New hires to address problems at VA Medical Center

Gigliotti replaced Bruce Triplett, who retired days after an Observer report detailed employee complaints. The complaints concerned a hostile work environment and veterans' growing frustration over rude caregivers who sometimes ignored their patients. The search for a full-time director is ongoing, with the top candidates selected for interviews. Eric Shinseki, U.S. Secretary of Veterans Affairs, is in charge of appointing a new director.

Since he took the reins, Gigliotti said, veterans have identified three main issues: limited parking, a nightmarish telephone system and a perceived rudeness by hospital employees.

And employees had one major suggestion: hold employees accountable to equal standards.

Gigliotti instituted a zero-tolerance policy for rudeness, and asked veterans to report rude staff members by name.

Reports of rudeness resulted in write-ups for employees, and in some repeat instances, termination.

Complaints about rudeness have dropped, Gigliotti said.

Of the 150 positions the VA is hiring, about 50 are nurses. The rest will be people to answer phones and schedule appointments. The hiring began about two weeks ago and should take about two months to be complete, Gigliotti said.

The VA's phone system isn't properly equipped to handle its volume of calls, and it didn't have enough people to answer them. That not only frustrated patients who had trouble calling in to schedule an appointment or ask about a prescription. Patients who were already at the hospital would grow frustrated waiting for doctors or nurses who were busy with scheduling appointments or answering phone calls.

"It was just an inefficient system," Gigliotti said. "If we didn't address it, we would not improve our perception of service to our veterans."

To help alleviate parking complaints, employees were asked to park farther away from the building. But the 300 spaces for patients just aren't enough to handle everyone.

Two 10,000 square-foot primary care clinics - at yet-to-be-announced buildings leased in Fayetteville - will reduce the demand for parking. One should open in three or four months, the other in about a year, Gigliotti said.

The accountability that employees asked for is a tougher issue to measure because it comes from consistent day-to-day decisions, he said.

A survey of 97 employees the VA conducted in December identified "a perception of favoritism, ... tensions related to diversity and inclusion, ... tensions between labor and management. ... and limited positive feedback."

Improving relations among employees will take time because it involves building trust, Gigliotti said.

"There's still room for improvement here, but it's definitely a willing workforce," he said.

Turnover since Gigliotti became director has been about 7 percent, or roughly 60 of the hospital's 900 workers.

Gigliotti said the hospital's quality scores that gauge technical proficiency of the caregivers remain high. That was never the issue, he said.

"We need to be more consistent in the customer service component of the healthcare experience for our veterans," he said.

Discord at the Fayetteville VA isn't new. Four directors have left the hospital since 1996 amid problems.

Don Talbot, a retired Army veteran and a veterans advocate, has spent several months speaking with employees and patients about problems at the Ramsey Street hospital.

He said he has faith in the interim director and applauds the work Gigliotti did to identify in writing the problems that exist.

But as an interim director, there's only so much he can do, Talbot said.

The real challenge will lie with the new full-time director, who will need to face long-standing problems and make long-term improvements.

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