New National CemeteryNew National CemeteryNew National CemeteryNew National CemeteryNew National CemeteryVA's 118th national cemetery opensin Texas — page 4

VAnguard

Inside: Consensus Congress, 6 ✩ Disaster Response, 10 ✩ VA/NASA Agreement, 14

U.S. DEPARTMENT OF VETERANS AFFAIRS

JUNE/JULY 2000

2 VAnguard

INTRODUCINGPaul Beadle

CCCCCONTENTSONTENTSONTENTSONTENTSONTENTS

CCCCCOLUMNSOLUMNSOLUMNSOLUMNSOLUMNS 17-20

VAnguardVA’s Employee Magazine

June/July 2000Vol. XLVI, No. 6

Printed on 50% recycled paper

Editor: Lisa RespessEditorial Assistant: Matt Bristol

Published by theOffice of Public Affairs (80D)

Department of Veterans Affairs810 Vermont Ave., N.W.Washington, D.C. 20420

(202) 273-5746E-mail: vanguard@mail.va.govwww.va.gov/pubaff/vanguard/

index.htm

❏ New Cemetery 4VA’s 118th national cemetery opens

❏ Nursing Awards 5Secretary honors five for excellence

❏ Consensus Congress 6Conference focuses on future of VHA

❏ USA Today Award 8Bar-code medication project honored

❏ Disaster Response 10-11VA participates in simulated exercise

❏ World Travelers 12Military service coordinators on the road

❏ VA/NASA Agreement 14Patient safety reporting system planned

On the cover: More than 2,500 peopleattended the dedication cer-emony for the Dallas-Fort WorthNational Cemetery in May. Thecemetery is VA’s 118th, and thesixth in Texas. It will providemore than 280,000 burial spacesfor area veterans and dependents.The 638-acre cemetery is one offive VA has opened over the pastthree years.

Paul Beadle, a counseling psy-chologist with the Vocational Reha-bilitation and Employment (VR&E)service at the Des Moines, Iowa, VARegional Office, was named Counse-lor of the Year for 2000 by theNational Rehabilitation CounselingAssociation. It’s the association’shighest honor and Beadle is the firstVA employee to receive the award.“I was very surprised, but also veryhappy someone from VA wasrecognized,” he said. “I truly believewe have a world-class organizationthat just isn’t recognized as muchas it should be.”

A Vietnamveteran, Beadlespent 17 yearswith the IowaDepartment ofVocational Reha-bilitation prior tojoining VA in 1987.Since then, he’sbeen involved in anumber of pro-grams that areimproving the livesof veterans with bothphysical and psychological wounds.One of those is called the Self Em-ployment Project.

It’s designed to help veteranswho are unable to obtain employ-ment due to the seriousness of theirservice-connected disabilities.Beadle teaches veterans in theprogram job-seeking skills such asresume and interview preparation,salary negotiation, and workplaceconduct. And if the job search comesup empty, and the veteran is eligible,Beadle can help him or her start theirown business. So far, he’s beeninvolved in the development of morethan 40 disabled veteran-ownedbusinesses.

If veterans are struggling withalcohol or substance abuse, Beadlehelps them kick their dependenciesbefore trying to find work. “We hadguys with 100 percent disabilityratings who were doing some realself-destructive behaviors,” he

recalled. “We had to figure out howto provide some structure in theirlives … to help them get throughcomplex medical problems and tohelp them communicate with theirfamilies.”

Both the veterans he serves andhis colleagues in the Des MoinesVARO recognize his commitment tohelping disabled veterans. “I getmore good comments from veteransabout Paul,” said Jack Hackett,director of the Des Moines VR&Eprogram. “He really connects with

the veterans heserves and he nevergives up on them.”So what’s hissecret? “The greatestquality we canhave as counselorsis that of beinglisteners,” he said.“That’s whatcatches theveterans’ atten-tion and is oftenthe first timesomeone has

listened to what they have to say.”Beadle listens, and then he helpsveterans turn their dreams intoachievable goals.

It’s not the first time he has beenrecognized for his work with veter-ans. The Small Business Associationnamed him the Iowa Veterans SmallBusiness Advocate of the Year in1995, and his knowledge of establish-ing a small business led the NationalRehabilitation Association to appointhim a Switzer Scholar in that sameyear. The honor is named after MarySwitzer, a pioneer in the earlyrehabilitation movement.

“We are extremely proud ofPaul,” said Julius M. Williams,director of VR&E in Central Office.“He represents the level of servicethat we are striving for nationwide inthe Vocational Rehabilitation andEmployment Service.” ❏

By Matt Bristol

June/July 2000 3

OutlookEileen T. Powell,coreFLS Project Director

Finance andlogistics activi-ties touchemployeesthroughout theDepartment.Many of us aredirectly in-volved inprocurement,inventory andfinance func-

tions. Many travel. Others needinformation to make decisions or torespond to Office of Managementand Budget (OMB) and Congres-sional questions.

VA’s Financial ManagementSystem (FMS) and the many “stove-pipe” legacy systems currentlyinterfacing with it (e.g., the Inte-grated Funds Distri-bution Control PointActivity Accountingand Procurement[IFCAP] system), areold technology—expensive to main-tain, difficult tomodify, and difficultto reconcile with one another.

The time is right for VA to moveto a fully integrated financial andlogistics system that can provideeasily accessible, consistent, timelyresponses to the many informationneeds throughout the Department.We can now procure Web-basedapplications linking people, pro-cesses, facilities and technology.

OMB has endorsed a replacementproject and VA’s Capital InvestmentBoard (CIB) has voted to fund anIntegrated Financial/LogisticsManagement Standards (IFMS)project. To more clearly describe theproject’s scope, IFMS has beenrenamed the “core Financial andLogistics System” (coreFLS).

coreFLS will replace VA’s exist-ing core financial management andlogistics systems and many of the oldsystems interfacing with them withan integrated, commercial-off-the-

coreFLS Will AffectMany VA Employeesshelf (COTS) package. ThroughcoreFLS, VA will be able to usetechnology now available in themarketplace to make our finance andprocurement jobs easier and moreproductive.

We will also re-engineer VAprocesses to adapt to the best prac-tices identified by our eleven busi-ness process re-engineering work-shops and those inherent in theCOTS package we select. Nationwideimplementation of coreFLS is thehighest priority in the Chief FinancialOfficer’s (CFO)’s office.

A master project schedule cover-ing the six workstreams governingimplementation of the project hasbeen completed. Business process re-engineering (BPR) is part of thefunctional process workstream and

has been underway since January ofthis year. It involves all segments ofVA.

Acquisition teams, also withDepartment-wide representation, arecurrently gathering and analyzinginformation on four candidate COTSsoftware packages for coreFLS. Weanticipate selecting the software byearly summer. A conference roompilot to test the software’s functional-ity is planned for the October/November timeframe.

