The Commercial-News, Danville, IL

February 9, 2013

VA restructures clinical programs


DANVILLE — The Veterans Affairs Illiana Health Care System has received approval from the Veterans Health Administration to restructure its clinical programs and “right size” its services.

“The veterans coming in probably won’t see any changes,” said Doug Shouse, administrative assistant to the director.

Illiana Health Care System has been evaluating for some time what should be the appropriate level of care provided at the Danville campus, he said.

Illiana’s goal is to provide safe and efficient patient care, he said, adding, “That can only happen if patients are placed in the appropriate level of care, have an infrastructure that supports it and staff are able to maintain an appropriate level of competence.”

Illiana is operating at that level now, and so, veterans will see no changes or impact on them, Shouse said.

The changes are:

Changing current Level 4 Intensive Care Unit beds to telemetry beds.

There are six beds in the ICU that haven’t been used in a year, Shouse said, which means the staff can’t keep their skills and competencies up to date.

Instead, patients will be monitored through telemetry on the hospital floor.

Converting the Emergency Department into an Urgent Care Department.

The local VA isn’t equipped to handle extreme emergencies, such as chest pain, severe headaches, severe bleeding or an unconscious person. The VA already has agreements in place with Provena United Samaritans Medical Center in Danville and other hospitals to handle veterans needing specialized care.

Instead, the emergency room will become Urgent Care, which will handle minor trauma, vomiting, diarrhea and other issues, and will be open around the clock.

A veteran who shows up with severe chest pains, for example, will be referred to or transported to another facility. If necessary, Medix will be called to take the patient to the appropriate place.

“We’ll do whatever we need to do to take care of the veteran,” Shouse said. “We’ll get them to the appropriate level of care, wherever that is.”

Designating Surgical Services from standard level to ambulatory.

The VA can’t do certain procedures now if there’s no ICU available. Instead, the surgical level will be considered ambulatory, which means the patient stays for 23 hours or less.

“The bulk of what we do is ambulatory,” Shouse said. The former standard level meant the VA could do hip and knee surgeries.

Veterans who need intermediate or complex surgeries will be referred to the VA at Indianapolis or one of the community health-care providers.

Shouse said these changes all continue to be in alignment with the current facility capabilities at the local VA, and what they have been currently operating at for some time now, he said.

Rationale for this decision included: the need to ensure safe and appropriate level of care for acute medical needs for patients; the challenges related to recruitment and retention of subspecialty providers; and a consistent low volume of patients at the facility during administrative and non-administrative hours.

An implementation plan is being finalized so Illiana can begin to move forward with the changes, and it’s continuing to keep veterans and other stakeholders informed as the process moves forward.

“We want to educate the veteran that we can’t handle certain things,” Shouse said.

About Illiana

Illiana provides primary and secondary health care services to veterans residing in central Illinois and west central Indiana. Inpatient services are available in acute and sub-acute internal medicine, surgery and psychiatry.

Community Living Centers provide a skilled care environment with special focus on rehabilitation, dementia and Alzheimer’s care, geri-psychiatric care, palliative care and extended care.

A full range of ambulatory care services is offered including primary care, ambulatory surgery, mental health, substance abuse and specialty care.

The hospital is located in Danville, along with Community Based Outpatient Clinics in Decatur, Mattoon, Peoria and Springfield in Illinois and West Lafayette, Ind.