2012 Report to the Community - VISN 8

2012Report to the CommunityCommitted to Exceptional VA Health Care

‘‘ OurVeteransCOuntOn us.Nevin M. Weaver, Director,VA Sunshine Healthcare Network, VISN 8‘‘2Annual Report 2012 » www.visn8.va.gov

Dear Veterans, Families and Friends,THIS ANNUAL REPORT IS MORE THAN ACOLLECTION OF FACTS AND FIGURES. IT TELLSOUR STORY OF POSITIVE MOVEMENT FORWARDWITH A FOCUS GROUNDED IN SERVING OURPATIENTS IN THE LARGEST, BUSIEST VA HEALTHCARE NETWORK IN THE NATION.During 2012 in VISN 8, we saw more patients, filled more prescriptions, and performedmore mammograms than any other network in the VA.We’ve grown to serve even more Veterans with larger clinics that replaced older ones,expanded existing facilities and services, and created new specialty programs to bettermeet our patients’ expectations.We’re putting every dollar to work--investing in new equipment, technology andemployee training so our patients benefit from the latest medical advances.We’re committed to being greener across our network of hospitals and clinics and we’regetting recognized for these efforts with “Green Globe” awards for environmental andenergy efficiency.Special populations like women, homeless and returning Veterans and those living inrural areas are getting the specialized services they need and deserve--when and wherethey need it most.Having the Veteran truly at the center of their health care is central to our efforts. We areengaged in a Cultural Transformation to do just that by empowering our employees toimprove patient experiences through learning, discovery and continuous improvement.As we continue this journey, we need to stay a step or two ahead in an ever-changinghealth care environment. In 2013, I see even more positive changes on the horizon aswe continue to provide exceptional health care for Veterans in the same way they haveworked tirelessly to preserve the freedom we all enjoy.With gratitude,Nevin M. Weaver, FACHEVISN 8 Network Directorwww.visn8.va.gov3

The busiest VA healthcarenetwork in the country.We care for more Veteransthan anyone else.570,309Patients Seen(highest in nation)THE VA HEALTHCARE20,544patientsTreated every day withinthe VISN 8 Network—highest in nation.7.5millionFY12 Outpatient Visits(highest in nation) 22,776Mammograms(highest in nation)4Annual Report 2012 » www.visn8.va.gov

886,408Inpatient Bed Days of Care(highest in nation)805,807Veterans enrolled for Care(highest in nation)best in va:Cholesterol Screening(in patients with ischemic heart disease)126,297Flu Shots(2nd highest in nation)NETWORK YOU COUNT ON2,856Operating Beds(Highest in nation. Includes hospital,nursing home, domiciliary beds)17.9millionPrescriptions Filled(highest in nation)34,806surgeries(2nd highest in nation)www.visn8.va.gov5

Who We Are &What We Stand ForVA has adopted Core Values andCharacteristics that apply universallyacross the Department. The five CoreValues define “who we are,” our cultureand how we care for Veterans, theirfamilies and other beneficiaries. TheCore Characteristics define “what westand for” and help guide how weperform our core mission.The Values are Integrity, Commitment,Advocacy, Respect and Excellence(“I CARE”).The Core Characteristics:Trustworthy: We earn the trust of those weserve – every day – through the actions ofour employees who provide care, benefits,and services with compassion, dependability,effectiveness, and transparency.Accessible: We engage and welcome Veteransand other beneficiaries, facilitating their use ofthe entire array of VA services. Each interactionwill be positive and productive.Quality: We provide the highest standard ofcare and services to Veterans and beneficiarieswhile managing the cost of programs and beingefficient stewards of resources entrusted to usby the American people.Innovative: We prize curiosity and initiative,encouraging creative contributionsfrom all employees, seeking continuousimprovement, and adapting to remain atthe forefront in knowledge, proficiency, andcapability to deliver the highest standard ofcare and services to those we serve.Agile: We anticipate and adapt quickly tocurrent challenges and new requirements bycontinuously assessing the environment inwhich we operate and devising solutions tobetter serve Veterans and others we serve.Integrated: We link care and servicesacross the Department; other federal, state,and local agencies; partners; and VeteransServices Organizations to provide useful andunderstandable programs to Veterans andother beneficiaries.Critical Care NursesPut Their Patients FirstThe Beacon Award for Critical Care Excellence is given annually by theAmerican Association of Critical-Care Nurses (AACN) to recognize thenation’s top hospital critical care units. In 2012, a Beacon Award went toa group of dedicated nurses at the Malcom Randall VA Medical Center.In particular, the hospital’s Surgical Intensive Care Unit (SICU) andCardiothoracic Intensive Care Unit (CTICU) units were recognized for theirefforts to improve every facet of patient care—a process that took fiveyears and involved many staff. The Malcom Randall team is one of three VAfacilities nationwide to receive the prestigious award.Bay Pines Recognizedas ‘Senior Friendly’In September 2012, the Bay Pines VAHealthcare System was recognized bythe Nurses Improving Care for Healthsystem Elders (NICHE) as a “SeniorFriendly” health care facility. This isthe fourth consecutive year the St.Petersburg, Fla.-based system hasbeen recognized for its commitmentto meeting the needs of hospitalizedelderly Veterans. As part of theorganization’s ongoing patient-centeredcare initiatives, Bay Pines is dedicated toproviding safe, quality care for seniors whileachieving high patient, family and staff satisfaction.A program of the Hartford Institute for Geriatric Nursing at New YorkUniversity College of Nursing, the goal of NICHE is to provide principlesand tools to stimulate and support systemic change in the culture ofhealth care facilities to achieve patient-centered care.6Annual Report 2012 » www.visn8.va.gov