Completion of beta testing isexpected in July 2001. We will betatest at the Financial Services Center,one site in VBA, and four VHA sites.Nationwide implementation willoccur from August 2001 to October2002.

While we recognize ourtimeframes may require adjustmentas we move forward, we are commit-ted to our schedule and plan to have

the coreFLS System functional on ornear the original target date.

VA employees who currentlywork with the financial and logisticssystems can expect their jobs tochange and will receive training andguidance on the new system. I wantto assure employees that all pro-jected cost savings are based ontechnological streamlining andprocess redesign rather than onelimination of current jobs. Jobfunctions will change. With singlesource data entry, data will beentered only once at the source.Employees will be able to do moredata analysis and considerably lessdata reconciliation.

The success of any project comesfrom communicating with theultimate users of the system. That’s

you! The entirecoreFLS team iscommitted tocommunicatingearly, often andopenly with VAmanagement andemployees. We will keep

you informed of the progress,successes and advancement achievedduring the life of the project, as wellas the challenges.

Our Web site, at www.va.gov/corefls or vaww.va.gov/corefls, willkeep you updated and informed.Check it for project plans, accom-plishments, current issues, andimpacts on VA employees.

You can also e-mail the coreFLSteam with questions, concerns orcomments. Simply type coreFLS inthe “to” line of Outlook e-mail. ❏

The time is right for VA to move to a fully integrated

financial and logistics system that can provide easily

accessible, consistent, timely responses to the many

information needs throughout the Department.

For more information...

check the coreFLS Website at www.va.gov/coreflsor vaww.va.gov/corefls.

4 VAnguard

VA’s 118th National Cemetery Opens in Texas

M ore than 2,500 peoplebraved the intense Texassunshine to attend the long-awaited dedication cer-

emony for VA’s newest nationalcemetery on May 12.

Located amid rolling hills be-tween Dallas and Fort Worth, the $13million, 638-acre cemetery willeventually provide more than280,000 burial spaces for veteransand dependents who live within a100-mile radius. More than 500,000veterans live in the greater Dallas-Fort Worth area.

Secretary of Veterans AffairsTogo D. West, Jr., gave the keynotespeech at the ceremony, whichincluded a 21-volley rifle salute by aJoint Honor Guard and the Lone Starchapter of the Paralyzed Veterans ofAmerica, performances by the 4th

Infantry Army Band from Fort Hood,a B-1 Bomber flyover and tours of thegrounds.

National Cemetery Administra-tion Acting Under Secretary forMemorial Affairs Robert M. Walkerand Cemetery Director JimmyAdamson also participated in theprogram, along with members of theTexas Congressional and statedelegations, veterans service organi-zations, veterans and their families.

The cemetery is VA’s 118th

national cemetery, and the sixth inthe state of Texas. The first phase,now open for burials, includes 14,600gravesites and 2,200 columbarium

and gardenniches on110 acres.The en-trance area,a publicinformationcenter withan auto-mated kioskfor quickaccess toinformation,an adminis-tration andmaintenancecomplex, anassemblyarea, amemorialwalkway,two committal service shelters androadway and utility systems are alsopart of the completed first phase ofconstruction.

Construction of the Dallas-FortWorth National Cemetery began in1997. Originally scheduled to openlast July, construction delays causedthe date to be moved back.

Initial burials at the new cemeterybegan on May 15, and the remains ofmore than 450 veterans and depen-dents have since been interred. Aspecial memorial service was held onJune 10 to honor this first group ofveterans and dependents to beburied. The service included areading of each person’s name, a

flyover, fullmilitaryhonors,playing oftaps andremarks byclergy. Since VAtook over thecountry’ssystem ofnationalcemeteries in1973, theDepartmenthas activelyworked toexpand thenumber ofburial sites

Members of the Lone Star chapter of the Paralyzed Veterans of Americajoined a Joint Honor Guard to perform a 21-volley rifle salute.

Secretary of Veterans Affairs Togo D. West, Jr., greets a local veteransservice organization representative on the stage during the dedicationceremony for the new cemetery.

2,500 Attend Dallas-Fort Worth Dedication Ceremony

and provide a wider range of burialoptions for veterans and their eligiblefamily members.

From 1997 to 2000, VA openedfive new national cemeteries—inWashington, New York, Illinois,Texas and Ohio—representing thelargest expansion of the nationalcemetery system since the Civil War.More than 75 percent of the nation’s25 million veterans are now servedby either an open national or stateveterans cemetery within 75 miles ofwhere they live.

VA’s short-term goal is to havemore than 80 percent of the veteranpopulation served with a burialoption by 2004. The Department isworking to achieve this goal byestablishing six new national cem-eteries in Florida, Georgia, Pennsyl-vania, Michigan, California andOklahoma.

Through future expansion andland acquisition projects, the exten-sion of the service life of existingnational cemeteries is planned. VA isalso working in partnership with thestates to establish, expand andimprove state veterans’ cemeteriesthrough the State Cemetery GrantsProgram.

Veterans from all periods ofservice are dying at an average rateof 1,500 per day, and more than560,000 died in fiscal year 1999. Thatnumber is expected to peak at620,000 in 2008. ❏

June/July 2000 5

T he dedication and commitmentof VA’s nursing staff—morethan 55,000 strong—werehonored at VA medical centers

nationwide during National NursesWeek May 6-12. Although nurseshave been at the core of veteranshealth care throughout VA’s 70-yearhistory, their roles have changeddramatically over the years. Today’sVA nurses are meeting new chal-lenges as clinicians, administrators,researchers and educators.

At a special ceremony in VACentral Office on May 8, Secretary ofVeterans Affairs Togo D. West, Jr.,presented the Secretary’s Awards forExcellence in Nursing to: Vicki Ellis,registered nurse at the VA Palo AltoHealthcare System; SherriPorterfield, registered nurse at theTucson, Ariz., VA Medical Center;Amy Sackmann, a licensed practicalnurse (L.P.N.) at the Fox ValleySatellite Outpatient Clinic, PrimaryCare Division, Milwaukee VAMedical Center; and Kristi Greeno,nursing assistant at the Tomah, Wis.,VA Medical Center. Richard P.Miller, retired director of the Jackson,Miss., VA Medical Center, receivedthe Secretary’s Award for the Ad-vancement of Nursing Programs.

Ellis, a clinical nurse specialist,has been an integral part of theHospice Care Center at the VA PaloAlto, Calif., Healthcare System sinceits inception in 1979. Her colleagues

credit her strong leadership skillswith helping the center develop intoa model hospice program. Health-care providers and caregiversthroughout the VA Palo AltoHealthcare System and the commu-nity seek out Ellis’ expertise in end-of-life care.

