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VA/DoD Collaboration The Way Of The Future

VA/DoD Collaboration The Way Of The Future. North Chicago VAMC. Established 1926 Current catchment area: 50,000 veterans 550+ inpatient beds Medical – 150 beds - ADC of 55 (FY05) Psychiatric – 25 beds - ADC of 16 (FY05) Long term care – 204 beds - ADC of 183 (FY05)

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VA/DoD Collaboration The Way Of The Future

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  1. VA/DoD Collaboration The Way Of The Future

  2. North Chicago VAMC • Established 1926 • Current catchment area: 50,000 veterans • 550+ inpatient beds • Medical – 150 beds - ADC of 55 (FY05) • Psychiatric – 25 beds - ADC of 16 (FY05) • Long term care – 204 beds - ADC of 183 (FY05) • Domiciliary – 186 beds - ADC of 141 (FY05) • Outpatient visits: FY04=211,933, FY05=214,209 FY06=204,097 • Veteran patients reside in northeastern, north central Illinois, and southeastern Wisconsin • Gender : FY04 FY05 FY06 male veterans 96.6% 96.4% 96.7%female veterans 3.4% 3.6% 3.9% FY04 FY05 FY06 Budget – $126,993,329 $140,168,561 $138,432,768. FTEE – 1,199.8 1,144.0 1,065.8 • Recent construction • 1.4M square feet distributed over 58 buildings • Building 133 - Constructed 1958 - Major renovation: 1996

  3. Naval Health Clinic Great Lakes • Naval Hospital established 1911 • Support Navy Recruit Training • Current building dedicated December 1960 • Casualty receiving hospital for Marines and Sailors injured in Vietnam • 850 Inpatient beds/450,000 square feet • Current catchment area: 67,000 beneficiaries. • Status prior to re-designation 1 June 06 • 22 Med/Surg/Peds inpatient beds • 7 Branch Health Clinics (medical & dental) • > 400,000 outpatient visits per year • 1,600 employees (active duty and civilian) • Annual Budget FY07 $105M (excludes military personnel expense) • Redesignated Naval Health Clinic • 1 June 2006

  4. Phase II Phase III Phase I • Initial Collaboration • October 2003 • Inpatient Mental Health transferred • TRICARE Network Provider Status • December 2004 • DoD Blood Donor Processing Center transferred • Network HospitalRelationship • January 2005: • $13M NCVAMC Project • Constructed four new Operating Rooms • Renovated four existing Operating Rooms • Expanded existing Emergency Department • June 2006 • Transfer of inpatient med/surg/pediatric wards • Transfer OR, ER, ICU care • Reimbursement via Tricare • Professional services provided by Navy Physicians for Surgery and Pediatrics • Integrated Federal Health Care Facility • FY2007 • Navy construction project begins • Construct parking structure • Renovate 45,000 square foot existing NCVAMC spaces • FY 2008 • Construct 201,000 square foot ambulatory care center • FY 2010 • Construction project completed • Functional integration of both healthcare organizations

  5. FY07 - $20M FY08 - $99M FY12 - $16M 9-15 Months > Dec 2011 Final RFP DraftRFP Demo Demolition $16M Addition/ Alteration Move In Final Design A&A Construction 35% Design $92M Alteration Const A&A 35% Design Final Design (Independent) $7M SBA Appeal caused delays Parking Final RFP Draft RFP A&A Design/Const Garage $20M SupportParking Utilities o o o o o o RoadImprovements JAN-06 JAN-08 JAN-09 JAN-10 JAN-07 JUL 07 AUG 06 SEP 10 FY12 FY11 FY06 FY09 FY10 FY07 FY08 DEC 2011 APR 08 SEP 06 MAY 07 SEP07 DEC07 JUN 2010 DEC 06 MAR 06 Acquisition Strategy & Funding Profile

  6. Phase I • MH Inpatient -October 2003 • Ward (131-4C) staff by VA personnel • 1.5 FTEE Navy assigned to unit • $1.5M annual savings – Navy Staff • $500K annual savings to tax payers DoD patients served Bed Days of Care FY 04 337 2372 FY 05 466 2182 FY 06 462 3251 FY 07 1st QTR 138 1210 • Blood Processing Center December 2004 • $3.2 million cost avoidance to renovate existing space at Navy • $900,000 cost avoidance for not building in new FHCF

  7. Phase II Workload June 1 through Dec 31, 2006 • ER • DoD = 8540 visits (40 per day) • VA = 4041 visits (20 per day) (10,000th DoD visit on Feb 6, at 8pm 8yo girl) • Surgical Suite Utilization (June 1- Dec 31) • DoD = 509 cases • VA = 576 cases • Inpatient Admissions (June 1- Dec 31) Medicine CCU Surgery • DoD 249 77 44 • VA 632 359 26