trustworthy“Dr. Andria Kliozeand her nurseJennifer Traversoare real jewels. I am proudto live in a country thattreats its Veterans as wellas this country does.”- Henry J. BillingsVietnam Veteran & Patientat the Daytona Beach VA Outpatient ClinicMedical Care CollectionsFund (MCCF)MCCF are funds collected by VA for copayments and health insurance reimbursements which are returned to local VA health care facilities to provide additional services for Veterans receiving care at that facility. This substantial one-year increase was the largest of any VA health care network.2012 $271.8 Million2011 $243.2 Million$29 Millionincrease inFY12 (largest inVeterans HealthAdministration )1.6Million VeteransLive in a service area spanning61,101 miles20,000Average Daily Outpatient Visits(highest in nation)www.visn8.va.gov 7

We’r eaccessibilityExpanding & Improving:ProvidingVeterans Access to Quality Health CareWhen and Where They Need It.92% of Veteranslive within 30 minutes of travel time to a VA facilityfor primary care and mental health services.Lee County Clinic Opens ForSouthwest Florida VeteransIn December 2012, the Bay Pines VAHealthcare System opened the Lee CountyVA Healthcare Center. The 220,000 squarefoot outpatient facility replaced the VA clinicformerly located in Fort Myers, Fla. The newfacility has greatly expanded the healthcaresystem’s ability to provide primary andspecialty outpatient health care services tothe Veterans of southwest Florida.Garage ExpansionAccommodates Growthin West Palm BeachNew Eye Treatment and AmbulatorySurgery Center in St. PetersburgThe Bay Pines VA HealthcareSystem completedconstruction of a twostorybuilding thathouses a new EyeTreatment Centeron the first floorand an AmbulatorySurgery Centeron the secondfloor. The new EyeCenter opened itsdoors to Veteransin October 2012. Fullactivation of all surgicalservices is expected in2013. The new facility on themain St. Petersburg, Fla. campus offers diagnostic,examination, and treatment services for eye conditionssuch as specialized low vision, cataracts, glaucoma,and medical retina conditions (including diabetes andmacular degeneration), as well as eye problems relatedto traumatic brain injury.When the West Palm Beach VA MedicalCenter opened in 1995, only about 31,000Veterans were expected. Today, the facilitysees more than 61,000. That’s why patientsand staff were so happy with the MedicalCenter’s garage expansion of an additional400 parking spaces this year.8Annual Report 2012 » www.visn8.va.gov