Pet therapy, unrestricted visitinghours, bereavement follow-up forfamilies and educational seminars onpalliative care are among the pro-grams she initiated. She has assumeda major role in the hospice’s expan-sion and relocation from the MenloPark Division to the Palo AltoDivision. She holds a faculty ap-pointment at the University ofCalifornia, San Francisco, and hasbeen a guest lecturer at the StanfordUniversity School of Medicine.

When Porterfield began workingat the Tucson, Ariz., VA MedicalCenter as a graduate nurse four yearsago, her colleagues there recognizedher potential to become an outstand-ing nurse. She quickly became aleader on a fast-paced medicaltelemetry unit. Both new and sea-soned nurses seek her out as aresource for her knowledge base andher critical thinking skills.

Her colleagues frequently use herguidance on alternative plans of carethat will maximize patient outcomes.While the Tucson VAMC is stilldeveloping its clinical computingpresence, Porterfield assembled local

and Web-based patient educationmaterials, modified them and createda resource library on the unit for useby all nurses both in teaching pa-tients and reinforcing what they havelearned before they are discharged.

Sackmann’s duties at the Milwau-kee VAMC’s Fox Valley SatelliteOutpatient Clinic include assistingwith specialty clinics and proce-dures, providing routine injectiontherapy and following up on patientswho do not show up for theirappointments as scheduled. Shedeveloped the L.P.N. clinic rotationschedule and worked with othermembers of the health-care team toidentify a flow plan for the primarycare clinics where three intake areasserve as interview areas for review-ing patient data and obtainingpatient information. Sackmann’splan eliminated confusion andstreamlined the efficiency of theclinic.

She quickly became an expertuser of the clinic’s ComputerizedPatient Records System, and sharedthat knowledge by developing a self-study/review of competencies on thesystem for her fellow employees.Sackmann is regarded as a leader byher fellow L.P.N.s, and has beeninstrumental in improving theperformance of staff members andthe overall efficiency of the clinic.

Greeno is known for her compe-tent and caring approach to patientcare on the Tomah VAMC’s nursinghome care unit. She consistentlydemonstrates the ability to providefor both the physical and emotionalneeds of her patients, while effec-tively communicating with con-cerned family members. Greeno hasbeen active in implementing theRestraint Reduction Task Forceprogram at the medical center, andcontinues to improve her skillsthrough continuing education.

Miller was recognized for hisconsistent support for integratingcontemporary nursing practices intoexisting nursing programs. Heapproved the use of nurse practitio-ners in acute inpatient settings andexpanded nurse roles to includeprescriptive authority. He was astrong advocate of nursing involve-ment at every level of the medicalcenter. ❏

VA Honors Achievements of Four Top Nurses

Secretary of Veterans Affairs Togo D. West, Jr., with nurse award recipients (from left):Kristi Greeno, Vicki Ellis, Sherri Porterfield, Richard P. Miller and Amy Sackmann.

6 VAnguard

W hat needs to change themost in VA in order tocreate a high-quality,responsive health-care

system? That was the question posedto an estimated 1,200 VA employeesand stakeholders who gathered tocelebrate the past, assess the present,and shape the future at the VeteransHealth Administration (VHA)Consensus Congress held May 9-11in Las Vegas, Nev.

During what was VA’s largestconference in years, participants hadthe opportunity to take on thechallenge of identifying strategiesneeded to develop a common visionfor the future as well as to reflect onrecent successes that have helpedtransform VA into a national leaderin health-care delivery.

Speaking on the significance ofthe Consensus Congress, VA ActingUnder Secretary for Health Dr.Thomas L. Garthwaite said, “This isnot a defining event, this is one stepin our journey. The goal here is tostop, reflect and celebrate, but also tosolidify the direction we are head-ing.” Later, he added, “I challengeyou, as we think about what we’vedone, to consider what is possible.”

To consider what is possible. Itwas a recurring theme throughoutthe conference. Two former VAleaders who looked beyond bound-aries and helped kick-start VHA’s

transformation were honored fortheir roles in shaping a vision for thefuture.

In a rousing speech that drew astanding ovation, former Secretary ofVeterans Affairs Jesse Brown encour-aged participants to continue tostrive for newheights. “Weaimed for thehighest—nothingless than the bestpossible model forhealth care.Please, keep yoursights high. Weconfrontedshortcomingswithout fear.Please continue tobe courageous.”

The applausecontinued asformer UnderSecretary forHealth Dr.Kenneth Kizerstrode toward thepodium toreceive a recogni-tion award forhis visionary rolein re-inventingthe delivery ofVA health care.Addressing theaudience, Kizer

characterized VHA’s transformationas a “great success” and describedthe Department as a “model forradical organizational change.”

He later recommended holdingadditional conferences to help guidethe re-engineering process throughthe years ahead. “We are in the midstof very tumultuous times and theneed to continue to transform, tocontinue to change to meet newchallenges, is going to be with us asfar as I can see into the future,” hesaid.

Other distinguished guests at theConsensus Congress includedNational Partnership for ReinventingGovernment Director MorleyWinograd; Miss America 2000Heather Renee French; and WilliamIhle, senior vice president for corpo-rate relations of Jackson & Perkins,developers of the Veterans’ HonorTM

Rose. Ihle presented two Veterans’HonorTM rose bushes to French andhanded Garthwaite a check for morethan $110,000. When the rose wasintroduced last May, the companypledged to donate a portion of thesales to VA research.

A poster exhibit featuring VHA

Consensus Congress Shapes Future of VHA

In a lighter moment, participants demonstrate their knowledge of VAacronyms and other trivia in a skit titled, “Who Wants to be a VAExtraordinaire?” Modeled after the popular ABC program “WhoWants to be a Millionaire?,” the skit—complete with the sametension-building music and sound effects—poked fun at what can bea confusing assortment of VA acronyms. Above, the Time Traveller(conference host) presents the fastest-finger question to (from left)Alma Lee, president, American Federation of Government Employees,Salem, Va., VAMC; Kenneth Mizrach, director, East Orange, N.J.,VAMC; William Conte, director, Bedford, Mass., VAMC; LarryDeal, director, VISN 7 (Atlanta); and Paul Low, clinical servicemanager, VISN 12 (Chicago).

George Van Buskirk, M.D. (left), a physician at the Orlando, Fla., VA Outpatient Clinic,explains the clinic’s transformation from a “Mom & Pop” clinic into a comprehensivehealth-care center to Dwayne Redman, chief of Audiology/Speech Pathology at theShreveport, La., VA Medical Center.

June/July 2000 7

lessons from the past, opportunitiesfor the present and ideas for thefuture was another highlight of theconference. The posters were de-signed to familiarize employees withinitiatives underway at VA medicalfacilities throughout the country, andcovered VHA advances in a numberof areas, including chronic painmanagement, restraint use reduction,clinical applications of virtual reality,patient safety and mental health.