  8. Phase II • Patient satisfaction • NCVAMC ED time one hour less than national average • 48-hour call back for all inpatients • ED patient call back • Decentralized patient advocates – all departments • NHCGL Patient Admin Dept liaisons 24x7 • Provides services such as follow-up appt for Active Duty

  9. First Pediatric Patient

  10. Devontay delivered September 13, 2006 at the North Chicago VAMC Emergency Department

  11. State-of-the-Art OR Suite

  12. State-of-the-Art OR Suite

  13. Joint Incentive Fund Projects • $9M in JIF projects • Women’s Health - $852K • Mammography - $470K • MRI - $3,426K • Oncology - $685K • Dedicated fiber optic connectivity - $248K • Hospitalist - $403K • Digital Radiography (PACS) – $638K • Project Management Support - $1,770K

  14. Draft Integrated Governance Phase 3 JEC HEC Advisory Board of Directors VHA BUMED VISN NME VA SES Director Stakeholders Advisory Council Navy O6 Dep Director Clinical Care Patient Services Facility Support (Admin) Ancillary LTC/Inpatient Nursing Pharmacy N & FS Audiology Medical Surgical Mental Health Nursing Home VA & Navy Clinics Healthcare Operations Business Office/Finance IRM Acquisition/Procurement Log Human Resource

  15. Proposed Advisory Board • Membership • Naval Service Training Command • VISN Director • Navy Medicine East (NME) • Veterans Health Affairs (VHA) • Navy Bureau of Medicine & Surgery • Federal Medical Center Director – Ex Officio • Roles & Responsibilities • Provides input on Director & Deputy Director evaluation • Advises on Mission, Vision, & Policy • Advises on Strategic Direction • Advises on Adequate Resources • Monitor Performance

  16. Stakeholders Advisory Council • Membership • Veterans Service Organizations • TRICARE Regional Office • Navy Line Representation • Community Representatives • Rosalind Franklin University Medical School • Other VA/Federal System Directors • Managed Care Support Contractor • Network/VISN Representatives • Congressional Liaison/Representative

  17. Legal and Congressional Liaison NATIONAL SENIOR-LEVEL STEERING GROUP • Development • Education/Training • LaborRelations • Other • Board • ReportingRelationships • Perf. Measures • Mission/Vision • BusPlan • Staff/Org. Structure • Budget • FinancialManagement • Accounting • Productivity • Workload • Other Finance/ Budget • Single System • All Functions • Medical Records • Other • Medical StaffOrganization • Credentialing • By-Laws • JCAHO • RM/QA • Education/Research • Pharmacy • Other • Security • Force Protection • Acquisition/Procurement/Logistics • Eligibility/Benefits • Facilities • Other HR Leader- ship IM/IT Clinical Admin National Task Groups

  18. Federal Health Care Facility(Great Lakes Project)“Big Rock” Issues • Command and Control (Governance) Model • Executive Decision Memorandum (EDM) • Facility designation (MTF, VA, network, combination?) • EDM • Financial Model • Budgeting and reimbursement methodology • EDM • Property ownership and investment fund • EDM

  19. Federal Health Care Facility(Great Lakes Project)“Big Rock” Issues (cont.) • Logistics Model • EDM • Electronic Health Record Model • AHLTA vs. VISTA • EDM • Personnel Management Model • Civilian Personnel • Title 5 vs. Title 38 • EDM • Military personnel • Use of IDCs and HMs • Adverse events

  20. Master Sharing Agreement VACO/BUMED/OSD/OGC National Steering Leadership Group VACO BUMED NME VISN12 OSD Regional GC -(Legal) • 5 TASK Groups Process Flow Federal Health Care Facility 2010 • CONOPS • Final EDMs • Timelines • Draft EDMs • Timelines of • Critical Elements • Showstoppers • Recommendations

  21. Federal Health Care Facility 2010 • Commissioning June 2010 • Projected catchment: 117,000 beneficiaries • ~ 400 hospital beds (59 Acute Care) • More than 600,000 projected outpatients visits annually • ~2500 employees • Staffing model under review • FTE savings will occur with integration • Annual budget approximately $240 million

  22. Naval Service Training Command Navy Recruit Training Command Rosalind Franklin University of Medicine and Science Rosalind Franklin University

  23. MASSING STUDY FROM NORTH

  24. Summary • Vision: We will create a federal health care center of excellence through world-class patient care, customer service, education and research. • Progress accomplished to date can be attributed to extensive cooperation at all levels between VA and DoD. • Phased approach has allowed the adaptation of cultures which has contributed to our success. • We have been given this opportunity to influence the future of federal health care. • The intent is to establish processes which can be exported.

  25. Questions?

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