nursing beds, and operates several regional referral programs including cardiovascular surgery and spinal cord injury care.
We are afliated with the University of California, San Diego School of Medicine and provide training for 1,399 medical interns, residents and fellows, as well as 676 other health profession trainees in areas such as nursing, pharmacy, dental and dietetics.
VASDHS has one of the largest research programs in the VA nationally with a $42.2 million budget, >200 principal investigators and 611 projects.
2018
FY 2018
$688.7million Operating Expenses
Total Employees
3,187
1,040 Volunteers
$42.2 million Research Funding
FY 2018 (10/1/17 – 9/30/18) Operating Expenses $688,713,443
Salaries, Wages & Benefts $416,286,980 Services $75,923,209 Supplies $114,848,668 Other Expenses $81,654,586
COMMUNITY CARE Total $103,490,859
Traditional Non-VA Care $63,456,123 Choice $40,034,736
ALTERNATIVE REVENUE VASDHS collected $28.3 million, composed of $27.3 million in Medical Care Cost Funds (MCCF), plus external sharing revenue of $1.0 million. These funds stay at our local facility to enhance services for San Diego Veterans.
Physicians (FTE) RNs (FTE) Other (FTE)
EDUCATION STATISTICS Total
Medical Residents & Students Other Clinical Trainees
VOLUNTEER STATISTICS Volunteers
Volunteer Hours
Donations: cash and non-cash
Total impact, value of hours worked plus donations
RESEARCH STATISTICS Total Research Funding
Principal Investigators
Research Projects
278 645
2,264
2,075 1,399
676
1,040
92,114
$619,416
$2,893,698
$42,200,000
>200
611
ACCREDITATION & CERTIFICATION • The Joint Commission • Commission on Accreditation of Rehabilitation
Facilities (CARF): Aspire Center, Spinal Cord Injury, Medical Rehabilitation, Wellness and Vocational Rehabilitation Enhancement, Homeless Veterans Programs and Substance Abuse Recovery and Rehabilitation Treatment Program
• College of American Pathologists • American College of Radiology (ACR):
Mammography, CT and MRI
• American Association for Accreditation of Laboratory Animal Care (AAALAC)
• Nuclear Regulatory Commission • American Association of
Blood Banks (AABB) • U.S. Food and Drug Administration (FDA):
Registered Blood Bank and Mammography Program
• Clinical Laboratory Improvement Act (CLIA) • Drug Enforcement Agency (DEA)
Operating Expenses & Number of Veterans Served200 225 250 275 300 325 350 375 400 425 450 475 500 525 550 575 600 625 650 675 700 725 OPERATING
EXPENSES DOLLARS
Fiscal $688,713,443
84,712
83,014
82,940
(in millions) Year
2018
Fiscal $647,650,965 Year
2017
Fiscal $708,024,474 Year
2016 NUMBER OF VETERANS
44 46 48 50 52 54 56 58 60 62 64 66 68 70 72
WORKLOAD STATISTICS Medical Center Beds Total (authorized) 296
5,000+
296
247,074
Number of Veterans Using
Telehealth*
Number of Veterans in San Diego and Imperial Counties
Number of Authorized Beds
Total Surgeries 4,818
Total Admissions
7,898
Acute Community Living Center Spinal Cord Injury Domiciliary
Admissions Total Acute Community Living Center Domiciliary
Patient Days Total Acute Community Living Center Domiciliary
Average Length of Stay Acute Community Living Center Domiciliary
Surgeries Total Inpatient Outpatient
134 43 50 69
7,898 7,307
298 293
92,582 67,241
9,325 16,016
8 Days 27 Days 38 Days
4,818 1,969 2,849
74 76 78 80 82 84 86 SERVED (in thousands)
Outpatient Visits Total 983,451 Chula Vista Clinic 31,407 Escondido Clinic 20,649 Imperial Valley Clinic 8,169 La Jolla Medical Center 655,262 Mission Valley Clinic 158,466 Oceanside Clinic 109,498
Telehealth Medicine Individual Instances of Care 16,869 Veterans using Telehealth* over 5,000
Patients 84,712
Number of Veterans in San Diego and Imperial Counties Total (estimated) 247,074
San Diego 240,926 Imperial Valley 6,148
*Telehealth Technologies include: home telehealth, imaging of eyes and skin (retinal and dermatological) and video appointments from the provider’s location to Veterans either at VA community clinics or to the Veteran’s home and mobile device.
