MONTGOMERY, AL (WSFA) - From appointment wait times to provider shortages and trust issues, the woman at the helm of all the Veterans Affairs healthcare facilities throughout Central Alabama is addressing the changes being made throughout the system.
Dr. Linda Boyle granted her first exclusive sit-down interview for an in-depth look at the Central Alabama Veterans Health Care System (CAVHCS).
Boyle spent 20 years in Alaska before moving to the Deep South. She served as the Associate Director for Patient Care Services at the Alaska VA Healthcare System (CAVHCS) and later was appointed interim director. She believes it was God's calling for her to come to Central Alabama.
"I love it down here. I love the people here and I love my job and I love the mission that I have. I think probably the reason I love it so much is because I'm a veteran, my husband is a veteran and to get the opportunity to lead an organization to take care of our veterans is just fantastic," she said.
Before her VA service, Boyle was the Medical Group Commander at the Patrick Air Force Base in Florida. A retired colonel of the United States Air Force, Boyle served on active duty for approximately 24 years as well as five years with the Air National Guard of Pennsylvania. She held a variety of healthcare leadership positions in her military career, including Clinical Specialist and Medical Support Squadron Commander.
As director of CAVHCS, Boyle oversees division campuses in Montgomery and Tuskegee and clinics in Dothan, Montgomery, Monroeville, and the Wiregrass in Alabama as well as Columbus and Ft. Benning in Georgia. The facilities provide healthcare to more than 48,000 veterans with a workforce of over 1,600 employees. CAVHCS is a 330-bed facility with an operating budget of approximately $280 million.
Boyle says she sees challenges at CAVHCS to be opportunities for improvement.
"I find that the majority of my staff are wonderful people. They're hard working. I see processes that perhaps don't work as well as they should. We have long discussions on rules versus principles and doing things by principle, versus looking always at what the rule book says. Not that I'm breaking laws, but I think it's an opportunity to look at things differently," she explained.
For her, communication with staff members and veterans is key. She's held several town halls and intends to host more in the future. She's reached out to Veterans Service Organizations and visited with lawmakers.
She feels that having permanent leadership in place will allow improvements to continue. Interim directors have been in place since 2014 when then-director James Talton was fired. At the time, his termination was the first the VA made under a law that helps speed up the process of demoting or removing top VA executives for poor performance or misconduct.
"When you keep changing out leadership, it's very hard for people to know how to follow or what they should be doing. The other thing that I bring with me is that whole idea of servant leadership because I truly believe the leader is on the bottom and the staff and the veterans are on the top," Boyle stated.
CAVHCS had some of the longest appointment wait times in the country and was part of a national scandal employees were caught putting veteran's names on paper wait lists so that the computer system wouldn't show how long they were really waiting for care.
In 2014, the system has an average appointment wait time for new patients of 75 days. That was the seventh-worst nationally. The average wait time for first-time mental health patients was sixth-worst at 57 days.
In 2017, the latest data shows that the average wait time across CAVHCS for primary care new patients is 30 days, first time mental health patients is 15 days and specialty care new patients is 15 days - wait times cut by 60-75 percent over three years.
Ninety percent of CAVHCS appointments are scheduled in 30 days or under.
"My wait times are not where I want them to be," Boyle said. "They have gone down somewhat but then they went back up again when we were looking at the loss of providers. The one thing I feel good about is that I believe the wait times are accurate. And that had been a difference in the past when there had been some issues with scheduling. My wait times are accurate."
Boyle says same-day services are now being offered at all CAVHCS facilities and a new out-patient clinic on Chantilly Parkway is helping get veterans care faster.
The VA's provider shortage has impacted the clinic but Boyle announced that a new doctor has been hired, as well as two nurse practitioners. Another physician, a fourth doctor for the clinic, is coming on board in August.
"We still have other positions that we need to fill and we continue to recruit for those," she added.
Boyle thinks her idea of "whole health" will also help move CAVHCS forward.
"What's important about that it's not what is the matter with me, it's what matters to me. If your provider doesn't take the time to find out what matters to you, that we, as healthcare providers, can't assist you with whatever's wrong with you," she explained.
She wants CAVHCS to be the best of the best and believes the system is a five-star program in the making.
"I believe everybody on staff is going to help to make that happen and our veterans are going to be excited to be here, to actually choose VA for their care when they have other opportunities available to them," Boyle added.
She's been working to build trust with the staff through monthly communication updates she sends out. Employees write back to her with comments. She also did an all-employee survey. She made it mandatory that all supervisors talk about the survey results with their staff.
"If an employee takes the time to fill out a survey, then someone should take the time to read it and see what changes need to be made to make a difference. I believe that if your employees are engaged, veterans will be happier when they come to be cared for here," Boyle said.
She believes there's less fear in the organization now from when she took over.
"There still is some fear with staff. I have pushed for accountability. I've looked at ways to hold people accountable. I've pushed for ownership. We're also looking at re-education of staff on every level," she added.
There's not been staffing changes yet at CAVHCS, Boyle revealed. The associate director has been turned into a deputy director role. The deputy director stays in Tuskegee and Dr. Boyle stays in Montgomery to provide leadership at both campuses. Boyle has looked at several administrative boards, but has not received the results yet.
When asked what needs to happen to continue to move CAVHCS forward, Boyle stressed that it's simple things the staff can do.
"One issue that veterans have brought up to me is just that we don't seem to smile enough. I sent out a couple messages to staff about smiling. I got several responses back from people saying they're on board and to count them in," she said.
She reviews each note left for her and meets with veterans who come to her office, believing in an open-door policy and ongoing dialogue.
"I recognize that trust is something that one has to win back. I very much so want veterans trust us again if they don't currently and I want to maintain that trust if they do," she said. "It's all about relationships."
The Tuskegee and Montgomery campuses just won an Emerald Award for leading the health care industry in sustainability and environmental stewardship. These two awards were among only 32 Emerald Awards given to VA hospitals nationwide this year.
CAVHCS has also launched several initiatives to help homeless veterans. An initiative that's a collaborative effort between CAVHCS, Family Endeavors and other River Region agencies and entities started last year to provide assistance to homeless veterans that are seeking permanent housing or at risk of becoming homeless.
A housing fair last year help more than 10 veterans get housing the same day of the event. A bell was rung and every time a veteran signed his leased and received his keys.
Bikes for homeless veterans and those looking for jobs were recently donated to a number of local shelters.
Boyle also discussed a renovation of the emergency room at the Montgomery VA hospital on Perry Hill Road that nearing completion.
It will include brand new monitoring system and overhauled rooms.
It increases the size from 3000 sq. ft. to 9000 sq. ft. and will add 25 beds, which includes beds for Mental Health and Women's Health. The renovation is currently scheduled to be completed in August.
"I think CAVHCS is on the move. I believe we're on the move," Boyle said.