Veteran Care in Texas to Improve from VA Hospital Policy Change

A recent change to the Veterans Administration policy may significantly improve the quality of care that is available at VA hospitals in Texas, and elsewhere in the United States.

In December 2016, the VA announced that it had expanded the services that advanced practice registered nurses (APRNs) may provide at VA hospitals. The change permits APRNs at VA hospitals in Texas and throughout the rest of the nation to provide all services that they are trained and qualified to provide, even if such service is currently limited by state law.

“Amending this regulation increases our capacity to provide timely, efficient, effective, and safe primary care, aids VA in making the most efficient use of APRN staff capabilities, and provides a degree of much needed experience to alleviate the current access challenges that are affecting VA,” VA Under Secretary for Health Dr. David J. Shulkin said in the Dec. 14, 2016, news release that announced the VA policy change.

The Dec. 14 release noted that advanced practice registered nurses all have advanced degrees and training, including master’s degrees, post-masters training, or doctoral degrees. Within the VA system, APRNs fill the following four positions:

  • Certified Nurse Practitioner
  • Clinical Nurse Specialist
  • Certified Registered Nurse Anesthetist
  • Certified Nurse Midwife

In the May 2, 2016, release that announced that the VA was considering granting expanded authority to advanced practice registered nurses, the president of the American Nurses Association praised the potential move as a positive step both for the nurses and for the veterans that they serve.

“This proposal removes barriers that prevent APRNs from providing a full range of services and will assist VA in its ongoing efforts to address staff shortages and improve Veterans’ access to care.” ANA President Pamela Cipriano said.  “APRNs are critical members of the health care workforce and an integral component of the health care delivery system with a proven track record of safe quality care and high patient satisfaction.”

Help for Veterans in Texas

Improvements to VA hospitals will definitely impact Texas, which is home to more veterans than any other U.S. state except California.

According to information from the National Center for Veterans Analysis and Statistics (NCVAS), about 1,650,000 veterans lived in Texas in 2016, including about 50,000 who reside in Bell County. Unfortunately, a Dec. 7, 2016 USA Todayarticle reported that Texas is also home to some of the lowest-performing VA hospitals.

The article, which was based on internal VA rankings that had previously not been disclosed to the public, noted that during the fourth quarter of 2015, four VA hospitals in Texas had been assigned one-star ratings, the lowest score in the VA’s five-star system. Two of those VA hospitals had improved to two-star ratings by the middle of 2016, but the other two remained at one-star status.

Four other VA healthcare providers in Texas received fewer than five stars in 2015, including the Central Texas Veterans Health Care System, a system that includes the Olin R. Teague Veterans’ Medical Center in Bell County. The Central Texas system received two stars at the end of 2015, and remained at the two-star level in the middle of 2016.

The VA’s star system for facilities in Bell County and throughout the United States is based upon a variety of factors, including wait times to receive services, infection rates among patients, and death rates.

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