EXECUTIVE LEADERSHIP (L– R)
VA San Diego Healthcare System
Robert M. Smith, MD
Director/Chief Executive Ofcer
Cynthia E. Abair, MHA Associate Director
Carmen Concepcion, MSN, MHA, RN Associate Director, Patient Care Services/ Nurse Executive
Kathleen Kim, MD, MPH
Chief of Staf/Medical Director
Ada Y.C. Clark, FACHE, MPH, VHA-CM
Assistant Director
DIRECTOR’S MESSAGE We have always thought of ourselves as an outstanding health care facility, but this year we renewed our commitment to assuring Five-Star quality and customer service in everything we do. That goal represents our focus on system-wide improvement, as well as having the external measurements embedded in the VA Strategic Analytics for Improvement and Learning (SAIL) data, and our customer service scores refect the quality that we provide. As a result, we have already made positive strides in improving our performance measures. In addition to increasing Veteran satisfaction scores, our hospital mortality, average length of stay, inpatient quality, and efciency scores are among the best in VA.
As part of these eforts, we have initiated a patient and staf rounding model based on top performing health care systems nationwide. On a weekly basis, leaders visit diverse areas of the facility and ask both patients and staf how we can do better. That feedback is then integrated into our improvement initiatives.
Other improvement eforts include expanding systems redesign eforts, capitalizing on innovation projects, and implementing nursing unit score cards. We continue to promote new technologies and research to provide the most advanced treatment for Veterans. We are promoting patient experience and relationship-based care, helping staf engage in teamwork and self-care, a healing environment, and benchmarking our care against other VA facilities and the community.
First and foremost, our work and eforts are about meeting each Veteran’s needs. We want you to know we are listening and acting on what we hear from you to improve the care and services we provide. We are here for you and want you to choose us to be your provider of choice.
I CARE DEPARTMENT OF VETERANS AFFAIRS
VA Core Values and Characteristics: I CARE
Integrity
Commitment
Advocacy
Respect
Excellence
Robert M. Smith, MD Director/Chief Executive Ofcer VA San Diego Healthcare System VA Desert Pacifc Healthcare Network
VA SOCIAL WORKER OF THE YEAR Louis T. (Ted) Canterbury, Assistant Chief of Social Work was selected as the national winner of the VA Under Secretary for Health, Excellence in Social Work Leadership Award. This is a prestigious award and selection is a highly competitive process.
COMMUNITY LIVING CENTER RECEIVED A FIVE-STAR SAIL RATING The Community Living Center received a Five-Star rating in the third quarter of fiscal year 2018. This metric shows the high quality of medical care and customer service VASDHS provides.
VA Community Living Centers have an overall rating system that allows close comparison to community nursing homes.
2018 COMMUNITY PARTNERSHIP AWARD VASDHS was one of two winners of the VA nationwide 2018 Community Partnership Award for their partnership with Team AMVETSTM. The Team AMVETS Welcome Home program collects donations for homeless Veterans in the HUD/VASH program including: furniture, household items, cooking utensils, and appliances; and has helped more than 5,000 Veterans since the program started in 2012.
MASTER OF THE AMERICAN COLLEGE OF ENDOCRINOLOGY DISTINCTION Robert R. Henry, MD, FACE, received the Master of the American College of Endocrinology (MACE) distinction. Dr. Henry is recognized as a distinguished endocrinologist; a role model for developing endocrinologists; and a contributor to the American Association of Clinical Endocrinologists and to the art and science of endocrinology.
HEALTHCARE EQUALITY INDEX 2018 The Human Rights Campaign Foundation, the educational arm of the country’s largest lesbian, gay, bisexual, transgender and queer (LGBTQ) civil rights organization, recognized VASDHS as a Leader in the LGBTQ Healthcare Equality Index 2018.
VA NCPS CORNERSTONE 2018 GOLD AWARD VASDHS received the VA National Center for Patient Safety, Cornerstone Recognition Program’s 2018 Gold Award, the highest standard within the Veterans Health Administration for patient safety.
