Local VA under pressure: Veterans Affairs gets tough with low-performing care centers

HARLINGEN — Veterans Affairs is putting its foot down on low-performing medical centers, including the one in Harlingen.

The VA announced this week “an aggressive new approach” to produce rapid improvements at its low-performing facilities nationwide.

VA is targeting 15 medical centers that received the lowest score on its rating system — a one-star rating out of five. And the VA Health Care Center in Harlingen is on the list.

Harlingen center representatives say it is already working to make improvements.

On Thursday, the same day as the VA central office announcement, the Harlingen center announced the creation of a working group to oversee and coordinate improvement of the quality of care provided to veterans.

“The working group that we have placed is going to take not just (the star rating system) but a really good look at how we are implementing these initiatives to improve,” said Ray Leal, a spokesperson for the Harlingen VA medical center.

“The working group is going to be more hands on and just as the VA central office is putting out these aggressive initiatives, we’re doing the same here at VA Texas Valley Coastal Bend to make sure that we’re doing exactly what we need to do.”

New strategy

The new strategy includes centralizing national accountability, identifying weaknesses, tracking progress and quarterly reviews by the central office. Failure to show progress could result in a change of leadership at the local level.

VA Secretary David Shulkin said in a statement that President Trump has made it clear veterans deserve only the best when it comes to their health care.

“We will employ tight timelines for facilities to demonstrate improvement, and if low performance persists, we will make swift changes — including replacing facility leaders — until we achieve the rapid improvements that Veterans and taxpayers expect from VA,” Shulkin said.

Efforts to make improvements in Harlingen have been under way for months, Leal said.

He said the local working group will be looking at ways to make sure the initiatives “really stick.”

How we got here

Since the last rating period, VA Texas Valley Coastal Bend, which includes Harlingen, has worked with community partners to improve the overall care coordination between VA and non-VA facilities, the Thursday announcement said.

This includes streamlining hospital admissions, discharges and medication management for veterans who need more complex care.

“The health care system is also making significant strides to regain the trust and confidence of Veterans by improving communication with their providers, improving access and being more responsive to incoming calls from our Veterans,” the statement said.

“We are working every day to fulfill our promise to care for our Nation’s heroes and provide them the service they earned and deserve,” Joe A. Perez, VA Texas Valley Coastal Bend director, said in the statement.

“Our ultimate goal is to improve the quality of care and the overall patient experience that we provide them.”

VA’s new strategy

– “Central, national accountable leadership.” That means one person has been designated to oversee improvements at each of the centers. That person will report directly to Dr. Carolyn Clancy, executive in charge of the Veterans Health Admin.

– Identifying vulnerabilities in each low-performing facility and setting specific targets for improvement.

– Tracking the progress of improvement against the targeted goals and quickly dispatching teams of “expert improvement coaches” to the medical centers to assist them in meeting the goals.

– Quarterly reviews by the VA central office. If the facilities fail to make rapid substantial progress, VA leadership will take prompt action, including changing the leadership of the medical center.