US. Department of Veterans Affairs VA San Diego Healthcare System THE FUTURE OF MODERN HEALTH CARE BUDGET & NUMBER OF VETERANS SERVED 200 225 250 275 300 325 350 375 400 425 450 475 500 525 550 575 Fiscal Year 2017 600 625 650 675 700 725 $647,650,965 BUDGET DOLLARS (in millions) 83,014 Fiscal Year 2016 $708,024,474 82,940 Fiscal Year 2015 $668,080,975 82,695 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86 NUMBER OF VETERANS SERVED (in thousands) FINANCIAL REPORT & STATISTICS BUDGET FY 2016 (10/1/16 – 9/30/17) Operating Expenses Salaries, Wages & Benefts Services Supplies Other Expenses $647,650,965 $396,150,853 $85,600,140 $105,949,519 $59,950,453 STAFFING STATISTICS (FTE = Full Time Equivalent) Employees (FTE) 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) RESEARCH STATISTICS Total Research Funding 3,101 267 635 2,200 2,121 1,383 738 1,286 100,667 $1,870,883.63 $42,950,000 Principal Investigators 205 Research Projects 686 WORKLOAD STATISTICS Medical Center Beds Total (authorized) Acute Community Living Center Spinal Cord Injury Domiciliary 296 134 43 50 69 Admissions Total Acute Community Living Center Domiciliary 7,754 7,153 332 269 Patient Days Total Acute Community Living Center Domiciliary 91,130 67,178 7,746 16,206 Average Length of Stay Acute Community Living Center Domiciliary 8 Days 25 Days 40 Days Surgeries Total Inpatient Outpatient Outpatient Visits Total Chula Vista Clinic Escondido Clinic Imperial Valley Clinic La Jolla Medical Center Mission Valley Clinic Oceanside Clinic Patients Number of Veterans in San Diego and Imperial Counties Total (estimated) San Diego Imperial Valley 4,632 1,780 2,852 944,462 30,696 17,343 7,442 615,137 160,925 100,936 83,014 ALTERNATIVE REVENUE VASDHS collected $26.5 million, composed of $25 million in Medical Care Cost Funds (MCCF), plus external sharing revenue of $1.5 million. These funds stay at our local facility to enhance services for San Diego Veterans. I CARE DEPARTMENT OF VETERANS AFFAIRS VA Core Values and Characteristics: I CARE Integrity Commitment 249,594 243,369 6,225 Advocacy Respect Excellence 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 located 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 1,383 medical interns, residents and fellows, as well as 738 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 budget of $42.95 million, 205 principal investigators and 686 projects. EXECUTIVE LEADERSHIP (L– R) Robert M. Smith, MD Director/Chief Executive Ofcer Kathleen Kim, MD, MPH Chief of Staf/Medical Director Cynthia E. Abair, MHA Associate Director Ada Y.C. Clark, FACHE, MPH, VHA-CM Assistant Director Carmen Concepcion, MSN, MHA, RN Associate Director, Patient Care Services/ Nurse Executive DIRECTOR’S MESSAGE Our 2017 Annual Report theme is The Future of Modern Healthcare. The theme refects our commitment to looking forward, using the most advanced technologies and continuously improving our care and services. I am extremely proud to announce that our research investigator, Kirk Hammond, MD, received the prestigious 2017 Middleton Award, the highest biomedical laboratory research award in the VA, for his work in promoting gene therapy to treat congestive heart failure. Every day Dr. Hammond and our other investigators are improving American’s lives. Over the last year, we’ve made signifcant progress in improving access to care through text message appointment reminders, direct scheduling for Optometry and Audiology, and implementation of same-day services for primary care and mental health. Our average wait time for outpatient appointments has shortened markedly over the last year and we are continuing to improve. At the same time, our Suicide Prevention team is actively working with the community, responding to local needs and monitoring risk indicators through the new national VA program called Reach Vet. Furthermore, we were funded for four VA Innovation Projects to develop and implement best practices in patient care. We launched a monthly digital Veteran Health Newsletter available through our web site to reach out to the San Diego Veteran community and provide updates and resource information. And, our many construction projects are moving forward with the second parking lot scheduled to be completed in 2018. On behalf of our staf, I want to assure you that our mission