The fate of Fort Waynes VA Medical Center always seems in flux.
In the past 10 years, the Department of Veterans Affairs has wavered between eliminating hospital beds at the complex to replacing and expanding the center to keeping the center but building a smaller outpatient clinic and then to putting the clinic in an existing building.
So when VA announced in October that it was suspending inpatient care for an undetermined period – what it called a pause – area military veterans and their advocates wondered what was coming next.
It turned out to be Denise Deitzen.
The new director of VA Northern Indiana Health Care System arrived in town this month to face a hail of questions from veterans, congressmen and media.
Two days after she started, the American Legion conducted a public meeting in New Haven where veterans voiced frustration over a lack of information from the medical center. The next two days, Legion officials visited the center at Lake Avenue and Randallia Drive and spoke with its staff, including Deitzen.
I told the American Legion: I dont see this facility closing. I think we have a vibrant future, Deitzen said last week. We have more inpatients coming in the door this year than we had last year. I see us continuing to grow and evolve and really become a center of excellence. Thats my goal.
Deitzen is the third permanent director of the regional health care system since late 2005. The system consists of medical centers in Fort Wayne and Marion and community-based outpatient clinics in Muncie, Goshen, South Bend and Peru. About 40,000 veterans in northern Indiana and northwest Ohio are treated at the various facilities.
The regional health care system now under Deitzens direction employs 856 people at the Marion campus and 610 people at the Fort Wayne complex. Marion has 150 nursing home beds and 75 acute care beds for mental health patients, compared with Fort Waynes 26 inpatient beds.
Deitzen described the centers as separate but equal, but acknowledged a rivalry of sorts between them.
They both feel that the other one has more of the resources, she said of a merger that began in 1995. These feelings arent new. Im hopeful that I can bring some transparency to the organization.
Deitzen, 49, earned bachelors and masters degrees in nursing and has worked 18 years for VA in Michigan, most recently as director of the Saginaw medical center.
Her challenge is to bring stability to the Fort Wayne operation and improve communications and relations among its workers, their patients and the community at large. She will be paid $173,600 a year.
Ralph Bozella, chairman of the National Veterans Affairs and Rehabilitation Commissions for the American Legion, the nations biggest veterans group, offered his first impressions after meeting Deitzen.
She cares deeply for this, said Bozella, who lives in Longmont, Colo. She wants this to succeed. And I think thats been a problem. The last few directors never came in with that attitude. Not that I know personally, but weve learned that through our interviews with staff.
Col. David Augustine, commander of the Air National Guards 122nd Fighter Wing in Fort Wayne, knew Deitzen when both worked in Battle Creek, Mich., a few years ago.
She will put her heart into that VA center as the new director, and shell make things happen, Augustine said. Theres no stopping the energy. Shell make sure that whatever issues she finds, shell fix them.
Deitzen notes that she sought the job.
I worked hard to get here. I am delighted to be here, she said. I have met lots of staff. And I think we have a great staff here. I think we have a lot of work to do, with good opportunities ahead of us, and Im ready to get to work.
Ralph Anderson Sr., president of Local 1384 of the American Federation of Government Employees, which represents workers at the medical center, had little to say about Deitzen.
Its still early. She hasnt been here long enough (to form an opinion), Anderson said.
‘A look at ourselves’
Deitzens first task is resuming inpatient care on the fourth floor of the medical center. The plan is for all 26 beds to become available in the first quarter of 2013. Inpatient chemotherapy infusions, the first stage of a three-phase reopening process, have already begun.
Staffing shortages were a factor in halting services, but not the main reason, Deitzen said.
We did this internal review, a look at ourselves. We didnt see the processes and the controls in place that we wanted to make sure we provided that best, safest care, she said. And so the decision was to make that pause so we could rebuild, so to speak, from the ground up, so we could do all of the training and get all of the processes and policies in place and have everyone focused 100 percent on that.
The American Legions Bozella was more direct in his assessment.
Culture change is the key term they are using, he said. They need to change the culture; they know that.
They are trying to build a solid infrastructure and a trusting process – trusting in that the staff will be able to work freely in an environment where key leadership staff will respect front-line staff, respect their ideas, work closely on communicating quality-of-care issues, ensuring that performance measures are met, and if they are not, there is proper communication in terms of what the problems are, he said.
Union leader Anderson cited a lack of leadership among staff chiefs who report to Deitzen.
The concern isnt the director; its whats underneath, Anderson said. Those are the people who have the most impact.
Bozella, the point man on Army infantry patrols in South Vietnam in 1971-72, said staff members reported conflict between front-line care providers and their supervisors. He believes Deitzens nursing background serves her well as a hospital administrator.
You have to have people that understand the systems that make the hospital work, that understand the processes. I think that she has a good handle on that, he said. And because she does have a medical background, I think she has a better handle on it.
Bozella is head of the American Legions System Worth Saving Task Force. The group is visiting 15 VA medical centers and plans to report to Congress on care for female veterans. The Fort Wayne med center will be the subject of a separate report.
One of our recommendations will be that they work closer with their veterans service organizations to communicate issues that involve the hospital, Bozella said.
He said a briefing Deitzen conducted Dec. 3 – her first day on the job – with county veterans officers and congressional staffers was a good start. But she should have invited representatives from the American Legion, Veterans of Foreign Wars, Disabled American Veterans and other veterans advocacy groups, he said.
In Saginaw, Deitzen did have regular meetings for staff and veterans, as well as public forums in nine cities with community-based clinics. She hopes for similar outreach programs in northern Indiana.
I do want to be where our veterans are, she said. That voice of the customer – the voice of the veteran – is whats going to help us improve.
Also in Michigan, Deitzen oversaw the formation of veterans councils that offered input on health care. Sheryl Grubb, public affairs officer for the northern Indiana system, said such a council will be started here.
Deitzen attended a recent meeting of the Fort Wayne Base Community Council, a support group for military families connected to the citys Air and Army National Guard bases. And she said she had meetings set with Mayor Tom Henry and the leader of a local hospital network.
My goal is to very much be a part of the community. I think the VA hospital is very much a part of the community that it is in, she said.
First things first
The Aleda E. Lutz VA Medical Center in Saginaw is named after a hometown girl who became an Army flight nurse for nearly 200 medical evacuations during World War II. She died in a 1944 plane crash in France and later became the first woman awarded the Distinguished Flying Cross, the nations second-highest military honor.
Deitzen joined the Saginaw center in 1986 as a nurse. After a couple of years, she left for private-sector work, later returned to VA, and went back to the Lutz center in December 2009 as its director.
The centers website includes a page for accreditations and achievements. The page lists several awards the center has received in recent years.
I had the least amount of work in those. Its all about the staff doing that, she said.
A similar webpage for the VA Northern Indiana Health Care System lists no awards.
Earning recognition for performance is part of building your team, setting those goals, really getting everybody aligned around those goals and giving them the support to make that happen, Deitzen said.
First things first. Theres an inpatient ward to reopen in Fort Wayne.
Patients in the door. That is No. 1 for me, Deitzen said. We want to get patients back in the door and back to full business.