Two Years After Nationwide Wait Time Scandal, the Dallas VA Hospital Details Expansions

Now more than two years removed since a nationwide scandal involving wait times upended the Veteran Affairs administration, the Dallas branch is moving forward with a slew of renovations and expansions meant to boost access to care and services.

A long planned outpatient clinic will open in Plano in September, freeing veterans who live in the region’s northern reaches from traveling all the way to the hub in South Dallas. A new 227,000 square foot expansion to its mental health clinic is in the design phase, which will also come with a 1,000-vehicle parking garage.

The organization is awaiting funding for a planned long-term spinal cord injury unit, which will add another 30 beds to the services there. Also in the design phase is an ambulatory surgery center, which will also be located on the main campus. And a major addition to the emergency department is currently underway and will be finished in the fall of 2017. That project will renovate about 15,000 square feet of space and add another 20,000 square feet, primarily for emergency mental health services. It’s also opening an expanded clinic in Tyler, complete with telemedicine services that will allow its East Texas veteran patient base to speak to specialists without coming to Dallas.

With a population that’s growing outward, the VA, with its $960 million annual budget, is shifting to try and provide more services to veterans where they are. In addition to the Plano and Tyler expansions, the system operates primary care facilities in Bridgeport, Sherman, Greenville, Granbury, and Denton. It serves 38 counties in North Texas and southern Oklahoma.

“We are aware of the population growth of where our veterans are and we’re looking to reach out and capture that population by giving them access to close proximity of primary care offices,” said Kendrick Brown, the associate director of VA North Texas.

The VA North Texas, the second largest in the nation for patient volume, largely escaped the controversy that plagued other locations, like Phoenix, where veterans died awaiting care. The Dallas regional branch was cleared earlier this year of any wrongdoing of its employees to cover up long wait times. A report by the Office of Inspector General found no evidence that its leaders were ordering records to be destroyed or stifling whistleblowers, claims that were voiced by Congresswoman Eddie Bernice Johnson, D-Dallas, in 2014.

Last week, the VA invited reporters to a conference room in the hospital to discuss the changes and additions occurring at the hospital. In all, 97.7 percent of its veterans were seen within a 30-day window of their initial appointment request. The remainders are sent to facilities in the community, an amount that has nearly doubled since 2013. Back then, the VA sent 15,019 consults out to other providers, which cost $52.9 million. In 2016, the VA anticipates sending out 30,399, an amount equal to $102.4 million. Despite being the state’s largest, the Dallas branch has the best 30-day appointment rate of the three located in Texas. It’s about half of Central Texas’ 7.5 percent rate and more than three times less than South Texas’ 10 percent rate.

Staffing is stable; the nursing turnover rate is at 4 percent, well below the national rate of 17.1 percent (as judged by Nursing Solutions, Inc.) Physicians have a turnover rate of between 7 and 10 percent, which the higher ups said they were pleased with.

And the Waco-based claims office is making waves into its backlog, which, in 2012, drew national attention when it reached more than 50,000 pending. As of April of this year, that number is down to 14,692.

“I like to say it’s like scaling Everest,” said John Limpose, the Waco regional director.

The Plano clinic will be one of five in the nation that uses what Brown calls a whole health approach, which involves the patient receiving primary and specialty services in one room. It’ll offer telemedicine services, primary and behavioral care, lab work, and alternative therapies like acupuncture.

It’s one of many ways the VA is looking to streamline the care it provides. The main hub has started to roll out direct scheduling services in specialties like optometry, audiology, urology, and radiology, which allows the patient to schedule the appointment while they’re on-site. It’s also hoping to upgrade its electronic health record to communicate with other systems and care sites where veterans may be sent, particularly Texas Health Resources and Walgreens.


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