Anthony Principi says it's time to stop the problems at the beleaguered veterans hospital. He suggests a change in leadership might help.
By PAUL DE LA GARZA
Published February 26, 2004
Principi
ST. PETERSBURG - Veterans Affairs Secretary Anthony Principi said Wednesday he might order a management shakeup at Bay Pines VA Medical Center to resolve leadership problems.
The hospital is the target of five inquiries focusing on allegations of mismanagement and problems with a new $450-million computer system.
Principi said it is time to put an end to the infighting at Bay Pines.
"We have got to get on and work together and care for patients and stop fighting," Principi said in an interview with the St. Petersburg Times.
A heated argument between two senior hospital officials Wednesday afternoon illustrated his point.
Hospital director Smith Jenkins and spokesman Larry Christman clashed over patient data Jenkins provided to Gordon Mansfield, the deputy VA secretary, during a briefing Monday at Bay Pines.
"We were trying to make sure you had the right information," Jenkins said, when asked by a Times reporter what had happened between him and Christman. "We had a disagreement over some of the information."
After the argument, Christman checked himself into the emergency room at Bay Pines with stroke symptoms. He was not available for comment but his wife said he appeared to be doing well.
In the interview Wednesday, Principi:
Accepted responsibility for installing at Bay Pines a pilot computer system that has resulted in hundreds of surgery delays.
Talked of possibly boosting staffing levels at the hospital to improve the quality of care.
Urged Congress to support legislation to increase the salary of VA doctors to make VA positions more competitive.
Encouraged hospital staff to take their complaints to the VA inspector general, without fear of reprisal from management.
"My approach to this is, "If a problem is identified, let's fix it,' " Principi said. "I don't subscribe to the theory that, "Let's circle the wagons.' "
Investigators are reviewing allegations that poor leadership is endangering veterans' health. They also are looking into problems with the computer system, introduced to Bay Pines on Oct. 6.
Doctors say a shortage of radiologists, which they blame on mismanagement, endangers patients because CT scans, MRIs and X-rays often go weeks and even months without being read.
The exams detect a range of complications, from pneumonia to brain aneurisms to cancer.
To deal with emergency radiology cases after hours, the hospital uses a taxi service to deliver film to radiologists under contract to Bay Pines.
Doctors, including lung specialist Samuel Carranza, have complained a pattern of harassment on the part of chief of staff Dr. Pramod K. Mohanty and Susan Angell, the hospital's associate director, have driven doctors away.
Mohanty and Angell repeatedly have declined to talk to the Times.
In an anonymous letter to Jenkins in October, doctors complained about Mohanty.
Dr. Elwood J. Headley, director of the VA hospital network in Florida, southern Georgia, Puerto Rico and the U.S. Virgin Islands, ordered an internal review of the allegations.
The investigation has been completed, but its findings have not been released. Doctors have questioned the thoroughness of the review because of its speed.
Principi acknowledged management problems at Bay Pines. Before he decides whether to retool the management ranks, he said, he would await the results of the inspector general investigation.
"I don't want to point fingers," the secretary said, "but there are definitely management issues that have to be corrected."
Principi also addressed the problems with the Core Financial and Logistics System, or CoreFLS, the software program developed to track and control finances, vendor payouts and supply inventories.
Hospital administrators say it has inherent flaws.
In an interview last week, Headley said the biggest problem is getting the three major components of the system to talk to each other.
Because of problems with the computer system, surgeries repeatedly have been delayed for a lack of surgical supplies.
Those delays were at the center of the argument between Jenkins and Christman.
The chiefs of the departments of urology and orthopedics said the number of patients waiting for surgery is in the hundreds.
But a fact sheet distributed to reporters during the visit by Mansfield, the deputy VA secretary, said the waiting time for patients in urology and orthopedics was zero.
In an interview, Jenkins said the data provided to Mansfield had nothing to do with a surgery backlog, but with the number of patients waiting to see a doctor at Bay Pines.
"There is no waiting list," Jenkins said.
Principi said he was not entirely convinced CoreFLS was the problem. He wondered whether personnel and management issues were affecting its effectiveness.
"Obviously, CoreFLS is exacerbating the problem," he said. "I'm not sure CoreFLS is the problem. That's what I want to find out."
Principi said he was prepared to pull the plug on CoreFLS if the problems cannot be fixed, but noted it would be "several months" before he decides.
Although CoreFLS came to Bay Pines in October, Principi said that with the holidays, hospital staff have not had enough time to see if it works.
In a visit to Bay Pines last Wednesday, Sen. Bill Nelson, the Florida Democrat who serves on the Senate Armed Services Committee, said somebody should be held accountable for testingCoreFLS at Bay Pines without a backup system. Bay Pines is the second-busiest VA hospital in the country.
On Wednesday, Principi responded.
"If Sen. Nelson wants to hold somebody accountable for bringing (CoreFLS) to Bay Pines, I am accountable," Principi said. "I support my people."
Nelson lauded the secretary, but he was not satisfied.
He pointed to the inspector general investigation.
"Let's see who they say is responsible for all of the bad things that have been going on at Bay Pines," the senator said, "and then I want to see the secretary of Veterans Affairs hold those people responsible accountable."
