STATEMENT OF
SHARON A. GREWE, PATIENT ADVOCATE, KANSAS CITY VA MEDICAL CENTER
VETERANS HEALTH ADMINISTRATION
DEPARTMENT OF VETERANS AFFAIRS
BEFORE THE
SUBCOMMITTEE ON HEALTH
COMMITTEE ON VETERANS AFFAIRS
U. S. HOUSE OF REPRESENTATIVES

June 17, 2002

Mr. Chairman, members of the subcommittee and other members of the Congressional delegation for the Kansas City VAMC, my name is Sharon Grewe and I have been a veterans advocate all my life, but in January 1997 I had the honor of being selected as the Patient Advocate at the Kansas City VA Medical Center.

Thank you for the opportunity to share the voices and concerns of many veterans. Their voices are strong with determination and hold the highest quality of patriotism to this country, with honor and respect for their fellow man. They are dedicated and fully committed to this facility, which they consider their home. Many are fearful that the long-standing negative publicity will result in the closure of this medical center.

Certainly, we have complaints at this medical center by some of the patients and families, some complaints have been about the cleanliness of this facility, but most are about other administrative or communication issues. The reporting of the 1998 events has brought comments in support of the VA's action by the majority of the veterans. What is of greater concern to our veterans is the fact that this issue is such a high profile issue now, when the incident occurred some four years earlier. Certainly this was a serious situation, but some veterans fear that this is a "ploy" to close this facility.

Some veterans ask "how often does this sort of thing happen and does it happen at other health care facilities." The publicity and journal article attempt to link overall cleanliness issues to the separate issue of nasal myiasis. This gives patients the perception that the cleanliness of the facility directly links to poor quality health care. The QUALITY OF CARE here has never been an issue. In fact, the majority of our veterans are extremely pleased with the overall quality of care they receive. The veterans tended to overlook the lack of cleanliness because of their satisfaction with the overall quality of care. Numerous veterans have come to me in support of the facility. Their comments range from "I have never once seen a mouse in this place…or a maggot…..or a fly….and I was in the ICU then or had surgery, etc. As a matter of fact, I haven't seen anything like what is being reported in the news."

The fact remains that the overall appearance of our facility had deteriorated over the years. But through the efforts of our dedicated staff these issues did not impact the quality of care the patients received, nor did the patients notice any decline in their care.

I don't mean to imply that every patient we treat is 100% satisfied. Complaints are brought forward on many different aspects of the services patients receive. However, the majority of issues brought to me are not of cleanliness, but of timely access to care, delays for a scheduled appointment, billing, phones not being answered, and getting prescriptions filled from their private doctor. These are national concerns across the country, both VA and non-VA.

It is important that the 1998 ICU situation regarding nasal myiasis and the overall cleanliness of the facility be addressed as two separate situations and shared as two separate situations with the veteran population.

One of my greatest concerns is that some veterans are expressing fear of even entering our facility because of the many adverse media reports that attempt to link the overall cleanliness issues to the quality of care our patients receive. Sadly this seems to affect our most vulnerable patients. In order to re-establish that trust, I often offer to meet patients and their families at the door and walk them through the facility so that they can look around for themselves. Patients and families can immediately see that our facility is clean and improvements are ongoing. As recently as Thursday of last week a veteran stated, "I was really concerned about coming to the KCVA yesterday because of the news of the dirty facility and the maggots, but I want to tell you the news has blown this way out of proportion. I've been coming here for a long time and have never seen what they are talking about. Yesterday when I got here, I noticed this place is really clean, I just want to tell you that and let you know the news is frightening me and other vets too."

The veterans are a very proud and unique group of individuals and we at the Kansas City VA Medical Center are honored to serve them. Sometimes our contact is the only personal interaction a veteran may have. We provide much more to veterans than health care. A common example is….one veteran experiencing a very bad day, got a hug from me and with tears in his eyes and a shaky voice, he said, "That feels so good to have someone just hug me, it's been many many years since anybody did that to me." Many are estranged from family and friends, have no home, and are living on the street, some by choice and other by circumstance. One veteran visiting my office relayed that he had been estranged from his family for 20 years. I was able to assist in reestablishing the connection with family by listening and placing three phone calls. I am not unique in these acts, as many of the dedicated staff at the KCVAMC perform the same sorts of things - day in and day out.

At this time, dramatic improvements are ongoing and immediately identifiable as you enter and walk through this facility. The veterans and our staff express pride and are quick to remark on the cleanliness and improvements being made. They especially appreciate the new location of the canteen, now located in the basement. Secondly, they are happy that the sisal wall covering is being removed and replaced with an open and brighter appearance. They are pleased with the noticeable improvements in routine cleaning and monitoring of public and patient care areas. However, they want to be assured that is not a "quick fix" and that we will never again allow this facility to fall in disrepair. Our patients and our medical staff will not tolerate a dirty facility, and will demand that we secure enough resources to maintain this facility at the level that our patients deserve.

Our veterans and staff are proud of this facility and are extremely satisfied with the healthcare provided. Patients and employees are frustrated and even angry that the positive things that are being done receive little or no attention, but the negative issues are always on the surface. Veterans and staff want to see more emphasis placed on the improvements made and the excellent services we routinely provide. This has been an upsetting time for our patients and the dedicated staff at this facility. Both patients and staff want to move forward.

The Department of Veterans Affairs has a responsibility to each and every one of our Nation's veterans to offer them a leg up - not a hand out. Our patients and our staff are very proud. Patients want the things they were promised and not feel like they are a welfare recipient. The staff wishes to provide the highest level of quality health care available, in a timely fashion. However, they need the resources to accomplish that goal.

Again I want to thank you for the opportunity to share the concerns of many of the veterans we serve.