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VA New England Healthcare System

 

Bedford/Boston Administrative Integration Proposal - Comments

 

Please note that all questions submitted through the comments section are answered on the frequently asked questions (FAQ) page. Please refer to our FAQ page for the answers to your questions. The FAQ page is updated regularly.

November 2011                                                                               (View older comments)

In this transition, if employees (GS/WG) in Boston are rated higher in grade or steps, than employees at Bedford doing the same job, how will that impact employees at the Bedford VA?
sounds like a very good idea. would save a lot of duplication.
I am writing you in regard to the proposal of combining the Boston and Bedford merger.  My husband is a victim of dementia and is unable to voice his approval for the merger.  Therefore I am writing this letter on behalf of him. 
This proposal of integrating the Bedford center makes perfect sense.  My husband has received medical care at Boston and Bedford and we have been very happy with the care he has received.  Please keep your good work going and continue to fight for the merger of the medical centers.

 

October 2011

I think the merger of Boston and Bedford will help our outpatient population especially with specialty services. My biggest concern is the merging of medical records. Fitchburg and Northampton records still have not merged and will not be until Feb 2012 and it is a much smaller entity than all of Bedford. Discussing this and plan to make the merger of the records would be very helpful.
The integration of Bedford with Boston is a win situation for veterans. It also provides an opportunity for greater management efficiencies and joining with a well established BHCS leadership team. There are many access and resource issues at Bedford that are beyond the scope of current continuing acting staff.
Discharge planning and coordination between Boston and Bedford would have a better chance of being implemented with a merger. Case in point Bedford Patient A d/c from BHCS; numerous appts on various days for this poor man not taking into consideration his stamina, transportation, etc...This is a good potential example of a poor use of multiple resources including the patient's
As an over twenty five year employee of the Bedford VA, I'm very alarmed by the prospects of a merger with the Boston Heath Care system. I am primarily a researcher and it is totally unacceptable to close the Bedford animal facility as has been proposed by VISN Leadership. Also, while Bedford has many flaws such as the time it takes to hire new employees or to get contracts, adding a layer of bureaucracy that is 20 miles away instead of just down the road would make the processes I have mentioned above even more cumbersome. Investigators I known have complained bitterly above the time it takes to get projects approved by the IRB at the Boston system. In summary I feel that the proposed merger would be a great loss to Bedford researchers who in many cases are the patient health care providers. If they leave Bedford it will be a great loss to patient care, which the network director indicates he wants to improve.
This is better for Veterans/patients, and that is what people need to focus on. It has been said that no one will lose their employment or have a cut in pay. We are all very lucky to work for the federal government, because that is something that never happens in the private sector. Mergers always mean a loss of jobs or layoffs. I have been laid off before in the private sector, and I am very thankful to work for a place that is committed to keeping me as a staff member. Since this will lead to better quality for our patients and staff are not taking a hit, this proposal seems like a no brainer. I fully support this endeavor and think everyone should get on board.
I have been assisting my father with his health care needs over the past three years at the VA facilities. He has had countless tests and two major surgeries. It would be TREMENDOUSLY helpful to have all records centralized. We spend hours trying to get all information to each facility and coordinating appointments. It was particularly difficult to get medication correctly administered for his eyes when he was an inpatient at W Roxbury for hip surgery. Please unify the system for the benefit of all. I can’t imagine what it is like for those patients who do not have outside advocates helping them through the maize.
this is a great idea as a veteran going into Boston no knowing your way around is never  easy going to Bedford after 9.30am in the morning is easy late appointments in Boston is traffic hectic so make this proposal happen please thank you
good idea the VA. has the best computer system going it is grate  too have the two joined as one this would improve all our info
I can't believe this wasn't done a very long time ago. Better for us patients and, I would think, more efficient and economical.
Sounds like a win-win situation.
As long as the integration is well-planned and implemented the efficiency to be achieved is a positive thing. I am for it.
I have two major concerns with this proposal:
1) Pharmacy Formulary. Some of my prescriptions available through Bedford are not available through Boston. Hopefully the formularies will merge and not be replaced.
2) Fee Basis personnel: Boston is HORRIFIC. They, as a policy, do not answer their phone or email. It takes, on average, over 1.5 years to process a claim. (Even hand-delivering the claims several times did not work.) Bedford is great. They were able to take care of my problem over the phone immediately. Please do not even consider replacing the Bedford staff with the Boston staff.
As a former hospital administrator and veteran who is serviced at both the Jamaica Plain and Bedford facilities, I have found it to be a bit frustrating to be treated under two systems. Though both are excellent facilities I feel it makes sense to combine records for treatment purposes.
I am an eighty-one year old veteran.  I live in Peabody and utilize the Gloucester VA facility.  Everything has worked out well for seven years and I have no complaints.

