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Legion urges local VA to reopen ICU

Task force report backs department despite few patients

– An American Legion task force recommends that Fort Wayne’s VA Medical Center reopen its intensive care unit, even though it was averaging only a couple patients a day before its suspension in October.

Restoring ICU services “will honor past clinical practices, scope and expertise of the facility in the years prior to the ‘pause,’ ” the Legion’s System Worth Saving Task Force said in the summary of its report on the Lakeside Avenue complex.

The report, issued last week, is based on site visits in December and May by the task force chairman, a staff member and other Legion officials.

A pause is what the Department of Veterans Affairs called its temporary suspension of inpatient care at the medical center in October. Since then, VA Northern Indiana Health Care System has gotten a new director, and the medical center has filled staff vacancies, revamped procedures and resumed inpatient chemotherapy, acute care and cardiac telemetry.

Along the way, VANHICS has said the six-bed ICU would be the last inpatient service evaluated for reinstatement. A spokeswoman said Tuesday the evaluation is underway.

“We need to assure critical services can be available 24/7 with appropriate contingency plans in place. Assuring that competencies can be met with low volume of patients is also a critical component,” Sheryl Grubb, public affairs officer for VANHICS, said in an email.

The System Worth Saving Task Force said it learned the ICU averaged only 1.8 to 2.2 daily patients in the five fiscal years before its suspension. The task force also found the ICU medical staff has been at low levels in recent years – a quarter of a doctor’s position was devoted to the unit in fiscal years 2008 through 2011, with two more physicians helping out. Those numbers rose to 1.25 ICU doctors and two “cover” physicians last year.

Another possible reason for the low patient census: The task force said the ICU medical staff “may not have had the appropriate skill set to provide higher acuity care that would be found in an ICU setting.”

VA costs for sending patients to other medical providers increased from $19 million in 2011 to $31 million last year in part because of ICU referrals, the task force reported.

Grubb said the medical center’s ICU is a lower complexity, which requires the transfer of certain patients to hospitals with more extensive life-support systems.

The System Worth Saving Task Force also recommends that the VA Medical Center conduct a cost-benefit analysis for providing its own ambulance service. It suggests various improvements in patient services, including better communications between staff and patients, the hiring of a patients’ advocate and a review of how well the center complies with a VA directive for processing non-VA medical claims.

The panel commended the medical center for its hiring efforts and improving training, morale and external communications in recent months.

The System Worth Saving Task Force regularly visits VA medical facilities across the nation and sends reports and recommendations to Congress and the White House. With 2.4 million members, the Indianapolis-based American Legion is the nation’s largest organization of military veterans.

bfrancisco@jg.net

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