Each participant was issued a“passport” and asked to “travel”throughout the poster exhibit visitingthe past, present and future of VAhealth care. They needed to get theirpassports stamped by at least fiveexhibitors as reminders of innovativepractices they could implement oncethey returned to their facilities. Withnearly 300 poster exhibits to choosefrom, it was difficult to decide whichfive to pick. Later in the conference, Dr.

Frances Murphy,Acting DeputyUnder Secretary forHealth, unveiled thesix VHA strategicgoals for 2006. Theyare:◆ Put quality first,until VA is first inquality;◆ Provide easyaccess to medicalknowledge, exper-tise and care;◆ Enhance, pre-

serve and restorepatient function;◆ Exceed patients’expectations;◆ Save more dollars

to serve moreveterans; and◆ Build healthycommunities. Murphysaid imple-menting thesegoals wouldallow VHA to“provide healthcare that is thehighest qualityto the highestnumber ofpeople at themost reason-able cost.Those are thegoals of thisconference andwe need to be able to translate theminto a strategy so that VA cancontinue to be a leader in those areasin the future.” She then offeredspecific strategies for reaching these

six goals, giving participants a clearunderstanding of the direction VHAis heading and what steps areneeded in order to get there.

As the conference wound down,participants could be seen exchang-ing business cards and discussinghow they could apply the conceptslearned at the conference. Themessage of the conference wasclear—change, though not alwayseasy, is a necessary element in theevolving world of health care.

The significance of VHA’s abilityto change was perhaps best ex-pressed by Garthwaite when he said,“By changing we’ve not only im-proved the way we provide care, butwe’ve also begun to teach peoplehow future changes are possible.

And even though it [change] can be alittle untidy in the beginning, in theend, it’s well worth the effort.” ❏

By Matt Bristol

Former VA Under Secretary for Health Dr. Kenneth Kizer acceptsan award from Acting Under Secretary for Health Thomas L.Garthwaite recognizing his leadership in re-inventing the deliveryof VA health care.

Veterans of the U.S. armed forceswho served in the military in theformer Republic of Yugoslavia arenow eligible for readjustmentcounseling services offered by VAthrough the vet center program.

Secretary of Veterans AffairsTogo D.West, Jr., approved therecommendation that veterans whoparticipated in one or more of threesuccessive operations in the formerYugoslavia (Kosovo/Bosnia)—Operation Joint Endeavor, OperationJoint Guard and Operation JointForge—be authorized full access tovet center counseling.

The vet center program is now 20years old. It was established by lawin 1979 and provides counselingservices at 206 locations in communi-ties across the nation.

Originally established to providecounseling to any veteran whoserved on active duty during theVietnam era, legislation passed in1991 extended eligibility to all post-Vietnam era veterans who served onactive duty at a time and placeduring which hostilities occurred.This opened vet centers to veteransof the Gulf War, as well as actions inLebanon, Grenada, Panama and

Somalia.In 1996, the law extended vet

center services to any veteran whoserved in the military in any war, orin any period in which armedhostilities occurred. That law autho-rized vet centers to serve all warveterans, and added World War IIand Korean War veterans to the listof eligibles.

Department of Defense dataindicates that up to 176,000 veteranscould be affected by this most recentchange, 30 percent of whom repre-sent ethnic minorities and 10 percentof whom are women. ❏

Former Secretary of Veterans Affairs Jesse Brown received a standingovation for his remarks to conference participants.

VA Expands Eligibility for Readjustment Counseling Services

8 VAnguard

A light clicked on in G. SueKinnick’s mind when theregistered nurse at the Topeka,Kan., VA Medical Center saw

the rental car company employee usea hand-held device to scan a bar codein the trunk of the car she wasreturning. If Hertz can track carsnationwide this way, she thought,VA should be able to track a patient’smedications in the same way. Sheshared the idea with her boss, andthat was the birth of a cutting-edgeprogram that VA officials believewill eliminate errors in dispensingpharmaceuticals.

Kinnick died three years ago aftera prolonged battle with breastcancer, but not before she workedwith a VA team developing a systemto implement her core idea in a 1994pilot project at the Topeka VAMedical Center. Colleagues say sheworked right up to her death andwas particularly concerned that thebar-code project would not expandbeyond Topeka.

Her fears were unwarranted, asthe tremendous success of the projectled VA policymakers to make thedecision to implement the programat all VA facilities. System-wideimplementation is expected to becomplete this summer.

Kinnick would be particularlypleased to hear how VA nurses areresponding to the bar-code system.One Amarillo, Tex., nurse said, “If Idon’t know a patient, that doesn’tmatter to the computer. It’s really a

nurses’ helper.” And the worldbeyond VA hasalso taken notice. The project,developed byVA’s Bar-CodeMedicationAdministration(BCMA) team,was one of threefinalists in thehealth-carecategory of thisyear’s USAToday QualityAward. Thenational award

recognizes teamsmaking signifi-cant contributions

to improvement of quality productsand/or services in an organizationby applying principles of qualitymanagement.

Tom Curley, president andpublisher of USA Today, said theaward honors “high standards of

quality, both at the team and indi-vidual level of an organization.”

The BCMA team was among 166nominees from Fortune 500 compa-nies, government agencies, educa-tional institutions, health-careorganizations and small businessesnationwide competing in fivecategories in this year’s ninth annualQuality Cup competition. Represen-tatives of the BCMA team demon-strated the project and attendedpresentation ceremonies May 5 atUSA Today headquarters in Rosslyn,Va.

Kathy Kardell, BCMA projectleader and computer specialist at theOffice of Information field office atthe Bay Pines, Fla., VA MedicalCenter, said health-care organiza-tions are becoming more and moreinterested.

“We expect the interest to riseproportionate to the success rate ofthe bar-code project,” Kardell said.“The inquiries have already startedto come in.”

The software program provides

USA Today Honors Bar-Code Medication Project

Tom Curley, president and publisher of USA Today, presents theUSA Today Quality Cup award to VA’s Kathy Kardell, BCMAproject leader.

Tribute to a Pioneer

Kinnick

Her colleagues at the Topeka, Kan., VA Medical Center were notsurprised that it was Sue Kinnick who led the way in developing aninnovative system to reduce medication errors. The registered nursewas known for her commitment to a safe patient environment, and shewas instrumental in fostering a more cohesiveworking relationship between the nursing andpharmacy staffs at the VA Eastern KansasHealth Care System.

Chris Tucker, a pharmacy specialist at theTopeka VAMC who worked closely with Kinnickfor seven years, said the nurse worked tirelesslyon the bar-coding project—right up until the daybefore she lost her battle with breast cancer in1997. Her last words to colleagues, according toTucker, were to “keep fighting to keep thisproject going.”

