VA Official: Staff Cuts Not Needed to Fix EHR-Related Budget Deficit

Hiring at the Mann-Grandstaff VA Medical Center will be subject to “considerable scrutiny" to address the EHR-related budget deficit, according to VA's Northwest regional director.

In a June 1st message to Mann-Grandstaff VA Medical Center staff, Teresa Boyd, VA’s Northwest regional director, said that the hospital wouldn’t need to cut its workforce to address an EHR-related budget deficit, according to reporting from The Spokesman-Review.

Robert Fischer, director of Mann-Grandstaff, shared Boyd’s message with hospital staff after the regional director met with hospital leaders on May 30th.

“We talked about how Mann-Grandstaff, not unlike any other healthcare system, must critically assess how to provide the best care to Veterans,” Boyd wrote. “I thanked your leadership team for their continuing collaboration and input into the ongoing improvement efforts during the Cerner ‘reset’ period.”

Announced in April, the EHRM reset period aims to help VA focus resources on system optimization at sites where the Oracle Cerner platform is being used before continuing further EHR implementations.

Boyd’s visit to Mann-Grandstaff preceded Fischer telling hospital supervisors in a May 9th email that the regional office had asked the hospital to reduce its workforce by removing some vacant positions instead of filling them to shrink a budget deficit that was drawing funds from other VA hospitals in the region.

Boyd wrote that her message aimed “to clearly address some discrepancies in hiring information that were recently circulated.”

The mandate to reduce the workforce in Spokane by the equivalent of 146 full-time positions, Fischer said in his email, was made despite the ongoing impact of the new EHR system, which has led to patient harm and limited the number of patients each clinician can see.

VA leaders authorized Mann-Grandstaff to hire additional staff in 2018 and 2021 to make up for lost productivity. However, the hospital’s director wrote on May 9th that the department had not allocated enough funds to pay those workers without hurting other hospitals in the region.

In her message, Boyd did not contradict Fischer’s email. Instead, Fischer said that hiring would be under “considerable scrutiny,” including evaluation by a task force charged with addressing the budget deficit.

She also noted that VA would eliminate vacant positions the task force did not agree to fill.

Boyd noted that Mann-Grandstaff had hired 122 employees during the fiscal year that began in October 2022, adding that hiring “faster and more competitively” is a priority for the agency.

“I ask that each member of the Mann-Grandstaff team remain committed to this priority and to providing our Veterans safe, high-quality care,” she wrote.

In response to follow-up questions from The Spokesman-Review, VA spokesman John Santos said, “Mann-Grandstaff has not been asked to reduce its staffing levels but instead to build a strategic plan for staffing and services that best meets the needs of Veterans in their market.”

“This plan is necessary to ensure that the medical center is best positioned to have the staffing and resources it needs to provide outstanding care to Veterans now and in the future,” he said in an email. “There was not and currently is not a prohibition on filling vacancies.”

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