Greetings Veterans – Since our last edition of The Fourteener, we have been through some tough times together. As the world entered into an unprecedented global pandemic in early 2020, we at VA Eastern Colorado Health Care System (VA ECHCS) have been working to navigate a safe path forward while continuing to provide you with seamless access to quality care in a new reality with the coronavirus. Thank you for your collaboration and understanding in recent months. While VA has long been an innovative leader in delivering high-quality virtual care, the pandemic has proved our capability to reach and serve Veterans across Eastern Colorado in rural and mountain communities. Despite these challenging times, we’ve already reached important milestones and victories this year. In June, we opened our brand-new Fisher House that will serve as a home away from home for 16 families while their loved ones receive care on the Rocky Mountain Regional VA Medical Center campus. In July, VA ECHCS was also recognized as ‘Most Improved in Patient Experience’ for Inpatient VA Survey of Healthcare Experiences of Patients (SHEP) scores between Fiscal Year 2019 Quarter 1 (62) and Quarter 4 (76)! Even though COVID-19 has delayed some plans to meet you in person out in the community, I always want to learn how we can serve you better and will gladly share meaningful conversations with you about our way forward with your care. In this issue, you’ll learn about how we’ve adjusted to COVID-19 and how the community has supported us along the way. You’ll read about how we are fulfilling VA’s Fourth Mission and what we are doing to keep you safe when you come to see us. I look forward to meeting you and hearing your story. As we move forward together, please remember to take care of yourselves and loved ones! ~Michael T. Kilmer
Tough times, tough team
Since the beginning days of the pandemic, VA Eastern Colorado Health Care System team members rose to the occasion of meeting a variety of challenges.
The COVID-19 drive-thru testing site at PFC Floyd K. Lindstrom VA Clinic in Colorado Springs (pictured on cover) was one of the first VA clinics in the country to set up a testing site and has served as a model for other VA's to learn from.
During the height of the pandemic between March and May, the Rocky Mountain Regional VA Medical Center (RMR VAMC) also activated a mobile 'Swab Squad' (pictured above) and a drive-thru testing site at both the Emergency Department and outside the north entrance of RMR VAMC to serve our Veterans.
Veterans, if you come to see us for a medically necessary appointment or for urgent and emergent needs, you’ll find that we've implemented a variety of safeguards throughout our medical center, emergency room and clinics to keep you safe during your visit:
- Plexiglass guards installed at information desks
- Hand sanitizer stations available throughout facilities
- Frequent cleaning and sanitizing methods throughout facilities
- Physical distancing cues in waiting areas and elevators
- Respaced chairs and tables in waiting rooms and at the Canteen to ensure physical distancing
To keep you and our staff safe, we maintain mandatory screening upon entry and ask for all persons to wear a provided earloop procedure mask (surgical mask) for the duration of your visit.
While you always have the option to connect with your provider through virtual and phone visits, please do not delay care if you are in medical need. We are here for you.
By Brandy Morrison, Public Affairs Officer
When the entire world is facing a global pandemic, life changes. Some changes are gradual and go unnoticed while others happen rapidly. The Rocky Mountain Regional (RMR) VA Medical Center has made life-changing modifications to their Emergency Department (ED) operations.
On April 3, 2020, RMR stood up a drive-thru ED triage and acuity level routing processes. Before a Veteran ever steps foot into the facility, they are met by a nurse in personal protective equipment (PPE) and triaged from their car. Today, that nurse was Eliza Russell, an 18-year veteran of nursing who has been on the front lines of the RMR ED.
As a key contributor to the development and implementation of the new ED routing process at the time, Russell stressed the importance of those measures, by stating, “We need to keep respiratory symptoms separated so that we are not unintentionally infecting people with COVID.” From the point of triage, Veteran patients can get routed through one of three ways; COVID-19 testing, drive-thru ED triage for acuity levels 3, 4 or 5, or the Emergency Department.
Mark Phillips, ED Chief Nurse, expressed how impressed he was with his team that took this idea and brought it to life, sharing that this operation “eases tension in the ED.” Phillips echoed the sentiments of Russell in the overall need for this process stating, “This helps eliminate our people walking into an area with COVID-19 and reduces their exposure.”