every day is to provide timely, quality and compassionate care for the Veterans in San Diego and Imperial Counties. If there is anything we can do to improve our services, please let us know. Robert M. Smith, MD Director/Chief Executive Ofcer VA San Diego Healthcare System VA Desert Pacifc Healthcare Network VASDHS investigators are conducting neuroimaging studies to help Veterans cope with post-traumatic stress disorder, traumatic brain injury, substance use disorders, mild cognitive impairment, Alzheimer’s and Parkinson’s. VA San Diego Healthcare System 2017 MIDDLETON AWARD 2017 Dr. H. Kirk Hammond received the 2017 Middleton Award, the highest biomedical laboratory research award in the U.S. Department of Veterans Affairs (VA) for his work in promoting gene therapy to treat congestive heart failure. The award is given annually to VA investigators in recognition of outstanding achievements in biomedical research and contributions to cutting-edge medical care for U.S. Veterans. Five VASDHS researchers have received the Middleton Award. NURSING RESEARCH AWARDS Veterans can now access same-day services in Primary Care and Mental Health during regular hours, in-person or via phone, video or secure messaging. VASDHS Research Health Scientist Jill Bormann, PhD, RN, FAAN, received the 2017 International Society of Psychiatric-Mental Health Nurses (ISPN) Research Award and the American Psychiatric Nurses Association Award for Excellence in Research. 2017 VETERANS HEALTH ADMINISTRATION (VHA) COMMUNICATIONS AWARD FOR FEATURE STORY VASDHS Public Affairs Specialist, Chris Menzie received the 2017 VHA Communications Award for his feature story on the new exoskeleton technology being used at VASDHS. Dr. Albert Leung and his team at the VASDHS Center for Pain and Headache Research have pioneered a treatment using transcranial magnetic stimulation to reduce headache pain caused by traumatic brain injury. AWARDS & ACCOMPL JEFFREY CHRISTOPHER MEMORIAL AWARD FROM THE SAN DIEGO BRANCH OF RECOVERY INTERNATIONAL The VASDHS Center of Recovery Education (CORE) team received the Jeffrey Christopher Memorial Award from the San Diego branch of Recovery International. The CORE program was recognized for outstanding work in improving the life of people in recovery from behavioral health challenges. Recovery International said, “The work you and your program do in supporting Veterans through the services of peers is commendable.” HEALTHCARE EQUALITY INDEX 2017 The Human Rights Campaign Foundation, the educational arm of the country’s largest lesbian, gay, bisexual and transgender (LGBT) civil rights organization, recognized VASDHS as a Leader in the LGBT Healthcare Equality Index 2017. GREEN AWARDS GREENHEALTH EMERALD AWARD VASDHS received two green awards this year: the 2017 Greenhealth Emerald Award for the organization’s ongoing commitment to improving its environmental performance and the 2017 San Diego County Recycler of the Year Award for the organization’s efforts in improving its environmental performance and in realizing a top standard of excellence in sustainability. ENERGY STAR AWARD VASDHS received the 2017 ENERGY STAR award for the seventh year for their reduced energy usage and the sustained operation of the co-generation plant. DAISY AWARDS Nine VASDHS nurses received the Daisy Award in fiscal year 2017. Daisy is an international non-profit organization that recognizes nurses for their outstanding contributions in providing excellent compassionate care. TRAILBLAZER AWARDS Eric Granholm, PhD, Associate Chief of Psychology and Director of the Center of Recovery Education (CORE) treatment program at the VA San Diego Healthcare System, is the winner of the 2017 Trailblazer Award from the Association for Behavioral and Cognitive Therapies. He developed Cognitive Behavioral Social Skills Training (CBSST) and has conducted several clinical trials of CBSST for schizophrenia. CONSTRUCTION • VASDHS signed a contract to build a new Chula Vista Clinic, which will be three times the size of the current clinic • Completed remodel of the 2nd floor halls and walls • Completed renovation of the Sterile Processing Service (SPS) area • Completed renovation of the Occupational Therapy/ Physical Therapy Service • Installed new PET/CT Scanner for Nuclear Medicine • Constructed a full-service