Silencing Employees? Is that Good for Patient Safety at the VHA?

From Beyond Chron

New Threats to Patient Safety at the VHA

by Suzanne Gordon on March 9, 2017

VA Hospital in Washington DC

VA Hospital in Washington DC

Ever since a physician at the Phoenix VA Health Care System reported that Veterans Health Administration (VHA) administrators had been gaming data on wait times for patient appointments, VA whistleblowers have been embraced on Capitol Hill. There may be disagreement in Washington about the future of the VHA, but there is bi-partisan agreement that VHA employees should be supported and rewarded when they act to protect their patients.

Unfortunately, not enough legislators and veterans advocates understand that acting to create real patient safety involves far more than being a traditional whistleblower, which, as Webster’s dictionary explains, is “one who reveals something covert or who informs against another.” Or as the Federal Whistleblower Protection Act defines it, involves reporting a “violation of a law, rule or regulation; gross mismanagement; gross waste of funds; an abuse of authority; or a substantial and specific danger to public health or safety.” 

As an extensive literature on patient safety documents, patient safety depends not primarily on the acts of heroic whistleblowers, but on the creation of a workplace environment where you don’t have to be a hero to voice concerns or criticisms, share insights, and make suggestions for change on a daily basis. READ MORE

VHA Still in Trouble Because of Trump’s Hiring Freeze

As I write in this new blog in The American Prospect, Trump’s hiring freeze is hurting the VHA in spite of exemptions.

Hiring Freeze Spares Some at VA, But Shortages Still Loom

But veterans who rely on the VA for benefits, pensions, compensation, and health care are still in big trouble. Chronic staff shortages and underfunding have been at the heart of a VA crisis centered on long wait times for care. Though doctors, nurses, and certain other essential health-care professionals and support staff have been exempted from the freeze, that still leaves the VA with a multitude of vacancies that will hamper its ability to deliver high-quality care.

To be sure, the recent exemptions have led some who are worried about the VA’s future to breathe a sigh of relief. When Trump announced his blanket federal hiring freeze, it did not exempt anyone at the VA. That led lawmakers and veterans’ advocates to protest that the freeze would cripple the VHA. In response, acting VA Secretary Robert D. Snyder sent out a memorandum on January 27 exempting doctors, nurses, and other health-care professionals and clinical support staff from the freeze. READ MORE

 

A Key to Patient Safety — Don’t Just Listen, Solicit Input

New blog post in BMJ

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suzanne_gordonWant to be a better physician or nurse leader? Enhance patient safety? Effectively lead teams? One of the current consultant prescriptions is the recommendation that leaders spend more time listening than talking. Whether in the larger management literature or in the articles and books that specifically target healthcare, listening is portrayed as a key to leadership.

I am all for listening. Of course people have to listen to each other rather than silence, ignore, dismiss, or denigrate one another. When it comes to the implementation of genuine teamwork and patient safety within the hierarchical environment of health care, I don’t think listening is enough. As Amy Edmondson has written in her book Teaming, “Research shows that hierarchy, by its very nature, dramatically reduces speaking up by those lower in the pecking order. We are hard-wired, then socialized, to be acutely sensitive to power, and to work to avoid being seen as deficient in any way by those in power.”  READ MORE

Trump Pick Could Help VA

This was just published on the Washington Monthly Site.  It’s a great piece by a Vietnam combat veteran who was also a psychologist at the VHA for many years.  Well worth the read.

VApicTrump’s Pick for VA Secretary Could Continue Obama’s Progress by Edgardo Padin-Rivera

January 20, 2017.

The Real Truth About VHA Care from Someone Who Knows

westroxburyThis amazing story was posted on the new website Fighting for Veterans’ Health Care.  It’s written by a veteran who was dismissed by private sector health care and really cared for at the VHA.  Samuel Jay Keyser is also writing a book about his experiences in both the private sector and the VHA.

My VHA Experience

Giving Back
Samuel Jay Keyser

July 7, 2014 was my 79th birthday. I spent the morning in an ambulance. As ominous as that might sound, it was a blessing. I was being transferred from a not-for-profit private rehabilitation hospital to the Veterans Administration (VA) hospital in West Roxbury, Massachusetts where, over the course of the next year and a half, as an inpatient and outpatient, I would receive the best possible care a spinal cord injured person could hope for.  READ MORE