Ralph H. Johnson VA Medical Center
Gastroenterology unit doubles capacity
On March 28, the Ralph H. Johnson VA Medical Center expanded their Gastroenterology (GI) Procedure Center from two to four rooms, doubling the future capacity for Veteran procedures, while becoming a national leader in patient satisfaction scores. GI procedures include colonoscopies, esophagogastroduodenoscopies, PEG tubes and liver biopsies.
For the three years leading up to the expansion--during the planning and construction phases--staff worked diligently, within the two-room space they had, to more efficiently see patients on the unit, increasing the total number of Veterans seen per year from 2,000 to 3,000.
"I couldn't have asked for a better staff," said Nurse Manager Sheryl Jones. "They always want to do what's best for patients in a safe environment."
Since opening the additional rooms in March, the GI Unit is averaging about 117 procedures per week, putting them on track to complete over 5,500 procedures this year.
"We are still recruiting additional endoscopists and once we have them on board we'll have the ability to complete about 38 procedures per day, putting at us around 8,000 total procedures for the year," said Jones.
Jones is the nurse manager for both the GI Unit and The Ambulatory Care Center (ACC). When patients are seen for their GI procedure they visit the ACC for pre and post-procedure evaluations. The Press Gainey scores, a patient satisfaction measure, for this area have just been recognized as the highest nation-wide among VA Medical Centers. Jones credits the high scores to an overall improvement in communication between ACC staff and the other units they support. The establishment of a dedicated ACC charge nurse and designating them as the main point of contact for other staff was critical.
"When a procedure is delayed more than 30 minutes , the charge nurse works collaboratively with other staff to find out the reason why and then communicates that reason directly to the patient and their family - with hourly updates," said Jones. "We have also been able to add additional curtains in the room for privacy, we reduced the amount of lead time a patient had to check-in prior to their procedure from three hours to two hours, and I, as nurse manager, address any Veteran concerns quickly and directly with the patient."
GI has also added a Saturday procedure day once per month where they see approximately 18 - 20 Veterans. Staff volunteers time outside of their normal hours to be able to provide this additional access for Veterans, which reduces the number of Veterans that have to be sent out into the community for care.
"Our Veterans love coming on Saturdays. It often fits into the schedule better and they always say how easy it is for them to park here," said Jones. "For this extra clinic day we have to have support from sterile processing service, housekeeping, medical support staff and the ACC. They all work together to make this happen for our Veterans."
Another positive change to the area is that one staff member is on-call 24/7 for any emergency procedures. This strategy also contributes to a reduction in the amount of patients sent out into the community for care.
The continued commitment from ACC and GI staff at Charleston VAMC, along with leaderships support, have improved access and patient satisfaction, and continues to be a leading example both locally and nationwide.