On the other hand, there is always room for improvement and it seems to me that this proposal is just that.  It is my wish, therefore, that I be recorded in total support of the consolidation.
I think the merging of medical records, and improved access to specialties at all locations would really be a plus. I would not want to see current staff being laid off. I would also like to see expanded services for all veterans.
Sounds like a great idea
If there are no lost jobs involved and the advantages are as explained in your letter then this should be a plus to patients and healthcare workers.
I've had some experience with Jamaica Plain and this integration could be a problem.  One appt system will be difficult.  JP never answers their phone!! I've spent hours trying to reach various offices.  It will depend who you put in charge of appts.

How will administrative overhead be reduced without reducing staff and personnel?  Doesn't seem possible.  I've had billing questions and concerns with JP and no one is ever in and they rarely answer their phone.

The only good thing I could see in this plan is the integration of medical record systems.  Now, the staff at Bedford VA can't see anything at JP VA. And vice versa.  Which is a real hassle when I want to get copies of data and test results.
If it's not broke, don't fix it---leave well enough ALONE
Such a proposal coming from the VA actually scares me, because it makes too much sense. The VA is not known for doing things that make sense.
I think this is a wonderful concept.  As a client I have experienced the disjointed communications between Boston area facilities and it has not been a pleasant experience.  A coordinated approach will bring the system to where it should be in this age.  It cannot help but be a great step forward for both the clients and the providers.  I have always been highly satisfied with my care and this proposal, if adopted, should be a bonus for all concerned.
I hope this does not affect the Fitchburg Operations
I live in Woburn and see my Doctor, get my eyes tested, get to visit the Brace Clinic to obtain my diabetic footwear, and get my prescriptions filled at Bedford facility. I am very pleased with this arrangement and hope it doesn’t require my going to Jamaica Plain for any of the above stated visits. I have been to Jamaica Plain for hearing needs and absolutely hate the drive and no place to park when I get there. Please tell me I will be able to continue my appointments at Bedford, and even better, tell me I can get hearing attention at Bedford.
Three veterans attended a monthly meeting and asked that the following feedback be shared:

