Engagement with Rotary Club - Service Above Self

Thank you all very much for having me here this morning to talk about Truman VA and the care we provide our Veterans. It’s my understanding that the Rotary’s motto is “Service Above Self.” This concept is one that I and my colleagues at Truman VA understand and embrace ourselves. I speak for all of us when I say that it is an honor to serve our nation’s heroes. 

For those who don’t know about the Veterans Health Administration, we’re one of three administrations that make up the Department of Veterans Affairs. Our main priority as part of the VA is to provide health care services to our Veterans. However, we also assist in the education of future health care professionals and conduct health-related research.

From a health system standpoint, Truman VA offers a full continuum of inpatient and outpatient health services to Veterans from 43 counties in Missouri, as well as Pike County, Illinois. Approximately 40,000 Veterans receive health care at Truman VA each year through comprehensive services that include primary care, medical and surgical specialties, behavioral health, physical and occupational therapy, pharmacy services, and more.

As a referral center, Truman VA also provides cardiovascular care to include open heart surgery. Additionally, Truman VA provides more than 400,000 outpatient clinic appointments for Veterans annually.

The VA operates the only health system in the world prepared to deliver the kind of care that America has promised its Veterans. In times of political change, the VA often is targeted as a costly governmental bureaucracy, whose function could be better served by the private sector. However, please let me give you just a few reasons why we’re the best-suited organization to provide health care for Veterans.

The health services provided by VA are difficult to imitate because we offer highly integrated, patient-centered care. At Truman VA we bring together all the components of medicine that make a person healthy and achieve continuity of care through a superb electronic medical record system.

Integrated care also requires that organizations address comprehensive patient needs using providers within their system. Smaller health care organizations often do not have the variety of specialists needed to coordinate patient care. Many systems, even large ones, also lack the appropriate IT infrastructure to facilitate safe and effective patient information sharing.

Many of the features that make VA care difficult to replicate in the private sector were developed in the organization’s early days. There certainly is evidence that the VA has made the most of its unique infrastructure, which also is designed to reduce health care costs. As an example, although VA’s patient enrollment increased by 70 percent from 1999 to 2003, its funding during that same period increased by only 41 percent. This statistic is remarkable given the fact that Veteran patients tend to be sicker, on average, than private sector patient populations.

Our top priority is our Veterans and their families. However, education and research also are strategic initiatives. In terms of medical education, it may surprise you to learn that more than 70 percent of all U.S. physicians have received training through the VA. Additionally, Truman VA is proud to affiliate not only with the MU School of Medicine, but also the MU Sinclair School of Nursing and the MU School of Health Professions by providing training opportunities for approximately 900 students each year.

In addition to providing excellent health care and medical education, Truman VA also has a nationally known research department, with a core mission of improving the lives of Veterans and all Americans through health care discovery and innovation. For more than 90 years, VA-funded research investigators have been engaged in significant breakthroughs in the treatment of cancer and heart disease, developing new diagnostic tools such as the CT scan, and receiving international acclaim through Nobel Prize awards.

Other significant historical VA achievements include the first implantable cardiac pacemaker, the first successful liver transplant, the development of the thermal nicotine patch for smoking cessation, and breakthrough therapies for treating post-traumatic stress disorder. VA research does impact the lives of everyday Americans. The next time you hear a doctor tell someone to take an aspirin each day for their heart, or you see a barcode used for medication tracking and disbursement, or someone you know receives a shingles vaccination — remember, these examples also are the result of VA research.

And this brings me to some of the newer developments right here in central Missouri:

·     You may have heard that Truman VA was ranked No. 1 nationally by the VA All Employee Survey for both 2017 and 2018. This is the first time a VA hospital has been ranked No. 1 for two consecutive years since the inception of the survey more than 17 years ago.

·     Just this past December, Truman VA became the first VA hospital to complete the “Hospital of the Future” project. The project was a three-year journey and was part of our on-going efforts to becoming a High Reliability Organization. Today, we now are training representatives from other VA hospitals in high reliability with our newly implemented HRO Academy.

·     Modernization is another key component of innovation and reliability. Truman VA is committed to modernizing care for Veterans —a concept of continual improvement to infrastructure, equipment and services.

·     Last August, Truman VA began construction to expand the current parking garage. The expansion project will result in a four-story structure that will provide our patients and staff with an additional 684 parking spaces. The garage expansion project is expected to be completed this fall.

·     Another construction project currently underway is an addition to our Ambulatory Care Unit. The new addition will expand ambulatory and dental care by adding a third floor to the northwest side of the hospital. The addition is a two-phase project that will result in 15 dental treatment rooms, 18 examination rooms, and 14 hematology and oncology infusion bays.

·     Also, we just opened a new, larger community-based outpatient clinic in Jefferson City. The new facility provides Primary Care, Behavioral Health, Podiatry, Optometry, Telehealth and Laboratory services.

·     We have upgraded our hybrid operating room with more advanced medical imaging technology. The Hybrid OR is a procedure room that is a cross between an OR and a Cath Lab. It gives us the ability to perform specialized surgeries, such as the TAVR heart procedure – which is a minimally invasive approach to replacing a narrowed aortic valve.

·     Last year, Truman VA became the first Veterans hospital to offer Immediate Sequential Bilateral Cataract Surgery. This new service is performed as a separate procedure for each eye, but on the same day. At most other hospitals, cataract surgery is completed on one eye and then anywhere from a few days to a few weeks later, surgery is completed on the other eye. With bilateral cataract surgery, the postoperative rehabilitation period is faster, and fewer visits to the clinic and hospital are needed.

·     Truman VA also recently implemented a new diagnostic tool for recurrent prostate cancer. The new system combines the use of PET scan imaging and a new radiopharmaceutical drug to detect cancer in patients who are difficult to diagnose due to repeat disease.

As we move forward, the leaders and staff at Truman VA are continuing to build high reliability into everything we do. My goal is to see high reliability characteristics serve as the foundation for every process and activity we perform. The culture here at Truman VA is one of continuous improvement. Each day we strive to honor Veterans through exceptional care, education and research. 

I should mention before I close that I’m not only the executive director of Truman VA, but I am also a patient. As a United States Marine Corps Veteran, I choose VA because I want the best health care available. So, I have a vested interest in making sure that we meet the expectations of every Veteran.

This is a very exciting time to be a part of VA, and at our medical center, we promise to do our part through our commitment to caring for our Veterans. As the country’s largest, most comprehensive and integrated health care network, the VA – and in central Missouri, Truman VA ― clearly is the best choice for providing our Veterans with the quality of care they deserve.

Thank you.

David Isaacks, FACHE, is a U.S. Marine Corps Veteran and Chief Executive Officer of Harry S. Truman Memorial Veterans’ Hospital in Columbia, Missouri.