When asked to describe the team of nurses and providers through the set up and implementation of the new emergent care process, Russell said, “In one word, solidarity.” She did not pause or hesitate, she was instead definitive and direct, “solidarity.” RMR has a team of true professionals who have united with a common interest – to keep each other safe and keep our Veterans safe.
Safety is the goal here—to mitigate and minimize risk to both Veterans and staff. VA Eastern Colorado Health Care System (ECHCS) has taken many steps to safeguard both of these populations. During the early months of the pandemic, ECHCS canceled all non-emergent surgical and procedural cases, closed down many face-to-face outpatient sites of care and has implemented screening protocols for COVID-19 symptoms for all staff and patients.
Solidarity has stretched across the health care system as Licensed Independent Practitioners (LIP) and nurses were realigned to assist with the surge. Melissa Munkwitz, an Orthopedic Physician Assistant, who supported the drive-thru ED triage as a treating LIP said, “This is awesome … We are doing this for the organization and the Veterans. This is teamwork.”
Tyree Morrison, a home-based Primary Care Nurse Practitioner who usually supports the Pueblo region during normal operations, went to Aurora to work side-by-side with Munkwitz. Morrison said, “This (pointing at the drive-thru operations) is how we do COVID responsibly.”
Since ECHCS had their first COVID-19 patient on March 9, 2020, they watched as the acuity level of their COVID patients increased. This is no longer a travel concern but is based on community spread. In Colorado, the COVID pandemic was projected to surge between April 17 and April 20 and VA ECHCS took every necessary step to be ahead of the surge.
If you are a VA ECHCS patient in need of urgent or emergent care, please be patient and kind as this has not been our normal operations. Every change that has been put in place is there for the safety of the community.
By Khristie Barker, Public Affairs Specialist
One thing is certain, during the COVID-19 pandemic, the Rocky Mountain Regional VA Medical Center looks vastly different. There are no groups of Veterans sharing stories, the waiting rooms are empty, tents are set up outside for various triage stations and much of our staff were temporarily reassigned to the labor pool to assist with the impending battle. Through all of these changes, one thing has remained the same. Tootsie, the facility therapy dog, is still making her rounds with her handler, Clinical Psychologist Dr. Elizabeth Holman.
As freezing rain turned to snow on a blistering cold Colorado day, a call came into the Critical Incident Response Team (CIRT) from Dr. Javier Perez, Emergency Department (ED) Chief. Perez’s team had been outside in the elements, testing Veterans for COVID-19. They were cold, tired and needed an uplifting moment.
The CIRT team consists of three psychologists, a chaplain and Tootsie, who when needed, always answer the call.
On this particular day, they ventured off to the ED to offer whatever support they could. During a time when we are instructed to keep our physical distance, Tootsie shows us “how hungry people are for touch right now, for contact. Being with Tootsie allows people a moment of joy in a day of stress and a time that is really scary,” said Dr. Holman.
VA Eastern Colorado Health Care System was the first VA to have an acute inpatient therapy dog. Tootsie, our second therapy dog, takes her job very seriously by offering warmth and comfort to all who come in contact. Dr. Holman stated, “when we are with animals, we are in our hearts. In this setting and time, we guard our hearts and Tootsie gives us a chance to connect with the sweetness that’s inside of them.”
So, what are Tootsie’s plans as we ride out this health care crisis? As long as she can continue to support the employees, she will be available to staff. In her time off, she looks forward to lots of walks and a few playdates (with physical distancing in mind, of course) to make sure she isn’t over stressed and her batteries are recharged.
With thousands of canceled blood drives across the country in recent months due to the coronavirus disease known as COVID-19, VA Eastern Colorado Health Care System (ECHCS) has partnered with community blood center, Vitalant, to host blood drives at the Rocky Mountain Regional (RMR) VA Medical Center in Aurora.
On May 20, 2020, the medical center’s first blood drive during the pandemic was coordinated by the ECHCS Emergency Management team as a pilot event to assess donor response and to accommodate the facility’s limited visitor policy. The blood drive was a success, resulting in all 46 appointment slots filled—28 of those were first time donors. This drive alone will go on to help 138 patients, according to Michelle Lowry from Vitalant.
