Spokane VA recognized for dramatic improvement in patient feedback

WASHINGTON – The employees at Spokane’s Mann-Grandstaff VA Medical Center have been through a lot in the past few years.

After caring for disabled veterans through a pandemic and serving as the test subjects for a troubled computer system, the hospital’s staff got some good news earlier this month when the Department of Veterans Affairs recognized them for making the biggest improvement in patient satisfaction among VA hospitals over the fiscal year that ended Sept. 30.

“There’s no bigger honor than being recognized by the veterans that you’re supposed to be serving, who’ve already served everybody,” said Brian Gavron, chief of acute care services at Mann-Grandstaff. “We weren’t aware that the award existed. It really is just a byproduct of the work that we’ve been doing together.”

The award, which the VA established in 2019, is based on surveys completed by patients when they are discharged from the hospital, according to Donna Richardson, an official in the department’s Veterans Experience Office. In an interview, she said Mann-Grandstaff vaulted from 101st place to 29th among the 122 VA medical centers that provide inpatient care.

The survey, which asks a random sample of discharged patients about their experience, is also used in private-sector hospitals. The results are listed on Medicare.gov, where Mann-Grandstaff is the only inpatient hospital in Spokane with a five-star rating for patient satisfaction. In comparison, Providence Sacred Heart, MultiCare Deaconess and MultiCare Valley hospitals each have three stars, while Providence Holy Family has four.

Both Gavron and Jenny Calkins, nurse manager of the hospital’s acute and intensive care units, attributed the improvement to an extra degree of diligence and camaraderie Spokane VA staff developed during the dual challenges of COVID-19 and the transition to a new electronic health record system.

“I think we have brought together a more collaborative approach in delivering patient care,” Calkins said, citing how employees worked together when pandemic precautions limited the number of people who could be with a patient. “We did these things before to a certain degree, but I think now we make sure that we double- and triple-check ourselves and confirm with the veteran.”

The flaws of the new computer system, developed by Oracle Cerner and launched at Mann-Grandstaff in October 2020, have forced health care providers to take special care to avoid miscommunication and other mistakes. Adapting to the Oracle Cerner system, Gavron said, has made the hospital’s staff come together “like a special forces team.”

“Going through that, our approach was to come together even more and be more vigilant,” he said, adding that Mann-Grandstaff’s outpatient and urgent care departments also deserve credit, because they all have to work together.

In a news conference on Oct. 25, VA Secretary Denis McDonough said he thinks often about the people who work at Mann-Grandstaff, whom he visited in April 2021 amid reports of the Oracle Cerner system contributing to patient harm.

While the pandemic impacted every VA hospital and clinic, he said, the effort to adopt the new electronic health record system “has been a massive challenge.”

“The data does not lie,” McDonough said.

“The veteran experience with the care, notwithstanding all of the contextual challenges,” he said, “speaks for itself, and we’re really proud of those guys.”

Calkins said the award has buoyed morale among health care providers who have worked through the pandemic and what has so far been a three-year experiment with a computer system that VA leaders now say isn’t ready to safely launch elsewhere.

“It’s a huge confidence booster to the frontline staff who are really doing this day in and day out, and that their dedication to delivering veteran care is being recognized,” she said, especially because the recognition is coming from their patients.

“The most important thing about this award is that it’s the voice of the veteran making this decision,” Calkins said. “That’s all that matters. At the end of the day, at the bottom line, that’s why we’re here, and their opinion is what matters most to me.”