VA interim undersecretary discusses Tomah VA’s 30-day plan

The interim undersecretary for health for the Department of Veteran Affairs returned to the Tomah VA Medical Center on Wednesday.

Dr. Carolyn Clancy kicked off the Tomah VA Medical Center’s Pain Management Workshop. She is also meeting with facility leadership to discuss the Tomah VA’s 30-day plan.

The plan aims at addressing problems with staff at the Tomah VA, and those in charge say progress is being made.

Five months after allegations of over-prescribing opiates and a hostile work environment at the medical center, the acting director, John Rohrer, introduced a plan to improve staff morale and, in turn, improve care provided to veterans.

Since implementing the 30-day plan, about 17 of its 19 points have been put into place. One of the categories, Tools For Providers,  was the focus of Wednesday’s event.

About 150 clinicians at the VA in Tomah took part in a day-long pain management workshop taught by experts from across the nation, focusing on providing pain management in ways other than just a prescription.

Clancy said sometimes it can be easier for a doctor to write a prescription than it is to talk with their patients about managing their pain with less medication, but at the workshop clinicians at the VA find out ways to start that conversation.

“Even though they’ll thank you later, right now it’s going to be hard,” Clancy said.

Clancy said there is no magical solution to managing chronic pain, but this workshop is part of the solution to solving the high prescription rates of VA doctors, something she said is a national problem.

“It’s very easy to say, well we’re using too much of one kind of medication, the challenge is then how do we help people with pain,” Clancy said.

Rohrer said though the plan only covers 30 days, it provides building blocks to improve the VA.

“This is a foundation and it takes a long time. This isn’t something that we change in 30 days and that wasn’t the intention. The intention was to lay the foundation for this, get the information going back-and-forth,” Rohrer said.

Rohrer said 15 listening sessions addressing culture change have been completed and six more are scheduled. Rohrer said the first step of the psychological training has also been completed for Tomah VA staff.

“You set your goals, you try to get them done within a certain time frame and I believe we are moving positively forward with the plan,” Rohrer said.

Specifically, the plan includes the following points:

Address cultural change Emphasize the importance of leadership/employee interaction Improve union partnering Tools for providers Improving access for veterans

“The ultimate goal is that we learn from where we have not done the best possible job so that we can do better by veterans now and in the future,” Clancy said.

Rohrer said he’s been given some positive feedback and “I think people will begin to trust now.”

“I think all of these things will show the employees we’re serious about making these changes,” Rohrer said.

“I think that we need to strengthen across our system a sense that this is a team sport,” Clancy said.

Clancy said there will be a new program installed into every VA in the U.S. by the end of the month. It’s called Academic Detailing. There will be a pharmacist in each VA hospital dedicated to one-on-one coaching with each clinician to help them do a better job prescribing medications and considering other alternatives tailored to the individual needs of each veteran.

There are two on-going investigation into the allegations of over prescribing opiates and hostile work environment. Clancy said those are very far along in the process and will be completed in the “very near future,” but she did not give a date.

Representative Ron Kind released the following statement after Clancy’s

“I was encouraged by my conversation with Dr. Clancy after her visit to the Tomah VA. The progress on the 30-day plan and the beginning of training for pain management are promising steps in the right direction, but the VA still has a ways to go” said Rep. Ron Kind. “We must remain vigilant to ensure our veterans receive the quality health care they deserve.”