“By taking an hour out of your day, you will be able to save up to three lives and help out our community and our Veterans.”
“We thoroughly enjoyed our time at [RMR]. Everyone was super friendly and so appreciative of the drive being hosted on site,” Lowry said.
Like many VA facilities across the country, ECHCS is leveraging community resources that stem the shortage of vital blood and blood products. These blood drives exercise VA’s “Fourth Mission” that provide back-up health services to the nation in times of disaster. This joint effort helps VA and the community better prepare for and support Veterans who may need blood or blood products in the near term.
“This partnership with Vitalant is so important right now. Especially with all the current events, blood supply is critically low,” said Eva Gergely, ECHCS Voluntary Services Chief. “By taking an hour out of your day, you will be able to save up to three lives and help out our community and our Veterans.”
ECHCS Voluntary Services plans to coordinate regular blood drives at RMR in the future. To schedule, visit Vitalant's website at https://donors.vitalant.org or call 303.363.2300. RMR Site Code is ‘5720.’
* Courtney Graham with VA ECHCS Voluntary Services (left) donates blood at the facility's first blood drive during the pandemic on May 20, 2020. If you are healthy, giving blood is safe and you can donate even if your community is under a stay-at-home order.
“This program is such in important piece to fighting this COVID battle; providing these meals has been such a gift to these front line employees so they are able to take care of themselves in order to take care of our Veterans,” according to Eva Gergely, VA ECHCS Voluntary Services Chief.
Gergely and her Voluntary Services team have often been the first point of contact for the delivery of the thousands of meals donated to VA ECHCS recently. On any given day in recent months, you could spot the team, along with Employee Engagement Officer Kristen Luevanos, wheeling carts packed with snacks and treats throughout the Rocky Mountain Regional VA Medical Center (RMR VAMC) or driving to outlying clinics to serve piping hot meals to staff.
Since March, everything from pasta, sandwiches, tacos, salad, donuts and coffee have fueled VA ECHCS essential workers across the medical center and outlying clinics.
“It has been such a delight delivering these meals to the different departments and seeing the faces on the staff,” Gergely added. “Many of them were in aww or disbelief that someone was thinking about them, and so they really appreciated the meals.”
Along with Gergely, several VA ECHCS staff members are excited to now have a list of restaurants they’ve been able to enjoy through these donations so they can pay it forward in the future.
By Terri Rorke, Public Affairs Specialist
Before physicians had science, they relied on the art of medicine, which according to Hippocrates consists of three things: the disease, the patient and the physician.
Former Denver VA Outpatient Physician, Dr. Stuart Smith, expanded this concept into a model he calls the Hippocratic Tripod representing the doctor-patient-illness relationship upheld by the Hippocratic Oath, research, practice and teaching. Through this model, Smith shares his message about the meaning of medicine, which he says has everything to do with community and clinical trust.
“I present to the patient, offering whole mind and body,” Smith said. “Medicine is human-to-human care.”
Smith knew he’d one day become a ‘country doctor’ after receiving great care by the one he knew while growing up in a Western Massachusetts town of 400 hundred people.
Years later, Smith deployed to Europe with the U.S. Army during the height of World War II where the experience of caring for the ‘comrade-in-arms’ to his left and his right affirmed his path in life.
As president of the Association of American Medical Colleges, Darley stewarded the surge of student enrollment in the 1950s with the new VA-medical school partnership. Meanwhile Weed introduced a system for organizing patient data and was the first to computerize patient records.
“Because they conceived ways of delivering understandable technology to all patients, these two are among the 20th Century’s most important and perhaps least acclaimed clinicians and teachers,” Smith said.
Today more than 40 different health professions are represented by affiliations with more than 1,800 unique colleges and universities, according to VA: “Whether you receive medical care at a Department of Veterans Affairs (VA) facility or with a private provider, odds are your doctor has trained with VA at some point. In fact, almost 70 percent of United States-trained physicians have received training at a VA medical center or clinic…”
Created with an image by LuAnn Hunt - "This local sheriff took about 30 minutes out of his busy day to donate a pint of blood at the local Red Cross blood drive. One pint of blood will save up to three lives!"