Larger Sebring Clinic a Realityfor Highlands County VeteransTo better meet the needs of Veterans in HighlandsCounty, the Bay Pines VA Healthcare Systemrelocated and expanded its Sebring CommunityBased Outpatient Clinic. The new 9,500 square footclinic opened to Veterans in November 2012 at nearlytwice the size of its previous location. About 3,100Veterans are served at the facility by 17 primary carestaff in a spacious, patient-centered environment.Services offered to Veterans include primary andmental health care, an anticoagulation clinic, EKGs,pharmacist consultation, phlebotomy, social work, andreferrals to specialty care offered at the Bay Pines VAMedical Center in St. Petersburg or at the Lee CountyVA Healthcare Center.New Clinic in Puerto RicoBrings Care Closer to HomeThe VA Caribbean Healthcare System (VACHS)opened its 10th outpatient clinic on Sept. 13, 2012.“Providing world class health care close to whereour Veterans live has long been a goal of the VA andthe VA Caribbean Healthcare System,” said WandaMims, former VACHS director. “Through the effortsof many and especially the Municipality of Ceiba,we are now able to provide needed services herein Ceiba and its surrounding municipalities.” Theclinic will serve Veterans of the municipalities ofCanóvanas, Luquillo, Río Grande, Fajardo, Ceiba,Humacao, Yabucoa, Naguabo Vieques, Culebrasand Las Piedras.Dermatology Clinic in GainesvilleServes Specialized NeedsIn January 2012, the North Florida/South GeorgiaVeterans Health System opened a primary caredermatology outpatient clinic in Gainesville, Fla. Theclinic provides diagnostic and therapeutic servicesto Veterans with skin-related problems or diseases,including a full spectrum of general dermatologicalconsultations, evaluations and treatments. The clinicalso offers Mohs Micrographic Surgery for advancedtreatment of skin cancer.$6.3 Million Expansion of VieraOutpatient ClinicA $6.3 million project to add an additional 30,000square feet to the Viera VA Outpatient Clinic (OPC)expands care to accommodate the rapid growththe clinic has experienced since it opened in 2002.Originally built to accommodate 119 employees and12,000 patients annually, the OPC is now 140,000square feet and is currently staffed by more than 365dedicated VA employees. More than 25,000 Veteransare treated there each year.www.visn8.va.gov 9

innovationExpanding ServicesforWomen VeteransNew MammographyUnits in San Juan andNew Port RicheyTwo new mammography units opened atVISN 8 facilities in 2012 including one atthe San Juan VA Medical Center alongwith a unit at the New Port Richey VAOutpatient Clinic. This brings the numberof mammography units in the network tonine with plans for additional units at theMalcom Randall VA Medical Center, theJacksonville Outpatient Clinic, and theLee County VA Healthcare Center. Breastcancer is the disease many women fear themost, and early detection and treatmentcan dramatically improve the chances ofsurvival. This equipment represents themost advanced in Digital Mammographyavailable on the market today.Remodeled Women’sClinic Is Private andChild-FriendlyThe Women’s Health Clinic at the MalcomRandall VA Medical Center is a place for womenVeterans to get the care they earned. In 2012,the Women’s Clinic was remodeled to includea new waiting room with a children’s area andbathrooms with infant changing tables.The updated clinic is wheelchair accessible andthe enclosed clinic area provides more privacyfor female Veterans. With the largest populationof female Veterans in VISN 8, the North FloridaSouth Georgia Veterans Health System has twoother Women-Only clinics located at the LakeCity VA Medical Center and the JacksonvilleOutpatient Clinic.10 Annual Report 2012 » www.visn8.va.gov

Health Care Provided to Women in VISN 8Total Patients Treated42,101#1 in the Nation44,38245,34647,79650,228FY08 FY09 FY10 FY11 FY1219.3%“I have cried many rivers in mylife. However, the West PalmBeach VA Medical Center hasgiven me the tools to build a bridge tomove forward on my life’s journey. I amgrateful for my engineers: my PatientAligned Care Team at the hospital; myPrimary Care provider, RN, case manager,clinical nurse, and clerk to social workers,chaplains, specialty clinic staff, specialtypsychologists, benefits advisors, and evenother Veterans. They are all there for me.”- Violet Galloway, VeteranU.S. Army, 1978 - 1985BEST IN VA:Breast Cancer Screeningfor Women Ages 40-69caring for veterans with disabilities - prosthetics$222MillionBudget(10% of VA’s totalprosthetic budget)Prosthetics inVISN 8thenation’slargestprogram280,000PatientsProsthetics BoutiqueJust for Women: ‘Your NewCamouflage Boutique.’Molly Boyle (left), a certified VA orthotist and fitter ofmastectomy devices, is the proprietor and catalystbehind the creation of ‘Your New Camouflage Boutique’located at the West Palm Beach VA Medical Center’sWomen’s Health Clinic. Thought to be the only one ofits kind in the VA—the boutique offers all major brandsof compression wear as well as custom garmentsdesigned especially for disabled women. Besidesoffering personalized fittings, Boyle issues limitedmaternity supplies to pregnant women Veterans.www.visn8.va.gov 11