The three veterans attending the meeting spoke about a range of topics including parking concerns.
The veterans broached the topic of the proposed merger between the Boston and Bedford VA.  They stated that they have heard about this from different sources.  They expressed concern that they did not have the detailed information needed to know whether this would have a negative or positive impact on their care.  They expressed hope that this could benefit them in terms of easier access to care.  They expressed suspicion that the lack of specific information was a strategy by the VA to keep veterans from giving informed feedback.  They expressed concern that this may be a follow-up strategy to the CARES program, and is designed to subsequently reduce or eliminate services at Bedford and force them to go to Boston or Brockton for services.  They expressed that they would not support the merger if it meant reduction of services at Bedford, or that they would have to move their care to Boston or Brockton.
Senior leaders, what's in this for you?  Promotion?  There may be no decreases in pay, but people will lose titles...not that that's important down here in the trenches.  How does this help vets?
I am a Veteran first, Employee second.  How is this going to help?  Do we really need to integrate an entire healthcare facility to a larger one to iron out a few software issues, ie, more accessibility to medical records?  That is a pretty flimsy excuse..yes we are scared and have every reason to be. If we can now access vets records active duty to integration into the VA, why can't we do it inter-VISN?
The re-integration is a progressive idea. There are management efficiencies that are needed. Many grade 4 nurses at Bedford which is unprecedented and leadership is poor. Also-there needs to be a more transparent and less paternal culture which affiliation with BHCS will provide given the management style is apparently more respectful. Bedford is not a "100 best places to work" facility. The culture is closed and male dominant.
I think this is a fantastic idea and far over due. This will help thousands of veterans conduct medical issues without worry about things such as transportation to connecting facilities; prescription drug medications; conflict with prescription drugs; medical record information; possible quicker appointments in other departments that has the equipments to conduct specific procedures (such as MRI, Mamography, Radiology, Dental and etc).Fantastic plan! Hopefully, in the future, a plan is implemented to bring a similar upscale medical and health care facility and benefits to the city of Lynn.
By all means integrate the two systems, anything that will prevent trips to Jamaica Plain is a positive move. The parking situation at J.P. is an outright disgrace and has been for over 25 years.
The lack of details on how the merger will look in the end is disturbing. I have lived through mergers in the private sector (BI-Deaconess - CareGroup) that were destructive despite everyone's good intentions. In the private sector, mergers are pursued in order to increase market share - which is irrelevant in the VA. I don't see why the supposed benefits cannot be achieved through VISN/Network cooperation - isn't that why there are VISNs? Having administrative functions centralized in Boston will leave Bedford unrepresented and create greater difficulties in resolving issues. When leadership is located on the same campus, the ease of having a face-to-face meeting to reconcile problems is invaluable. Also, leadership will receive a memo written by Bedford researchers that outlines our concerns under a merger, e.g. fewer opportunities to apply for grants that are limited 1/facility. I do not know of one researcher at Bedford that has had a satisfactory experience going through the VABHS IRB. Lastly, as a member of GRECC, I was greatly disturbed to see a response to an oversight committee recommendations that was recently submitted AND rejected by the committee because of the biases in the document. The response was clearly written 75% from the Boston campus perspective and distorted facts that I will be communicating/correcting to Bedford leadership to try to compose a more fair and balanced response. This experience leaves me unconvinced that the Bedford staff will have a "voice" in a merged VABHS.
I think the integration is a good idea from the standpoint of providing better care to our veterans. I also feel that Bedford administration in Primary Care needs to be evaluated for their effectiveness as leaders and their attitudes towards staff. Nursing is under a great deal of stress with more expected of them every single day. There is no support and most fear retaliation if they speak up. There have been multiple incidents where staff has been threatened or yelled at. This is an unacceptable situation and everyone who has tried to get something done about it has been targeted or ignored. The chain of command has failed as well.
DO supervisors lose their grade and salary? You say they do not but after two years when they do not have the same job description, they get downgraded.  IS THAT CORRECT??
As a Vet who gets primary care in Bedford and specialty care in Boston group, I am very much in favor of the proposed  integration.  One big improvement would definitely be sharing of Lab results between physicians in both facilities.  I frequently use the shuttle between Bedford and JPVA. I expect that this will be the same or better service after such integration. Thank You for giving us a say in this matter.
sounds reasonable. re improved access; can providers expect to see patients from other geographic areas, who previously went to other facilities exclusively for episodic visits? will current panels remain basically intact? Also, this sound like a huge undertaking for IRM as a unit. Would that staff be expanded? to support us through the transition?
It appears to be progress and more efficient.
Will "all" outpatient care remain at the same facilities (Bedford) or would some of those change to a greater Boston facility. Parking is sparse at Bedford.  BTW is it possible to restrict employee and student workers be restricted to the lot near the golf course.  That would relieve the patient only parking more available.  It is truly shameful for young healthy students take up nearby parking spaces for older and less healthy Veteran Patients.   Likewise for the other facilities. Parking at  W.Rox and J.P.  is absolutely horrible.  Will travel pay still be available in Bedford.
This proposal seems to be a  great idea. It has my vote..
Is the 'integration' of VAMC Bedford/ Boston administrative dependent  on 'integration' of the medical records? What has been done to ascertain the steps required to 'integrate' the administrative as well as the medical records?
What about comment boxes for VA Boston employees who do not have access to outlook?
What will happen to the training programs?  There are currently separate training programs for interns, post-docs, practicum students, residents, etc.  Will these continue to stay separate?
I thought this integration already took place, for obvious reasons.  
1) I'm worried that the centralized leadership structure will mean that it takes even longer to get things done. Bedford's hospital director is asked to sign a host of documents, from cell phone requests to research funding proposals. I can only imagine that a centralized leadership structure will mean that we need to add another 2 weeks to a month to processes that already take too long to complete. Integrating the medical record is a good idea. Eliminating local executive decision-makers is not.

2) In working in both healthcare systems, I can say that the culture is very different between Boston and Bedford. In my particular service line I find Bedford to be more innovative, Veteran-centered and mutually empowering (for staff and Veterans). By comparison I found Boston to be more hierarchical, stuffy and by-the-book (read, less innovation, more top-down). At Bedford folks in my service line wear open collars. At Boston the majority wear ties. While these differences might sound minimal, I'm concerned that Bedford staff and programs will be expected to assimilate to the dominant Boston way of doing things, if not directly, indirectly via funding decisions, setting of priorities and willingness to accept and support innovative ideas that come from Bedford staff (who have usually gotten the ideas from Veterans).

