CINCINNATI — Cincinnati VA Medical Center's executive medical center director Jane Johnson said she's focused on changing the culture within the organization. An Air Force veteran, she served as a nursing leader on inpatient psychiatric and alcohol treatment units, according to the news release sent out by the Cincinnati VA Medical Center Public Affairs Office.
“We know there are many things we need to do better. So, we have this culture, and we live this daily,” Johnson said. “How do we create a culture of getting better each day? That's important to me, personally. I don't want to be the same as I was yesterday. I want to keep getting better.”
She earned a Master's degree in gerontological mental health from the University of Cincinnati and received her Associate's and Bachelor's in nursing from Northern Kentucky University.
Even though the leadership of the VA has changed five times in the past six years, Johnson said the professional staff who remained in their roles during that time kept the mission on track.
“So, it didn't matter who was here," she said. "It matters that we have a great team out there. We were a five star regardless of who was sitting in this chair. Hopefully, I can continue to move our culture forward. And so that's why I am excited to be here, personally.”
Johnson took over as interim director in February 2020 at the start of the pandemic.
“We opened a 22-bed telemetry unit in our cafeteria. We had two COVID units going at any one time. We had to hire rapidly, so we hired a lot of new nursing staff, respiratory therapists, lab techs in order to get the job done,” Johnson said.
They closely monitored the daily numbers and rates of infection in New York and other larger cities to gauge how those infection rates may impact local veterans who come to the CVAMC for treatment, she said.
“Instead of a surge where we were overwhelmed, we had a steady high rate of veterans,” Johnson said. “We had 19 veteran deaths due to COVID and one employee death due to COVID.”
The pandemic has forever changed how they do health care – she said their virtual care via telehealth and virtual appointments grew dramatically.
“COVID taught us that we could do health care better," Johnson said. "So that's one, virtual, the others really taking more advantage of outpatient clinics, Bellevue, Florence, Dearborn.”
In the middle of the pandemic and her role as interim director, the Department of Veterans Affairs Office of Inspector General held a virtual inspection of the Cincinnati VA's procedures and policy.
There were a variety of topics covered, but the majority of issues came down to clerical errors, and Johnson said patient care was never compromised.
“We were doing the right thing,” she said. “The report says that basically you didn't call it the right thing, and that is correct. So they're accurate. That's an accurate picture. It's just you got to keep it in the context."
Clerical errors aside, there were concerns brought to light in the inspection report tied to pain management and opioid therapy.
In a very small sample of just 9 patient records pulled, one third of those patients' files were missing informed consent documentation prior to initiating long-term opioid therapy. The discovery suggested those patients may not have been told of the dangers of being on an opioid and the long-term effects that could cause.
“There's a saying in healthcare, if you didn't document it, it didn't happen," Johnson said. "But I would say to you that our teams really work hard around opioids, really, their prescribing practices, how they're prescribed when they're prescribed. The veterans are well-informed of the addictive properties.”
She said through retraining and renewed emphasis on the use of their pain clinic for any veteran on a long-term opioid treatment plan, the safety of patients is greatly improved.
The VAOIG inspectors also didn’t agree with the expedited hiring of a practitioner. The report said, "inspectors did not find an urgent need for the practitioner to be appointed in this manner and circumvent the standard credentialing process."
Johnson said the inspectors report regarding this issue is an opinion, and that employees are being properly vetted within the guidelines laid out by the Department of Veterans Affairs.
“At given times, we may need to bring a practitioner on urgently. We still do the basic things, we still make sure their credentials are in place," she said. "We still check with the national practitioner data bank; we still do the minimum to get them on and to ensure our safety and veteran safety. And then we go back and still do the other pieces as well."
Looking forward, Johnson said, she has an open-door policy and encourages both employees and veterans to come to her with concerns.
“When I see negative information out there, it worries me. Not for me. It worries me that it might scare a veteran from coming here,” Johnson said. “I work so hard every single day to make sure I can gain veterans' trust. And it went from really low numbers... you remember during the access crisis, to now we're in the 92 to 93 percentiles of trust. So, veterans trust us again. That's important to me.”
You can read the Inspector General's full inspection report HERE.