accessibilitybringing quality va health care to veterans in rural areas“My Care isexcellent atthe Miami VA. It’sespecially convenientto have a clinic nearwhere I live.”108,600Patientslive in rural areas43,536VeteransServed via telehealth- Merlene Isler, U.S. Air Force VeteranPatient at the Community BasedOutpatient Clinic, Hollywood, Fla.TELEHEALTH:VA Doctor Will See You NowYour Choice: drive hours to your nearest VA medicalfacility OR connect via video from your closestcommunity-based outpatient clinic.Some Veterans live many miles from a VA medicalcenter, making visits to the doctor an all day event.Others, those with chronic conditions, requireconstant monitoring but opt to stay at home ratherthan in the hospital.In both cases, VA’s telehealth program providesgreater access to health care through the use oftelecommunications and videoconferencing. VApatients are finding telehealth to be just what theyneed to receive personalized care from their VAmedical center.The Veterans Health Administration (VHA) is thenation’s leader in telehealth technologies, whichmeans doctors and patients can meet for healthservices without physically being in the same place.“With telehealth, our Veterans can connect with VAspecialists in mental health, cardiology, dermatology,gastroenterology, rheumatology and urology,” saidPatricia Ryan, Associate Chief Consultant for VHATelehealth services.The Be Active and MOVE! preventive health careprogram provides a physical activities group class tomultiple VA outpatient clinics in the VISN 8 healthcaresystem via Clinical Video Telehealth (CVT). The classesare an extension of the MOVE! Telehealth program andare held for one hour weekly for eight weeks.“This is important, because a large percentage of our ruralVeterans are advancing in age. They have chronic healthconditions that require constant monitoring. If it wasn’tfor Telehealth, we’d be hard pressed to deliver the kind ofday-to-day observation they require,” Ryan said.Clinical Video Telehealth (CVT) gives patients andproviders the opportunity to conduct several aspects ofmedical examinations that do not require in-person visits.Veterans are able to visit a VA clinic near their home,connect to medical centers through videoconferencing,and transfer medical information by way of speciallydesignedtelecommunications equipment.12Annual Report 2012 » www.visn8.va.gov

innovationGOInG GREEn:Reducing Our Energy FootprintProviding Veterans with safe, high quality and accessiblehealth care while focusing on innovations that reduce ourenergy footprint in a sound, fiscally responsible way is atop priority. Here are “green” highlights from two of ourVA healthcare systems—one in Florida and the other inthe Caribbean.Bay Pines VA Recognized With Green Globe AwardsIn 2012, the Bay Pines VA Healthcare System receivedthe Green Globe Awards for environmental and energyefficiency campus-wide. In total, 16 of the major buildingson the St. Petersburg, Fla. campus (to include the mainhospital) received Green Globe certification. The BayPines VAHCS is one of only 11 VA campuses acrossthe country recognized for “campus-wide sustainablecertification.” The Green Globe Awards are a project ofthe Green Building Initiative (GBI) for environmental andenergy efficiency.Going Green with Cost Saving,Energy Efficient ProjectsThe VA Caribbean Healthcare System has a large energyand resource footprint in the Caribbean with one majorhospital in San Juan and 11 smaller facilities in PuertoRico and the U.S. Virgin Islands. In 2012, VA Caribbeaninvested $4.5 million in innovative energy efficient projectson its main campus including a Photovoltaic System-Renewable Energy in a Special Intensive Care Unit; a SiteSolar Renewable-Energy Multilevel Parking Garage, and aVertical Wind Turbine System in a state-of-the-art patienttower. The San Juan VAMC also has Green BuildingInitiative certification.Solar Carport: On the Bay Pines VA Medical Center’s St.Petersburg, Fla. campus, construction was completed in2012 on a 1.48 megawatt Solar Photovoltaic System. Thecarport-like design will reduce Bay Pines’ energy bill byabout $189,000 a year while providing 773 shaded parkingspots for Veterans and VA staff that reduce the temperaturesinside vehicles as much as 35 degrees Fahrenheit—awelcome relief in Florida’s heat, especially in the Summer.Healing Day in theEvergladesThe power of nature to help heal is welldocumented and in South Florida, natureis nearly synonymous with one of thelargest protected natural wonders inthe United States – The Everglades. InFebruary 2012, the Airboat Association ofFlorida hosted a “Day in the Everglades”celebration for Veterans and their familiesthat included games, food, music and ofcourse – airboat rides.14Annual Report 2012 » www.visn8.va.gov