As evidence of Kinnick’s persistence in pursu-ing a goal, Tucker points to a story Kinnick told from her childhood.Growing up in Kansas, Kinnick longed for a backyard swimming pool.When she and her brother asked their father for a pool, he respondedby handing each of them a shovel. If they would dig the hole, theirfather told them, he would put in a swimming pool. Far from beingdissuaded, the siblings spent all summer digging the hole—and theygot their swimming pool the following summer.

“Her spirit can be felt throughout the medical center on a dailybasis,” Tucker said of Kinnick. “She touched many lives and was lovedby everyone. Sue’s commitment to excellence still provides inspirationto many employees at our medical center.” ❏

June/July 2000 9

online patient medication informa-tion and uses bar-coded patientwristbands and bar-coded medica-tion to ensure the patient receives thecorrect medicine and dose at thecorrect time.

The system works simply. First, adoctor uses a desktop computer toorder a patient’s medicine. Thepharmacy and the nurse receive theorder. Then the nurse takes a com-puter cart—wireless and configuredfor each facility—to the patient’sroom, scans the patient’s wristbandand the medication packet—indi-vidually wrapped and bar-coded fordrug and dosage information. Anerror message appears on the com-puter screen if it’s the wrong drug,dose or time. If there are no alerts,the nurse dispenses the drug andrecords it in the computer.

The medication record becomespart of the computerized patientrecord for a doctor or nurse to see atany time what medication was givenor missed.

The BCMA project team reportscontinued improvement through

USA Today Award (cont.)

Memorial Day 2000

Thousands Attend VA Observances NationwideWreath-layings, speeches by

dignitaries, military aircraft flyovers,honor guards and patriotic musichighlighted the many Memorial Day2000 ceremonies held throughout thenation. Secretary of Veterans AffairsTogo D. West, Jr., joined PresidentClinton at Arlington NationalCemetery for his eighth MemorialDay address and wreath-laying, thefinal one of his presidency.

In his remarks, the Presidentfocused on Korean War veterans,whom the nation will honor over thenext three years during a 50th anni-versary commemoration of thatconflict. He pledged to reaffirm thenation’s commitment to the morethan 1.7 million Americans whoserved in Korea, the more than36,000 who lost their lives there, andthe more than 8,000 still missing.

VA facilities across the countryhosted or joined in local observancesof Memorial Day. National cemeter-ies were the sites of Memorial Dayobservances attended by thousands

of veterans, their families andcommunity members. As in pastyears, volunteers including the BoyScouts and the Girl Scouts ofAmerica placed more than a millionsmall American flags on individualgraves, and the cemeteries displayedtheir Avenues of Flags, flying burialflags donated by families of deceasedveterans.

At the Houston National Cem-etery, approximately 7,000 veterans,family members and dignitarieshonored the 50th anniversary of theKorean War in a ceremony that alsofeatured flyovers and a display of theGold Star Mothers’ Heroes Wall,which included photos and memora-bilia of loved ones killed duringmilitary service.

The dedication of a VeteransMemorial before an estimated crowdof 1,500 was the highlight of Memo-rial Day observances at the River-side, Calif., National Cemetery. Thebronze statue was a gift from Denversculptor Tom Schomberg and New

Jersey entrepreneur Thomas F. Kane.The 12-foot black granite monumentdepicts a fallen soldier on the battle-field, and is designed to honor thepersonal and emotional sacrifices ofveterans, and to acknowledgeAmericans who have lost loved onesin battle.

Memorial Day observances at theLos Angeles National Cemeterywere highlighted by the presentationof a Silver Star by California Gover-nor Gray Davis to retired ArmySergeant Thomas J. McGowan forgallantry in action 54 years after hisparticipation in World War II’s Battleof the Bulge. At the conclusion of theprogram, 2,000 carnations werescattered over the Pacific Ocean by aVietnam veteran flying in a local TVnews helicopter. The cemetery alsoheld a ceremony on May 28 todedicate a new entranceway, a 7,000-foot-long wrought iron fence, andother improvements donated byVeterans Park, Inc., a local non-profitorganization.

Army soldiers from Fort Lee, Va.,participated in the Richmond, Va.,VA Medical Center’s Memorial Dayprogram by visiting the bedsides ofpatients who were unable to attendthe ceremony, and escorting othersto the program. Fort Lee’s Armyband played patriotic music as F-16sfrom the Virginia Air NationalGuard flew in formation over theaudience. A wreath-laying at themedical center’s Memorial Wall,taps, and the planting of anotherVeterans’ HonorTM rose bush cappedthe VAMC’s observance.

The Kansas City, Mo., VAMedical Center, along with the VAEastern Kansas Health Care Systemand the VISN 15 (Kansas City) office,accepted the city’s invitation toparticipate in its “Heart of AmericaSalute to Veterans” Memorial Dayparade. Using donated funds,employees, volunteers and veteransconstructed a float on a trailer loanedby the Air National Guard. The float,with the theme “Veterans ServingVeterans,” celebrated both thecontributions of local veteransservice organizations and the OneVA concept of coordinated health,benefits and burial services. ❏

statistical analysis of error rates inthe medication administrationprocess, where, combined withtranscription, nearly 50 percent ofmedication errors occur. Eachimprovement in a statistical countindicates an improvement in theprocess, since averted errors indicateinefficiency in the process.

The greatest measure of improve-ment is the count of actual medica-tion errors. Through April 2000, theTopeka VA Medical Center hasdocumented no errors and preventedsome 378,000 while dispensing somesix million doses since the softwarewas implemented there.

The 16-member BCMA projectteam includes people from across theVeterans Health Administration andthe private sector. While the coreTechnical Services team continues toenhance the bar-code system, thenational customer support, trainingand implementation teams aredeploying the product throughoutVHA facilities. ❏

By Ken McKinnon

10 VAnguard

M ore than 4,000 peoplegathered in the quaintSouthern town of Augusta,Ga., May 19 to hear the

President of the United States deliveran address to health-care profession-als about medical resources withinthe departments of Defense andVeterans Affairs.

The early morning speech at thedowntown division of the AugustaVA Medical Center was certainlynewsworthy in this town more notedfor the Masters golf tournament thanfor presidential visits.

Gathered outside was a livelygroup of protestors who broke themorning calm with their chants.Their presence was typical; lawenforcement agents long accustomedto presidential visits took no specialnote of the protests.