2018 Awards & A
SYSTEMS REDESIGN/INNOVATION/IMPROVING ACCESS VA San Diego is a leader in the use of Lean Systems Redesign and Innovation initiatives. Over 400 staff members completed SR/Lean process improvement training and more than 100 completed Human Centered Design training. Improvement projects’ outcomes include: • Improved delivery of operating room surgical instruments and consumables. • Improved patient flow for emergency department patients who are admitted. • Streamlined community care referral processes for Veterans seeking dental care. • Redesigned Spinal Cord Injury (SCI) annual exam process for a single-day comprehensive exam. • Implemented direct scheduling in specialty care areas, including Smoking Cessation,
Screening Mammography, and MOVE! Weight Management; Eye Care and Audiology. • VA San Diego innovation projects chosen by the VA Center for Innovation as
“Innovation Investments” or Shark Tank finalists for FY18: ◦ SEGUE Mobile Application ◦ A Safe, Secure, and Efficient Wound Image Capture and Storage Solution
◦ Postoperative Urinary Retention (POUR)
◦ Improving Audiology Same-Day Access Using Hearing Aid Drop-off Process
VASDHS CONSTRUCTION PROJECTS • Chula Vista Clinic ground breaking (4/5/2018) • Medical Center:
◦ Completed second parking structure ◦ Started Emergency Department Triage/Psychiatric Emergency Clinic remodel
(projected completion date: 12/2018)
◦ Started Inpatient Psychiatric Unit expansion (projected completion date: 2/2019)
ds & Accomplishments
2018 AMERICAN PSYCHOLOGICAL ASSOCIATION (APA) EXCELLENCE IN TRAINING AWARD VASDHS/UCSD received the 2018 APA President’s Excellence in Training Award for Serious Mental Illness/Severe Emotional Disturbance Section of Division 18 (Psychologists in Public Service) “in recognition as an outstanding psychology training program, preparing learners to provide recovery-oriented, evidence-based services to adults diagnosed with serious mental illness.”
VA HEROISM AWARD RECIPIENTS VASDHS Police Officers Caddell, Kemmlein and Gould received the VA Heroism Award from the VA Office of Security & Law Enforcement Office in August 2018. The officers faced a dangerous situation where a patient was causing harm to himself and potentially others when the officers intervened to protect the Veteran and bystanders.
FIVE-STAR INITIATIVE INITIATIVES TO RAISE OUR SAIL RATING AND IMPROVE CUSTOMER SERVICE VASDHS launched a Five-Star Campaign to focus on improving customer service and the national metrics for VA hospital performance including: • Focused studies to improve performance on: readmission rates, infection control, access and mortality, etc. • Phone Courtesy Greeting Campaign • We Care Rounding • Streamlined communications for call center to improve responsiveness
GREEN AWARDS 2018 WASTE REDUCTION/RECYCLING AWARD FROM THE CITY OF SAN DIEGO VASDHS received a Certificate of Recognition from the City of San Diego for its Waste Reduction and Recycling efforts which will assist the city in achieving its zero waste goals.
2018 GREENHEALTH EMERALD AWARD VASDHS received the 2018 Emerald Award for building a more environmentally sustainable organization.
DAISY AWARDS Six VASDHS nurses received the Daisy Award and three received the Nurse Leadership Daisy Award in fiscal year 2018. Daisy is an international non-profit organization that recognizes nurses for their outstanding contributions in providing excellent compassionate care.
VHA MISSION Honor America’s Veterans by providing exceptional health care that improves their health and well-being
VHA VISION • VHA will continue to be the
benchmark of excellence and value in health care and benefts 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.
MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego, CA 92161 (858) 552-8585 (800) 331-VETS (8387)
WEB ADDRESSES For more information, visit us at: www.sandiego.va.gov www.facebook.com/VASanDiego www.twitter.com/VASanDiego
CLINICS VA Chula Vista Clinic 865 Third Avenue Chula Vista, CA 91910 (619) 409-1600
VA Escondido Clinic 815 East Pennsylvania Avenue Escondido, CA 92025 (760) 466-7020
VA Imperial Valley Clinic 1115 S 4th Street El Centro, CA 92243 (760) 352-1506
VA Mission Valley Clinic 8810 Rio San Diego Drive San Diego, CA 92108 (619) 400-5000
VA Oceanside Clinic 1300 Rancho del Oro Drive Oceanside, CA 92056 (760) 643-2000
VA Sorrento Valley Clinic 10455 Sorrento Valley Road San Diego, CA 92121 (858) 657-1980
VA Rio Clinic 8989 Rio San Diego, Suite 360 San Diego, CA 92108 (619) 228-8000
VA Aspire Center 2121 San Diego Avenue San Diego, CA 92110 (855) 297-8397
VET CENTERS San Diego Vet Center 2790 Truxtun Road, Suite 130 San Diego, CA 92106 (858) 642-1500
San Marcos Vet Center One Civic Center Drive, Suite 150 San Marcos, CA 92069 (760) 744-6914
Chula Vista Vet Center 180 Otay Lakes Road, Suite 108 Bonita, CA 91902 (877) 618-6534
24-HOUR NURSE ADVICE LINE (877) 252-4866
ENROLLMENT & ELIGIBILITY QUESTIONS (858) 552-7523
APPOINTMENT SCHEDULING (858) 552-7475
GPO
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