“Because of theincredible medicalcare I received fromDr. Heather Hockman, I’mcasting my vote for her tobe ‘Doctor of the Year.’She virtually saved my life.”- Matthew James Hennessy,Veteran, U.S. NavyPatient, Orlando VA Medical CenterTampa VA’sPain Center IsChanging LivesThe Comprehensive Pain Center(CPC) at the James A. VeteransHospital in Tampa serves over7,200 Veterans annually offeringa wide range of treatmentoptions through its outpatientclinics, integrated interventionalmedicine, and interdisciplinarypain rehabilitation programs.All services are focused onimproving functioning andincreasing quality of life forVeterans living with chronic pain.In May 2012, the CPC receivedits second Clinical Center ofExcellence Award from theAmerican Pain Society (APS)recognizing its outstanding andinnovative pain services.Dr. Heather Hockman, M.D.LEADERS AnD EDuCATORS InAnkle JointReplacement SurgeryTotal ankle replacement surgery is an excitingand remarkable procedure used to treat posttraumatic and degenerative arthritis of theankle joint. This operation represents a viablealternative to ankle fusion which until the pastdecade has been the only surgical option.The podiatric surgeons at the James A. HaleyVeterans Hospital in Tampa are leaders andeducators in ankle joint replacement surgery.In 2012, the podiatric surgeons at the hospitalperformed 85 ankle replacements—more thanany other VA in the nation.www.visn8.va.gov15

accessibility51,122Number of military servicemembers providedtransition assistance30,000new enrollees inVA health care(#1 in nation)350number of Outreachevents held(103 more than in 2011)reaching out to returning troopsReturning Troops Using VA Health Care in VISN 8 – FY02-1239,78835,3171342%IncreaseOver 10Year Period29,24625,576Number of People17,46621,78614,07311,6017,6012,7593,189FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12Providing End-Of-Life Care & CompassionChuck Mirasola, a volunteer at the Bay Pines VA Healthcare System received anaward from the National Council of Hospice and Palliative Professionals (NCHPP)during the organization’s clinic team conference in Orlando, Fla. on Nov. 6, 2012.The 71-year-old U.S. Army Veteran was one of only three volunteers recognizednationally for receiving the NCHPP’s “Volunteers are the Foundation of HospiceAward,” for his commitment and service to Veterans and their families during histime as a volunteer in the facility’s hospice and palliative care unit.16Annual Report 2012 » www.visn8.va.gov

$24.7MillionMonetary Value of all Donations(Money, items, activities & volunteer hours)8,470Volunteers912,631Volunteer HoursvolunteersTAMPA VOLunTEERGoes Above & BeyondU.S. Navy Veteran Mary Ann Keckler of Valrico, Fla. is oneof the amazing volunteers at the James A. Haley VeteransHospital. Using a motorized wheelchair to get around, MaryAnn volunteers at the hospital seven days a week on the spinalcord injury and polytrauma units and also during recreationtherapy special events. Over the last 15 years, she hasaccumulated nearly 6,000 volunteer hours in the hospital andin the community as an advocate and volunteer ambassadorfor Veterans, wounded active duty service members and theirfamilies. For her exemplary service and tireless dedication, shewas awarded the 2012 George H. Seal Memorial Trophy by theDisabled American Veterans service organization.A ‘Thank You’ fromParalympic Gold Medalist Brad Synder“It is a testament to the high caliberof care that I received that I was ableto make an incredibly quick recovery.In a few short weeks, I was recoveredenough to be transported to the JamesA. Haley VA Hospital near my home inTampa, FL. There the amazing supportcontinued. My physical therapistsLindsay and Jenny were quick to getme up and running on a treadmill, thetwo of them pushing me straight oneither side of my hips.”Brad Synder Blog, August 24, 2012A year after being blinded byan Improvised Explosive Devicehe stepped on during duty inAfghanistan, former SpecialForces U.S. Navy lieutenantBrad Synder went on to win twoswimming Gold medals at theLondon Paralympics in 2012.Synder, of St. Petersburg, Fla., isone of many Veterans who usesports as part of their medicalrecovery from severe injuries.Brad SynderIn his Blog, this world-classswimmer writes a “Thank You” tothose who had been instrumental in helping make his journeyto London a reality. Among those he thanked were the staff atthe James A. Haley Veterans Hospital where he received careafter his injury.U.S. Navy photowww.visn8.va.gov 17