Until the explosion.The blast ripped through the

medical center, partially destroyingthe building. Scores were killed or

injured by the explo-sion. Amid the chaos,federal officials alsoconfirmed their worstnightmare: deadlynerve gas wasdetected. The presidentimmediately issued adeclaration of emer-gency, activating theFederal ResponsePlan and the NationalDisaster MedicalSystem (NDMS). Pre-positionedmedical elements ofVA, the Departmentof Defense (DoD), theFederal EmergencyManagement Agency(FEMA), the U.S.Public Health Service(PHS) and localhazardous materials(HAZMAT) teamsresponded to thescene lending medi-cal, decontaminationand evacuationsupport. Law officersset up perimeters and

protected the integrity of the crimescene.

Near the Augusta VAMC uptowndivision, another explosion con-firmed what had been suspected—terrorist activity.

This is a drillIf you don’t remember hearing

about this incident, that’s because itnever happened. The 48-hour“simulated” exercise was the culmi-nation of Consequence Management2000 (CM2K), held at Ft. Gordon,Ga., May 15–20.

For the last two years, VA’sEmergency Management StrategicHealthcare Group (EMSHG), incooperation with federal, state andlocal governments, has orchestratedthis “real world” training to measurethe capabilities of military andcivilian authorities working togetherto manage the aftermath of a disas-trous event involving weapons ofmass destruction (WMD). Weapons

of mass destruction include nuclear,biological or chemical (NBC) agentsand high explosive devices deliveredin a way that could result in a largenumber of casualties—such as bombsor missiles.

“VA has been very involved inplanning the exercise and we haveundertaken a huge nationwide effortto coordinate resources. ‘Weapons ofMass Destruction’ is an area of majorconcern to us,” said EMSHG DirectorDr. Kristi Koenig.

“First and foremost, we need tomake sure that we can continue totake care of our veteran patientsshould they converge on our hospi-tals as victims of a WMD event, andprotect our own staff as well,” saidKoenig. “However, we also have arole in the National Disaster MedicalSystem. We participate as one of thefour partner agencies in NDMS(along with DoD, FEMA and PHS)preparing our medical facilities forcatastrophic events,” she said.

According to Koenig, the han-dling and treatment of WMD casual-ties requires stringent proceduresand training to protect emergencymedical personnel, firefighters andpolice officers from contact withcontaminated victims. Anotherchallenge is the coordination be-tween agencies that use differentterminology, acronyms, means ofcommunication and equipment toexact the same outcome.

Classroom TrainingIn order to meet these challenges

and learn more about treatingvictims of WMD and reduce thenumber of deaths involving theseagents, participants devoted them-selves to five days of extensiveclassroom instruction in threeeducational tracks: clinical, emer-gency management and mentalhealth.

The clinical track offered coursessuch as “Principles of Patient Treat-ment,” “Medical Considerations forAir Evacuation,” and “Nuclear,Biological and Chemical Casualty.”

The emergency managementtrack offered courses such as “Preser-vation of Evidence,” “Managing

Disaster Response

Augusta VAMC Sets the Stage for CM2K

Soldiers at Ft. Gordon, Ga., try out their acting skills during themock bombing conducted for Consequence Management 2000.

PHOTO BY MICHAEL HOLOHAN COURTESY OF THE AUGUSTA CHRONICLE

June/July 2000 11

Mass Fatality Incidents,” and “Man-aging Responder Stress.”

The mental health track includedthe Red Cross Disaster MentalHealth Certification Course.

Additional courses included“Dealing with the Media,” “Radia-tion: Basic Concepts and the Impacton Healthcare Facilities,” and roundrobin classes on litter (stretchers) anddecontamination procedures.

Then came the actual exercise,where two days of training trans-formed into two days of nonstopreaction to WMD scenarios.

“Casualties overwhelmall hospitals”

The exercise was carefullyscripted by a civilian/militarycommittee headed by Bruce Young,exercise director, EMSHG, and BruceMartin, area emergency manager,Birmingham, Ala., VAMC, whospent two years compiling a compre-hensive scenario that tested themettle of everyone on the ground forCM2K.

Imagine if you will a script from amovie set, complete with specialeffects like smoke grenades tosimulate a bombing and bodiessporting “gaping injuries” strewnthroughout a demolished structure.The scenario dictated the exercisedevelopments––from the bombing ofthe Augusta VAMC to the evacua-tion of patients to regional hospitals.

For example, aportion of thescenario lookedlike this:

11:00 a.m. -Urban searchand rescue effortcommences atthe AugustaVAMC. Person-nel to includeover-pressurizedand self-con-tained air supplysuits. 12:50 p.m. -First group, 15-20 patients,arrive at BushAir Field fortransfer to theAtlanta (VAMC)federal coordinating center. 2:00 p.m. - Casualties overwhelmall hospitals within a five-mile radiusof Augusta. 2:05 p.m. - The Atlanta, Birming-ham, Charleston and Columbia VAhospitals are activated.

Exercise “challengingand successful”

Army Reserve Col. RobertRoswell, commander of the 73rdField Hospital, St. Petersburg, Fla.,had to prepare his unit to react.Roswell, also the VISN 8 (Bay Pines,Fla.) director, explained their role asnot providing definitive treatmentbut accepting casualties that thegreater Augusta metropolitan area isunable to handle because they areoverwhelmed.

“Our priority [in the ArmyReserve] is to make sure that civiliancasualties brought to this site arefully and completely decontaminatedso they don’t continue to sustaininjuries from chemical agent expo-sure and they don’t become a hazardto others or family members,” saidRoswell over the constant din ofmilitary field telephones and genera-tors.

“Second, we want to evaluatethem as carefully as we can to assurethere isn’t additional trauma thatrequires treatment. Then we getthem evacuated as quickly and assafely as we can to a civilian tertiaryhealth-care facility which might belocated in Atlanta, Charleston orColumbia, S.C., or as far away as

Registered nurses Diane Yoder, from the Philadelphia VAMC, andCasmir Olszewski, from the Erie, Pa., VAMC, triage a “victim.”

Edward Dickerson, R.N., from the PittsburghVAMC, helps Kevin Frank, also from thePittsburgh VAMC, with the personalprotective equipment worn during the drill.

Birmingham,” Roswell said.At the uptown division of the

Augusta VAMC, site of anotherbombing incident, Safety ManagerKathy Frazier had her hands fullwith Richmond HAZMAT teams, aU.S. Army Reserve chemical unit, theGeorgia National Guard and A.R.Johnson High School students, whoseemed pleased to be “decontami-nated,” or sprayed with water on ahot day.

“We exercised four key elementsfor the first time—first responders,WMD agent reconnaissance, decon-tamination experts and communitymedical control,” said Frazier. “Itwas challenging and successful.After decontamination, patients weretransported to the downtowndivision of VA and local communityhospitals.”