3) Finally, until now I have chosen not to be involved in the feedback process re: the integration as it comes off as more of a done deal than a "proposal."  When I saw the first intranet image of the new catchment areas it pretty much reinforced the idea that executive leaders have made the decision and are putting out carrots after the fact to pull staff along. While I appreciate the opportunity to provide feedback it does not seem like it will impact the final decision.
How will this impact our outpatient clinics?
1. Do we have to send staff to Bedford?
2. What do we do if we do not have available personnel (physicians, mid level providers) to staff Bedford?
Since, the VABHCS continues growing through integration with other VA facilities and new veterans due to current war, great percentage of the population we care for becomes in need of long term care among other services.  So, my question is...does the VA have think about having its own Nursing home facility for long term care?  probably you are aware that the property across from JP VA (New England Home for Little Wonderers) is moving out of its current location in the next couple of years.  (I read that in one of the local newspaper few months ago.  In my humble opinion that would make a good site for what I mentioned before.  Thanks.
Great Proposal. It would be great to have teams of specific medical areas i.e. Dermatology, visit a VA periodically to treat patients locally.  I have to travel to JP several times a year and cannot collect mileage since the appointments are not directly related to my disability. Shuttle wastes a whole day and Rte 9 is an accident waiting to happen. Please expedite this implementation. 
I had applied for a position at Bedford ~ 2 yrs ago and was told that Bedford does not use PAs.  I was surprised as well as disappointed by these statement.  Considering the long, success utilization of PAs in the VA HCS nationwide I was hoping to start my career at Bedford since it is geographically much easier to commute to then JP.  I have been at JP and enjoying my experience in providing safe, quality healthcare to our Vets.  Especially, since I am a Vet myself the VA is where I need to practice as a PA.  Is there any possibility of getting PAs involved at Bedford as healthcare providers?
I think that this proposal is a great idea. I always wondered why they were not integrated previously.
This is a great idea. I would like to see the audio services in Bedford at least one day a month or week. Thanks for the opportunity for comments
I think it is an excellent plan -- I particularly like the single medical record
Sounds like a great (no brainer) go with it
I support the merger of all the locations for my own and convenience of the vets that use the Lowell VA. It is very inconvenient to have to go in to Boston and spend the better part of the day there for a test that takes less than 5 minutes. A short trip to Bedford, either by bus or private car, would be much more convenient for the Vet.
As a VA patient living in Lowell, some of my appointments require me to go to JP and it turns out to be an all day affair for one appointment for I choose to take the shuttle. If I could go to Bedford for the same appointment, say ENT, I could drive there and wouldn't have to spend an entire day.
I have used both the Bedford and Boston systems and have never understood why they were not integrated. I think this proposal is excellent and long overdue. Go ahead with it.
I think this makes sense, however will the Lowell Clinic remain open.  You talk about lab work at Bedford or Gloucester, Lynn and Haverhill.  What about Lowell?  They have a great clinic there.
I think merging the two systems would be a great idea because they both really serve the same patients anyway.
to this vet having used the West Roxbury hospital. for my colon cancer 5yrs.past and feeling good I can only say any chance to combine all of the v.a.as one could be the best way to go. god bless the vets and the VA
In the literature regarding the Integration Proposal I see no mention of the integration of the pharmacy services. I am a Bedford patient, if I am prescribe a medication in Jamaica Plain will I be able to pick it up at Bedford? Will I be able to get a refill at Bedford?
This proposal sounds like a very good one. I am in favor of it.
My Dad is a Veteran and has all of his medical care provided through the VA.  He is 86 years old.  We have both read the informational flyer that was recently mailed to him.  We are both very much in favor of the proposal.  It would be so much easier for him and for our entire family to have these services combined and to have medical records, doctors and clinics available at both sites.  Thank you.
I think this is a fantastic idea and is a first step in joining the 21st century of medical care. It should be extended as far as possible, even to private providers. In this case, more is better for the patents, doctors and costs.
With all the changes, it would be greatly beneficial to many of the Bedford campus users to have a branch of the audiology lab located there.

 

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