trustworthyHelping PatientsSuRVIVEHEART SuRGERyIn January 2012, Tampa VA heart surgeon Dr. ErnestoJimenez, M.D., and anesthesiologist Dr. PaulinoNunez, M.D. used a novel, minimally invasive leftventricular support device called the Impella 5.0 toperform high-risk surgery on a 62-year-old cardiacpatient who had been considered not suitablefor surgery. The procedure, which required closecooperation between anesthesia, cardiology andsurgery, featured a precision effort to place the deviceinto the patient’s left ventricle from the subclavianartery, where it remained for six days post-surgery tosupport the patient’s heart function.Tampa VA heart surgeon Dr. Ernesto Jimenez, M.D. (right) andanesthesiologist Dr. Paulino Nunez, M.D. are using a state-of-theartdevice to help cardiac patients survive surgery. The hospital isone of only a few places nationwide using the Impella 5.0 devicefor left ventricular support after aortic valve surgery.A team of highly trained doctors at the James A.Haley Veterans Hospital are using a state-of-theartheart assist device to help save the lives ofseriously ill cardiac patients. And Haley is one of theonly places in the country where the device is beingused in this procedure.The surgery was a challenge for the surgical team,however, according to the physicians, the procedurewent flawlessly and the patient was dischargedwithout complications.Ultimately, the success of the operation was due tothe high quality, post-operative care provided by theperfusionist, cardiology, and the Surgical IntensiveCare nurses and physicians who all share equally inthe patient’s good outcome.Prior to its recent use at the Tampa VA, the Impella5.0 device had been used for left ventricular supportafter aortic valve surgery in only a few patientsnation-wide.profile: (FORMERLy) HOMELESS VETERAnname: Lamont P. GarnerMilitary Service: U.S. Air Force, 1974-1977This formerly homeless Veteran was addicted todrugs and in and out of prison for 30-plus years.In 2011, he went through the Bay Pines VA HealthcareSystem’s Substance Abuse Treatment program.Today: He still lives in VA-supported housing in the local communityand is going to school to be a Substance Abuse Counselor.“After years of homelessnessand addiction, I woke up oneday and realized I was going todie if I didn’t make a change. That sameday, I borrowed $450, caught the busto the Bay Pines VA Medical Center, andasked for help. The VA not only helpedme beat my addiction, they also gave meskills to help me be successful. Today, I’menrolled in college to be a substance abusecounselor so I can help those who strugglewith addiction like I did. It’s the way I wantto help – like VA helped me.”- Lamont Garner, Veteran18 Annual Report 2012 »www.visn8.va.gov

Caring For Our MostVulnerable VeteransIf it takes a village to raise a child, it takes acommunity to end homelessness. Nowhereis this more evident than in Miami, Fla.,where the number of homeless living on thestreets has dropped from the thousands intothe hundreds in just a few years. In 2012, theMiami VA Healthcare System was selectedto host a National Homeless Outreach Eventthat highlighted the Miami staff ’ s success inidentifying and helping Veterans without homesfind housing, health care and employment.New Rehab/Recovery Centerin Orlando Helps ThoseStruggling with Mental IllnessIn 2012, the Orlando VA Medical Center opened a new PsychosocialRehabilitation and Recovery Center (PRRC), an outpatient transitionallearning center designed to support recovery and communityintegration for Veterans challenged with serious mental illness andsevere functional impairment. Programming is curriculum-based andspecifically designed to teach the requisite skills for realizing Veterans’self-chosen roles and goals in all domains of life. PRRC services arepart of VA ’ s mental health continuum of care and are coordinated withother services in the Orlando VAMC and in the community.helping the homeless & others at risk2,023Patients ReceivingVeterans JusticeOutreach Services(82% increase over FY11)18,636Homeless Veterans Helped(2nd highest in nation)131,677Veterans ProvidedMental Health Services133New StaffHired to support MentalHealth Serviceswww.visn8.va.gov19

integrationVA nuRSE EDuCATORHelps Others Manage Tough SituationsClinical Simulation advances knowledgeand confidence about managing toughsituations—it helps health carepractitioners provide better care andoutcomes for their patients. A nurseeducatorwho is the SimulationCenter Coordinator at the VAMedical Center in Gainesville, Fla.has made major strides in this areaand was recognized nationally forher contributions.Denise Cochran, RN, BSN, receivedthe 2012 VA Under Secretary forHealth’s Excellence in Clinical SimulationTraining, Education and Research Practice.Cochran was recognized with the awardfor her contributions in the field ofclinical simulation to include leadingthe creation of the InterdisciplinarySimulation Education Center (ISEC),a simulation center for medicine,nursing, surgery, anesthesia andrespiratory therapy. She alsodeveloped simulation-basededucation and training to addresspatient safety issues, assists in thedevelopment of simulation-basedcurriculum for training residents, staffand students, and provides simulationinstructor training.putting everyNew PAResidencyProgram inPrimary CareA new Physician Assistant (PA)Residency Pilot Program inPrimary Care at the North Florida/South Georgia Veterans HealthSystem that began in fall 2012is one of only six in the country.The program is a collaborationbetween the NF/SGVHS, theUniversity of Florida Collegeof Medicine and the Universityof Florida School of PhysicianAssistant Studies. The programestablishes two residencypositions which will advancethe mission of UF’s Collegeof Medicine to provide betterpatient-centered medical care.20Annual Report 2012 » www.visn8.va.gov