The likelihood of the presidentbeing at a VA facility during aterrorist attack with explosions andnerve gas is remote. Nonetheless,through realistic exercises likeCM2K, VA’s emergency respondersare better equipped and trained thanever before. In fact, with more than1,500 participants, advisors, observ-ers and players, ConsequenceManagement 2000 was the largestfield exercise ever conducted.

Planning for next year’s exercise,named “Consequence Island 2001,”in San Juan, Puerto Rico, has alreadybegun. ❏

By Jan NorthstarAtlanta OPA Regional Office

12 VAnguard

W hen Tom Lefferts waspreparing to leave theNavy in 1971, Navypersonnel debriefed him

on what was ahead of him andbenefits available to him in civilianlife. But it seems they didn’t exactlygive him the most accurate informa-tion. “They told me the VA wouldbuy me my house and pay for myeducation. Hellooo…” Leffertsrecalled, laughing.

Now Lefferts is one of a distinctgroup of VA employees known asmilitary service coordinators (MSCs)who give the truth, the whole truthand nothing but the truth to separat-ing servicemembers both statesideand abroad.

“This is a good job,” said Lefferts,who currently is a team leader for theVBA outreach program in Togus,Maine. “It’s a good job to have and agood job for VA to have finallyundertaken… to grab these peoplebefore they leave active duty and tellthem the truth about their homeloans and GI Bill.”

The Transition Assistance Pro-gram (TAP) and Disabled TransitionAssistance Program (DTAP) werecreated as joint efforts of the Depart-ments of Defense, Labor and Veter-ans Affairs in 1990 to ease thetransition of military personnel fromactive duty to the private sector. Aspart of the program, VA MSCs likeLefferts regularly conduct briefings

on benefitsand services tomilitarypersonnel atinstallationsthroughout thecountry and tomilitarypersonnelstationed inEurope andthe Pacifictheater. Initially, aMSC wasdesignated ateach VBAVeteransServiceDivisionnationwide,

with some coordinators outbased tolocations near large military popula-tions. The coordinators and otherVBA counselors, in addition to theirsupport of TAP, also provide benefitbriefings at regular pre-separationand retirementprograms and areinvolved in outreachto members of theReserve and Na-tional Guard. Theprogram wasexpanded in fiscalyear 1992 to stationVA military servicecoordinators inEurope and thePacific.

In fiscal year1999, VA militaryservice coordinatorsconducted morethan 5,000 benefitpresentations atTAP workshops, retirement seminarsand pre-separation briefing sessionsattended by more than 217,000servicemembers. These sessionsresulted in more than 80,000 personalinterviews in 1999 by VA MSCs. Inthe overseas program in fiscal year1999, 12 MSCs (six working per six-month period) conducted more than350 briefings attended by more than10,000 servicemembers and con-ducted almost 7,000 personal inter-views.

“We have an obligation to get theword out to all those who may beeligible or may become eligible forVA benefits and health care,” saidDiane Fuller, assistant director ofVBA’s Demand Management staff,which administers the MSCs andTAP and DTAP programs.

MSC Al Klar, from Nashville, hasconducted separation benefitsbriefings at stations as diverse asHoward Air Force Base in Panamaand an old radar site on a mountaintop in Germany.

He recalled a recent briefingconducted in a small building in anArmy tank motor pool area inSchweinfurt, Germany, where hecould barely hear himself talk asarmored personnel carriers “rumbledand clanked by.”

“The soldiers attending mybriefing weren’t particularly dis-tracted, so I talked between vehiclesgoing by,” Klar said.

One of Klar’s more interestingclients was Army Specialist Steven

Gonzales, one of the three Armysoldiers taken prisoner during lastyear’s conflict in Kosovo. Klarpersonally briefed Gonzales on VA’sfar-reaching POW benefits andhealth-care programs following alarger briefing of 40 soldiers at theirhome base in Schweinfurt.

Klar was conducting briefings atConn Barracks in Schweinfurt lastJuly when he learned an Armysergeant stationed there had beenkilled a few days earlier in an

Military Service Coordinators Travel the World BringingVA Benefits Information to Separating Servicemembers

Military Service Coordinator Hal Farrington assists a servicemember inhis office at the Naval Submarine Base New London in Groton, Conn.

Margie Pastorek, right, with a servicemember aboard the USSLand, off the coast of Sardinia.

June/July 2000 13

accident in Kosovo. Klar took theinitiative to locate the soldier’s wife,who lived at Conn Barracks with thecouple’s two children. Klar briefedthe woman on the benefits she likelywould be entitled to and helped herfill out the necessary VA application.

Hartford, Conn., MSC HalFarrington said he sees his jobresponsibilities as two-fold: to assistclients as they file for VA benefitsand to share his expertise on militaryentitlements.

“I love doing my job,” Farringtonsaid. “It’s exhausting, but veryrewarding. On the average, morethan 300 people pass through mydoor each month. The only place onbase busier than the VA office isMcDonald’s.”

The MSCs—stateside or abroad—are on the move all the time,conducting briefings they arrange orthat are requested by base com-mands within their geographic area.

Andy Carver, from Montgomery,

Ala., is the first MSC sent to Korea—serving there from mid-January tomid-April in 1999. During 57 work-days, Carver provided a total of 62briefings to 1,879 active dutyservicemembers, retirees and depen-dents at 14 different bases.

Carver was quoted in the U.S.Forces publication, “Seoul Word,” assaying, “If servicemembers have anydoubt regarding a particular benefit,go ahead and apply. The worst wecan do is turn him or her down, butthe worst they can do is not apply.”

Margie Pastorek, from San Diego,recently returned from a three-monthtour as a MSC in Italy. She sentphotos to VAnguard from briefingsand interviews she did aboard theUSS Land off the coast of Sardinia,on La Maddolena Island in Sardiniaand in her office in Aviano, Italy—all during a week’s time in February.

Pat Cullen, from New Orleans, iscurrently on duty for VA in Ger-many. He said it did not take him

long to realize that “to [MSCs’]audience, we are VA, and that’s a bigresponsibility for each of us.

“We’re there to give them infor-mation. That’s what they’re hungryfor,” Cullen said. “In many cases,I’ve been told that they feel betterafter a briefing, because life, orstarting a new kind of life, doesn’tseem as scary to them.

“It’s hard work but a fun job,which involves a lot of time on theroad, many dinners alone, and theability to work independently andwithout a regimented schedule.Flexibility is probably the key assetfor any [overseas] MSC.

“The best part is that we’re doingthis in great locations throughout theworld, with most weekends free toenjoy the culture, history and people,as only few fortunate souls get to do.I’m always grateful for the opportu-nity,” Cullen said. ❏

By Ken McKinnon

C ommemoration of the 50th

anniversary of the KoreanWar, which began June 25,1950, got off to an early start

during Memorial Day ceremoniesthat focused largely on that periodand its veterans.