Prosthetics Lab in the Oceanside Clinic SUICIDE PREVENTION The VASDHS Suicide Prevention Team is committed to reducing Veteran suicide rates in San Diego and Imperial Counties through the VA “Getting to Zero” initiative. The ReachVet program monitors predictors for risk of suicide, takes action if needed and provides extensive community outreach. VASDHS provides same-day mental health services and emergency mental health services for Veterans including those with an “Other than Honorable” discharge. LISHMENTS SYSTEMS REDESIGN AND INNOVATION Systems Redesign (SR) and Innovation initiatives enable staff to tackle challenges with new ideas, eliminate work that adds no value to the patient, and focus on improving quality, safety, and value. Over 350 staff members completed SR/Lean process improvement training and more than 100 completed Human Centered Design training. VASDHS completed 35 systems redesign and Lean projects this year. • Improvements in clinical areas include streamlining the patient discharge process for admitted patients, improving same-day services and patient access, and improving patient flow for patients. • Administrative process improvements include streamlining employee onboarding processes and improving internal messaging systems. • San Diego joined the VA Innovators Network this year. Four VA San Diego projects were chosen by the VA Center for Innovation as “Innovation Investments” for FY17: • Shared Medical Appointments for Weight-Loss Medication Management • View Alert Support System • A Safe, Secure and Efficient Wound Image Capture and Storage Solution • Primary Care Musculoskeletal Clinic Replication REDUCED HOMELESSNESS IN VETERANS IN 2017 The annual Point In Time Count conducted by the Regional Task Force on the Homeless reported that from 2016 to 2017, the total number of homeless Veterans decreased by 9% and unsheltered homelessness decreased by 21%. The Homeless Outreach team continues to make significant progress toward reducing the number of homeless Veterans in San Diego. IMPROVING ACCESS TO CARE: • Initiated direct scheduling for Optometry and Audiology giving Veterans direct access to those clinics without the need to see their primary care provider • Implemented text message appointment reminders for select clinic appointments • Conducted Consult Stand Down events to review open consults and make sure Veterans are scheduled promptly • Established Same Day Services in Primary Care and Mental Health allowing Veterans to receive care right away during regular hours in-person, via telephone or video, or secure messaging based on the Veterans’ care needs • Implemented a Veteran Appointment Request (VAR) mobile application that provides Veterans with the ability to make an express care appointment request • Started using a new, more efficient and Veteran-centered scheduling process called VistA Scheduling Enhancements The VASDHS Suicide Prevention Team is using a new technology called ReachVet to identify and assist Veterans at risk of suicide. VHA MISSION Honor America’s Veterans by providing exceptional health care that improves their health and well-being. ACCESS IMPROVEMENTS IN FISCAL YEAR 2017 VHA VISION 36% REDUCTION IN PENDING APPOINTMENTS 8,000 7,000 6,000 6,859 5,000 4,000 4,386 3,000 2,000 Number of appointments scheduled more than 30 days reduced by 36% 1,000 0 SEPTEMBER 30, 2017 OCTOBER 1, 2016 FY16 VS FY17 APPOINTMENT WAIT TIMES, IN DAYS (PENDING) PRIMARY CARE 5.4 DAYS FY16 3.3 DAYS FY17 SPECIALTY CARE 11.1 DAYS FY16 8.0 DAYS FY17 MENTAL HEALTH CARE 8.2 DAYS FY16 4.7 DAYS FY17 0 1 2 3 4 5 6 7 8 9 10 11 12 • 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. 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 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 WEB ADDRESSES • 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) MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego, CA 92161 (858) 552-8585 (800) 331-VETS (8387) 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 24-HOUR NURSE ADVICE LINE VA ASPIRE CENTER (877) 252-4866 2121 San Diego Avenue San Diego, CA 92110 (855) 297-8397 ENROLLMENT & ELIGIBILITY QUESTIONS (858) 552-7523 APPOINTMENT SCHEDULING (858) 552-7475 GPO U.S. GOVERNMENT PRINTING OFFICE : 2017 – 000-000 VA Rio Clinic 8989 Rio San Diego, Suite 360 San Diego, CA 92108 (619) 228-8000