Veterans Benefit From State-of-the-Art Dental Equipment, TechnologyImagine you need a crown. For most people, thatmeans several trips to the dentist. However, for eligibleVeterans receiving dental services at the Tampa VAHospital, it’s one-stop shopping at the clinic wherepatients can leave their appointments with their finaltooth restoration in place.The dental experts at the Tampa VA areusing the state-of-the-art CERECSystem (CEramic REConstruction)onsite. With CEREC, teeth canbe restored in a single sittingwith the patient, rather than themultiple sittings required with earliertechniques. The dental staff workwith the system’s 3-D imaging captureand computer assisted technologies tofabricate porcelain restorations such ascrowns, veneers, onlays and inlays usingdifferent types of ceramic material.dollar to workNew Telehealth EquipmentExpands Specialty CareAn investment in new Telehealth equipment installedat the West Palm Beach VA Medical Center’sCommunity Based Outpatient Clinics expandsdelivery of health care for several specialties includingpharmacy and pain management, speech therapyconsultations, surgery, wound care and rehabilitationtherapy. In 2012, the West Palm Beach VA providedtelehealth services to nearly 6,800 Veterans—98 percent more than the year prior.Imaging Advances at Daytona Beach Clinic A Phillips Ingenta MRI (Magnetic ResonanceImaging) scanner installed at the Daytona BeachVA Outpatient Clinic in June 2012 helps makethe procedure more pleasant for larger patientsand those who are mildly claustrophobic. An MRImachine uses a magnetic field and radio wavesto create detailed images of the body. With thisnew equipment, more patients have access to MRIservices at the clinic.www.visn8.va.gov21

innovationWorking on aCure for DiabetesDr. Robert V. Farese, M.D., aresearcher at the Tampa VAHospital since 1973, receivedthe 2012 William S. MiddletonAward for outstandingachievement in biomedicalresearch. The MiddletonAward is the BiomedicalLaboratory Research andDevelopment’s highest honorfor scientific achievement. The award recognizesDr. Farese’s service to the VA and to thebiomedical profession as well as his contributionsto the scientific body of knowledge about insulinaction and the pathogenesis of Type 2 diabetes.Among Dr. Farese’s research is a potential curefor Type 2 diabetes that blocks production of aprotein, using compounds found in treatments forrheumatoid arthritis.Million VeteransProjectThe VA healthcare systems of Bay Pines,Miami and North Florida are currentlyparticipating in the Million Veterans Project(MVP) with plans for Orlando, Tampaand VA Caribbean to be involvedas well. The Million Veteransprogram is a national, VA-runvoluntary research programthat partners with Veteransreceiving VA health careto study how genes affecthealth. To do this, MVP willbuild one of the world’slargest medical databases bysafely collecting blood samplesand health information fromone million Veteran volunteers.Data collected from MVP will bestored anonymously for research ondiseases like diabetes and cancer,and military-related illnesses suchas post-traumatic stress disorder.22$33.4MillionResearch FundingAnnual Report 2012 » www.visn8.va.govHonoring a Lifetime of Research Achievement:the Miami VA’s Dr. Andrew SchalleyHe’s a Nobel Prize Winner tacklingcancer, heart disease and otherresearch while devoting fivedecades to serving medicinewith VA. What Dr. Andrew Schallyhas done with those 50 years isnothing short of extraordinary. Thisextraordinary man has publishedmore than 2,400 papers, hostedhundreds of professional lectures,discovered new techniques inmedicine and, to cap it off, received the Nobel Prize inMedicine in 1977.Surrounded by fellow researchers and VA officials fromaround the world, the Miami VA Medical Center hosteda commemoration of Dr. Schally’s 50th anniversary withthe VA on Oct. 19, 2012. And although the celebrationwas a look back at a career of achievement, what mostpeople are talking about isn’t Dr. Schally’s award-winningbreakthroughs. Rather, it was the excitement over what hewill discover next. Just this year, he has published paperson seven different kinds of cancer and heart disease.innovative researchFOCuSES On IMPROVInG VETERAnS HEALTHSignificant areas of research added over the lasttwo years in VISN 8 include aging, ambulatorycare, behavioral science, clinical epidemiology,diabetes, genetics, health economics, neurobiology,neuropsychology, obesity, ophthalmology, PTSD,pulmonary diseases, respiratory, rheumatology, traumaticbrain injury, vascular surgery, virology, and wound repair.The network has three ResearchCenters of Excellence (COE). TheJames A. Haley Veterans Hospital’sCOE is “Maximizing RehabilitationOutcomes.” Also, the Malcolm RandallVA Medical Center has two COEs: theBrain Rehabilitation Research Center andthe Rehabilitation Outcomes Research Center.Additional information on these centers can befound at http://www.research.va.gov/programs/default.cfm#rrd-ctr693Active Research Projects

