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West Texas VA Director Speaks Out About Needing a Further Audit

Michael L. Kiefer, director of West Texas VA Health Care System, said the details of the audit have not been released. But Kiefer did point out various problems being addressed at the hospital.
A national review of all the Veterans Affairs hospitals in the nation found that the West Texas location still needs an extra review to determine the scheduling and access management practices of the hospital.

On Tuesday, Michael L. Kiefer, director of West Texas VA Health Care System said the details of the audit have not been released.

“Honestly I have no idea what is in their detailed report about Big Spring,” he said.

But Kiefer did point out various problems being addressed at the hospital.

When the auditor team visited the hospital they found various lists that did not comply with the directive.

The first list was made by hospital staff and included new veterans in need of appointments.

“Because of the way we are set up we could get veterans in pretty quickly so we never had to put them on a list to take them off a list,” Kiefer said. “And as we developed our personal shortages, there became a gap.”

He said his staff was not aware of the VA procedure and created a list out of the regular standards.

“We had well-meaning staff who created a list electronically separate than the near list and they didn't understand that there was an unproved process,” he said.

Another list noted by the auditors was a list of patients to be seen by the chief of staff.

Kiefer said his chief of staff does not regularly see patients, but was working as a doctor to help alleviate the backup.

He visited various VA clinics and someone from the staff created a list outside the VA directive.

“So when he goes there he said ‘ok who are the people who are sick I really need to see today?’ They created a list for him, and oh my goodness they did that the day before the auditors come,” Kiefer said.

After being told by the auditor it was wrong, Kiefer agreed that it was “not an approved process.”

The West Texas VA is also last in the region in the time it takes to see new veterans.

“12 Days, 12 days and if you look back on the VA guidance they like us to see them in 14 days,” Kiefer said. “So while we’re the longest, we were still within what the VA would like us to be.”

But the problem is not just with new patients. Veteran and longtime patient of the West Texas VA, David A. Weseloh said the hospital constantly cancelled his appointments, delaying the time it took for him to see a doctor.

“Two and a half months. Two and a half months trying to get through to him and had two cancellations during that time, two appointments set up on the telephone and nobody even called to cancel,” Weseloh said.

Kiefer had an explanation:

“Often times we do end up having to cancel those patients but we try to get them back in quickly and sometimes we don't do well as our statistic shows us,” he said.

The hospital attributes the problem to a shortage in staff.

They are currently more than 40 people short and say many employees leave West Texas because of the high cost of living.

“Retaining staff is our biggest challenge today,” said Iva Jo Hanslik, Community Relations Coordinator at the West Texas VA Health Care System. “The workforce isn't here, they're moving to the oil field, where the money is.”

As of May 15, when the data was collected, 150 patients in West Texas remain in the electronic wait list.

The new veterans wishing to receive care from the West Texas VA, have all been contacted, Kiefer said. They currently have a list of 213 people, but 32 were not reachable. For those 32, the hospital sent certified letters to assure contact.

The second round of audits is expected within weeks, Kiefer said.

The West Texas location currently serves 17,000 veterans. In addition to their main location in Big Spring, they have clinics in Abilene, Odessa, Hobbs, Fort Stockton, Stamford and San Angelo.

“We're going to get through it and I have no doubt we will,” Hanslik said.

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