2. LDR 630 Baheejah Lumumba Alex Bondar

3.  In order to consolidate the various programs into a single agency, the veterans administration, the forerunner of the department of veteran affairs was established in 1930 to provide benefits and medical care to honorably discharged persons.  In 1946, the aftermath of WWII created support for expanding medical care benefits and the Veterans Administration was formed.

4.  By the 1990s, the VHA had a reputation for delivering limited, poor quality care, which lead to health care reforms.  By the 2000s, the VHA had substantially improved in terms of indicators of processes improved in terms of numbers.  Some evidence show’s that its overall performance now exceeds that of the rest of U.S health care.  The apparent turn around in the VHA’s performance offers encouragement in their health care system.

5.  “ Today’s VA Hospitals, especially, in the office of public and intergovernmental affairs (OPIA) have shifted focus on creative innovative ways to connect with vets, the media and other stakeholders.” (OPA)  Started Facebook and Twitter profiles.  They want Vets to be part of their dialog about some of their issues and concerns.  OPIA’s mission is to make sure the right message get to the right veteran at the right time  VA on Twitter

6. VA REFORM BILL H.R.3230  According to Rep. Jeff Miller, (R- Fl) there are currently over 470 executives in the VA health system. The corruption, mismanagement and lack of accountability across the board will now be addressed due to the passing of the VA reform Bill H.R.3230  To focus on making government more accountable  It starts larger conversation on how they will reform the department so that it will better serve the veterans.  Get the Veteran off the waiting list, and provide more power to VA secretary of health to hold the failing executive accountable.

7.  Secretary Robert McDonald, announces town hall events at Veteran’s facilities nationwide.  McDonald has directed all Veteran affairs ( VA ) health care and benefits to hold town hall events.  To improve communication with and hear directly from veterans nationwide (8/5/14 )  Robert A McDonald was nominated by president Obama to serve as the eighth secretary of Veteran Affairs and was confirmed by the United States senate on July 29, 2014.

8.  Communication is done daily by the government oracle orders, which are from the president of the United States to the secretary of veteran affairs.  McDonald, who is the VA secretary, sends out  Daily emails to all VA hospitals and health facilities  Each manager and supervisor receives the messages and instructs the. other employees.

9.  “Sets the strategic direction and articulates the vision that places the VA Human Resources community at the cornerstone of the VA mission of care and services to the Nation’s veterans and their families” (HR&A)  Mission of HR&A  “Lead human capital management strategies, policies, and practices that cultivate and engaged, proficient and diverse workforce to transform and continually improve service to veterans and their families” (HR&A)

10.  “Promotes a healthy working environment through prevention, resolution, and processing of workplace disputes” (ORM).  “ORM to foster prevention by ensuring that managers and staff are educated on the elements of a healthy working environment” (ORM).  “ORM has resolution experts who promote and deliver alternative dispute resolution techniques, which includes alleged equal employment opportunity (EEO) discrimination in a timely manner” (ORM).

11. WHAT IS THE COMMUNICATION AT VA HOSPITALS LIKE FOR NURSES?  VA Hospitals have own internal communication system  “Communication can be basic, from a floor meeting to specific department meetings to general whole clinic meetings” (E.Bondar, 2014)  “Each shift of nurses in hospital has own half-hour meeting to receive updates as to what happened last shift” (E.Bondar, 2014)  “Patient updates at each shift change during the half hour shift/floor meeting and the charge nurse is responsible for a verbal and printed report of the meeting”(E.Bondar, 2014)

12.  Chain of command, for work related issues.  Regular nurse  Charge nurse  Assistant manager of unit  Unit manager  On call floor manager  Day Time:  Charge nurse  Assistant unit manager  Unit manager  Physicians  Nurse practitioners  Night Hours:  Charge nurse  On call hospitalist (M.D.)  On call nurse practitioner – (has right to write prescriptions in scope of field of practice) WHAT IS THE CHAIN OF COMMAND FOR NURSES AT VA HOSPITALS?

13. HOW DO EMPLOYEES COMMUNICATE AT VA HOSPITAL?  Human Resources to nurse communication only about administrative issues, not patient related issues  VISTA –VA Hospital employee database communication system  “Employees from one hospital can theoretically check records of a patient in any VA hospital, but this is against certain HIPA rules and internal VA rules.” and “there is a special technology department that monitors this” (E.Bondar, 2014).  “There were instances of VA employees accessing the records of famous people out of curiosity, they were fired” (E.Bondar, 2014).  Employees stealing medication  VA has own police unit that has its own station inside the VA hospital will be involved  Employee health department will check employees for substance abuse

14. ARE THERE ANY MOTIVATIONAL TECHNIQUES USED FOR EMPLOYEES?  “No motivational tools from the charge nurse” (E.Bondar, 2014).  “The unit manager can award for doing good, but you have to do something that really stands out” (E.Bondar, 2014).  “Teamwork used as motivation” (E.Bondar, 2014)  “Publish success stories in the Milbank Quarterly journal”

15. WHAT IS THE HIRING PROCESS AT VA HOSPITALS?  According to Eugene Bondar priority is given to:  “Current VA Employees changing Departments/Positions”  “Veterans applying”  “Outside people”  “Many of the employees are veterans”

16. WHAT MAKES VA HOSPITAL DIFFERENT FROM OTHER HOSPITALS?  “At VA Hospital each patient is in his or her own private locked room and employees have to knock and greet the patient” and, also “we say thank you for your service”

17.  About VA (History) http://www.va.gov/about_va/vahistory.asp  Office of Public and Intergovernmental Affairs (Office of Public and Intergovernmental Affairs) http://www.va.gov/opa/  Office of Human Resources and Administration (Home) http://www.va.gov/employee/  Office of Resolution Management (ORM) (Home) http://www.va.gov/orm/  Bondar, Eugene. Registered Nurse, Cleveland VA Hospital. Personal interview..