“The CAREat theWest Palm Beach VAis suPerB.The servicecouldn’t getany better.”Major General Wayne P. Jackson, U.S. Army retiredMilitary Service: 1946-1984, World War II & KoreaGeneral JacksonTampa to Host Veterans Wheelchair GamesWould you like to be involved in an exciting event todraw more than 500 Veterans from across the UnitedStates, Puerto Rico and Great Britain? If so, thousandsof volunteers are needed for the 33rd National VeteransWheelchair Games (NVWG), the largest annualwheelchair sports event in the world. The Games willbe held in Tampa July 13 to 18, 2013. This is only thesecond time the Games have been held in Florida; Miamihosted the event in 1991.During the Games, Veterans participate in 18 competitiverehabilitative sport events which include air guns, archery,basketball, boccia, bowling, field events, handcycling, amotorized wheelchair rally, nineball, power soccer, quadrugby, slalom, softball, swimming, table tennis, track,trapshooting and weightlifting. The event is open to allU.S. military Veterans who use wheelchairs for sportscompetition due to spinal cord injuries, neurologicalconditions, amputations or other mobility impairments. Allevents are free and open to the public.With the theme,“Seize the Day inTampa Bay,” the33rd Games will behosted by the JamesA. Haley Veterans’Hospital along withthe Paralyzed Veteransof America’s Florida GulfCoast Chapter.Volunteers are needed in all areas and can be asyoung as 14 to participate. Anyone interestedin serving as a volunteer during the week of theGames, please visit James A. Haley’s homepage atwww.tampa.va.gov. You can also contact CamillaThompson, Tampa Volunteer Coordinator at (813)972-2000, ext. 6580 for additional information.If you or a Veteran you know may be interested incompeting, go to www.wheelchairgames.va.gov.www.visn8.va.gov23

VA Sunshine Healthcare Network - VISN 8Office of Communication140 Fountain Parkway, Ste 600St. Petersburg, FL 33716Questions/Comments? E-mail us atVISN8OfficeofCommunication@va.govNevin Weaver – Network DirectorMary Kay Hollingsworth – Communication ManagerSusan J. Wentzell – Deputy Communication Managerand Managing Editor, Annual ReportVA Sunshine Healthcare network » www.visn8.va.govat allMedical CentersGeorgiaFloridaMalcom RandallVA Medical Center1601 SW Archer RoadGainesville, FL 32608352-376-1611 * 800-324-8387www.northflorida.va.gov7VA healthcaresystemsLake City VA Medical Center619 South Marion AvenueLake City, FL 32025386-755-3016 * 800-308-8387www.northflorida.va.govOrlando VAMedical Center5201 Raymond StreetOrlando, FL 32803407-629-1599 * 800-922-7251www.orlando.va.gov8Joint Commission-Accredited VAMedical Centers55+Outpatient clinicsPuerto RicoSt ThomasBay PinesVA Medical Center10000 Bay Pines Blvd.Bay Pines, FL 33744727-398-6661 * 888-820-0230www.baypines.va.govSt CroixVISN 8 Network Office140 Fountain ParkwaySt Petersburg, FLJames A. HaleyVeterans’ Hospital13000 Bruce B. Downs Blvd.Tampa, FL 33612813-972-2000 * 888-811-0107www.tampa.va.govLakeOkeechobeeWest Palm BeachVA Medical Center7305 North Military TrailWest Palm Beach, FL 33410561-442-8262 * 800-972-8262www.westpalmbeach.va.govBruce W. CarterVA Medical Center1201 NW 16th StreetMiami, FL 33215305-575-7000 * 888-276-1785www.miami.va.govVA Caribbean Healthcare System10 Casia StreetSan Juan, Puerto Rico 00921787-641-7582 * 800-449-8729www.caribbean.va.gov2012-623-026/60007