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Cincinnati VA Medical Center


Power of Performance: April

The Power of Performance Recognition is a way for employees to recognize peers who work to provide Veterans with the best care possible.


Tiffanie Boone and Jean Holthaus, Social Work ServiceLinda D. Smith, Director, Tiffanie Boone and Jean Holtaus 

Ms. Holthaus and Ms. Boone have made significant contributions to improving the delivery of inpatient hospice and palliative care services to Veterans seen at Cincinnati VA Medical Center.  There are 3 matrices that objectively demonstrate the impact they have on the delivery of end of life care over the past three years. Matrices include the number of consults received for services, the number of deaths that have a completed consult, and the results of the Bereaved Family Survey (BFS).  Over the past month they have completed 56 Inpatient Hospice and Palliative Care (HPC) consults representing a 36% increase over the same period last year. It also signifies 37% of the total FY 13 consults completed. Through a variety of innovative practice and education processes they have increased the total number of consults from FY10= 271 to FY12=477. This year's transformational measure for HPC consults within the last year prior to death is 73%. Currently the program is at 69% which is up 3% from FY12. Due to their commitment, diligence to education staff, and to develop screening tools they are directly responsible for an almost 30% increase in the number of consults received since 2010 (FY10= 49% - currently 69%).

The current 1st quarter BFS performance monitor indicates a 74% excellent rating which is up from 49% in FY10. Additionally the program finished FY12 as either the top performer of tied for the top performer in the 5 highly correlated questions component of the BFS. In summary the distinctive dedication, passion, and commitment that Ms. Holthaus and Ms. Boone demonstrate on a daily basis has brought a quality of dignity and respect to veterans at the end of their lives.


Linda Dubois, Evette Hunter and Bonnie Crawford, Patient Business Service and Social Work Service

Evette Hunter, Bonnie Crawford, Linda Dubois and Director Linda D.SmithSignificant achievements were made to improve the Special Mode Transportation (SMT) Program to include: reducing the number of inappropriate and fraudulent payments, incorrect mileage, and inappropriate SMT authorizations. The group was able to develop an electronic algorithm to drive the decision regarding clinical eligibility. The algorithm was formatted into the patients' record as an electronic consult request, which allowed Veterans' actual needs to be easily addressed and have a permanent history and record and identify the correct level of transportation. The new electronic process allows simultaneous reviews to determine administrative eligibility, psychosocial concerns, and medical eligibility for the type of travel requested.  Documentation of the SMT needs in the Veteran's medical record has aided Veterans and staff in assuring that those Veterans deemed eligible are afforded the appropriate transportation they need. Eliminating inappropriate use of SMT has yielded a substantial cost savings to the Medical Center, allowing funds to be used for Veteran's health care in other ways. The revisions of the SMT Program directly contributed to a total savings of approximately $1 million from the Medical Center's annual budget for Beneficiary Travel.


Tammy Carnahan, Nursing Service  

Tammy Carnahan, Nursing Service with Linda D. Smith, DirectorTammy has been the Primary Nursing Service Scheduler for the past 3 1/2 years. During this time, Tammy has been innovative and intuitive in what the needs for nursing staffing have been. Tammy was given the Lawson Scheduling System 1 year ago and has mastered the system, updating each nurse’s schedule and adding important details such as phone numbers and preferred work areas, making the system invaluable for the VA Hospital as a whole.

Tammy is also in charge of updating the overtime/agency folder and the daily census sheets. This is a small part of daily updating she uses for nursing scheduling success she uses to make the VA Hospital a success.  Tammy has taught Lawson as well as all of her other scheduling methods, for complete transparency in making sure the hospital is staffed properly. Tammy has been insistent in her pursuit of mastery of this new system and has resolutely made sure that each of her students has knowledge of the system and its importance. Her expertise has been immeasurable in the successful pursuit of patient care, staff achievement and nursing development. 


Kimberly Rouser and Kimberly Scott, Patient Business Service 

Kimberly Scott, Patient Business Service and Director Linda D. SmithThis facility has a dynamic duo patient advocate team, known as Kim & Kim; Kimberly Rouser, Outpatient Advocate and Kim Scott, Inpatient Advocate.  Both advocates work tirelessly to assist the Veterans and family members they come in contact with.  To say they continuously go above and beyond to help those in need is an understatement.   They each provide invaluable service to our Veterans and are information resources for staff.  They will relentlessly seek a resolution to a problem that most would retreat from in defeat.

After being informed that a Veteran we referred to Cleveland Clinic for a procedure could not afford the cost of lodging, Ms. Rouser made several calls to various departments in the Cleveland Clinic system until finally reaching someone willing to assist.  This effort resulted in the Veteran receiving cost free lodging for 2 nights which included free breakfast and shuttle service.  On another occasion she assisted a Veteran’s spouse in receiving cost free lodging for 3 nights with a discount on the remaining nights.  Her efforts were cost saving to the Veteran and spouse.

Ms.  Scott learned of a Veteran who was having difficulty cashing his cashier check at the Agent Cashier office during a travel meeting.  The Veteran needed the cash to purchase a bus ticket home and had no other means of transport.  Without being asked, Ms. Scott intervened on the Veterans’ behalf.  She confirmed the Agent Cashier could not cash the check then proceeded to seek a resolution to the issue.  After meeting with the Chief, Canteen Service about the matter, the Canteen Service agreed to cash the check.  Ms. Scott shared this information with the staff and made sure the transaction was completed prior to the 4:00pm closing time of the Canteen.  Without the efforts of Ms. Scott, the Veteran would have remained an inpatient until his transportation issue was resolved.  Her efforts were cost saving to the facility.

Kim and Kim always rise to the occasion when tasked with complex issues.  Their dedication and resilience is truly an asset to this facility.

Dr. Tara Carr, Mental Health Care Line and Director Linda D. SmithCertificate of Appreciation 

Dr. Tara Carr, Mental Health Care Line

In appreciation for dedicated participation and significant contributions as a FY12 Office of Mental Health Operations site visitor.