On Memorial Day, Secretary ofVeterans Affairs Togo D. West, Jr.spoke at the Korean War Memorialand, in his speech at ArlingtonNational Cemetery, PresidentClinton called for continued effortsto identify the 8,176 Americans stillmissing from the war.

Commemorative events began inearnest across the country in June,highlighted by June 25 openingceremonies in Washington, D.C., andSeoul, officially kicking off the three-year commemoration. PresidentClinton presided over the ceremonyat the Korean War Memorial inWashington. Simultaneously,Secretary West and Republic ofKorea leaders presided over theopening ceremony in the Republic ofKorea.

VA and all of its facilities areparticipating as full partners, indi-vidually and collectively, with theDepartment of Defense (DoD) 50th

Anniversary of the Korean WarCommemoration Committee. Undera memorandum of agreement

reached in June, VA joined theCommemorative CommunitiesProgram designed by Congress andDoD to celebrate the 50th anniversaryof the three-year period of hostilitiesin the Korean War.

As a partner in the program, VAmedical centers, network offices,outpatient clinics, nursing homes,domiciliaries, regional offices,national cemeteries and area NCAoffices will receive commemorativeinformation and products to hold atleast three activities during each ofthe three years of the commemora-

VA Joins DoD to Commemororate Korean Wartive period. Events can range fromhonoring veterans and their familiesto supporting school programs thatteach the history of the Korean WarEra. Military and civilian communi-ties, schools, businesses and corpora-tions are joining the CommemorativeCommunity program.

Information on the Commemora-tion Committee, the CommemorativeCommunity program, a calendar ofevents and educational informationabout the Korean War are availableon the committee’s Web site at http://Korea50.army.mil. ❏

Korean War VeteransAs the nation prepares to commemorate the 50th anniversary of what

has sometimes been referred to as “the forgotten war,” here’s a snap-shot of today’s Korean War veterans:■ There are approximately 3.9 million Korean War Era veterans in theUnited States and Puerto Rico, down about 21 percent from the nearlyfive million living in 1990. Korean War Era veterans make up nearly 16percent of the 24.4 million total living veterans.■ The median age of Korean War Era veterans is 69, with 336,500under age 65, 3.25 million age 65 to 74, and 363,000 age 75 or older.■ The five states with the most Korean War Era veterans are California(431,000); Florida (294,000); Texas (243,000); New York (220,000); andPennsylvania (201,000).

14 VAnguard

S ixteen San Franciso-area Boy Scoutssacrificed a Satur-day in May to take

on a worthy project—refurbishing the Battle ofthe Bulge MemorialMonument and Traillocated on the grounds ofthe San Francisco VAMedical Center.

The scouts and theirtroop leader spent 10 hoursconstructing a wood railfence along the steep 100-yard trail, clearing brush,and pouring and levelinggravel on the pathway.They also cleared weeds and debrisfrom around the monument andtrail.

The Battle of the Bulge Monu-ment and Trail, sponsored by the

VA and the National Aeronauticsand Space Administration (NASA)are teaming up to create a ground-breaking system for reporting health-care errors and “close calls” in VAhealth-care facilities.

Under an agreement signed byofficials from both agencies on May30, VA and NASA will develop avoluntary external patient safetyreporting system for the Department.The system will be modeled on theAviation Safety Reporting System(ASRS) that NASA operates for the

FederalAviationAdministra-tion. The ASRSreceivesabout 35,000reports ofclose calls oraviationmistakeseach year,and sendsout about 20safety alertsa month,callingattention topotentialproblems.The reports

come from pilots, air traffic control-lers, flight attendants, mechanics andothers who are involved in, orobserve, an incident or situation thatmay compromise aviation safety. Allsubmissions are voluntary and heldin strict confidence.

The VA system will be similarlydesigned and will be operated by theAmes Research Center, NASA’s leadcenter for Information Technology,Aviation Capacity and AerospaceOperation Systems, which hasoperated the ASRS since it was

established in 1976. When a VAhealth-care worker either makes orwitnesses a mistake, he or she will beable to fill out a form describing theincident, including their name andphone number on a removablesection of the form.

A NASA medical expert willreview the report and contact theemployee if clarifications or addi-tional information are needed. TheNASA analyst will then remove theemployee’s name and phone numberbefore entering the report in adatabase, allowing the employee toremain anonymous and free frombeing personally penalized for theerror.

The data collected can then beanalyzed for patterns, and alerts canbe issued. The goal is to focus oninstalling safeguards against mis-takes, instead of placing blame,according to Dr. James Bagian,director of VA’s National Center forPatient Safety.

Dr. Thomas Garthwaite, VA’sActing Under Secretary for Health,signed the agreement on behalf ofVA, while Dr. Henry McDonald,director of NASA’s Ames ResearchCenter, signed on behalf of the spaceagency. VA will provide NASA $8.2million in funding to develop aprototype by 2003. ❏

VA, NASA to Develop Patient Safety Reporting System

Dr. Thomas Garthwaite, VA’s Acting Under Secretary for Health, listensto Dr. Henry McDonald, director of NASA’s Ames Research Center,during a news conference announcing the agreement.

Golden Gate chapter of the Veteransof the Battle of the Bulge and dedi-cated to the memory of the soldierswho fought in one of World War II’sbloodiest battles, is the only monu-

ment of its kind on the WestCoast. Boasting breathtakingviews of the San FranciscoBay and the Marin Head-lands, the trail is marked withthe names of the French,Belgian and Luxembourgcities involved in the Battle ofthe Bulge. Benches positionedalong the trail allow patientsand other visitors a quietplace to reflect and meditate. The civic improvementproject was led by troopmember Tony Burr, an EagleScout. He coordinated thescouts’ beautification effortswith members of the Veter-

ans of the Battle of the Bulge toensure they were in keeping with thememorial trail’s original concept.More than 19,000 Americans werekilled in the Battle of the Bulge. ❏

Boy Scouts Take on Worthy Cause at San Francisco VAMC

The Battle of the Bulge Memorial Trail was refurbished by BoyScouts from Troop #68 in time for Memorial Day.

June/July 2000 15

First Successful VA Heart/Kidney Transplant Performed

Marine veteran Bill Fish, with wife Kathy,became the recipient of the first heart andkidney transplant performed in the VAhealth-care system.

T here are currently about 62,000patients in the United States ontransplant waiting lists. ElevenAmericans die every day

because of the lack of availableorgans. Bill Fish, 53, used to be onone of those lists, but that changed inFebruary when he underwent asuccessful heart and kidney trans-plant at the Nashville VA MedicalCenter, a first in VA.

“Heart/kidney transplants arestill relatively rare,” said JavedButler, M.D., who directs the Nash-ville VAMC Transplant Service. “Aliterature search finds that onlyabout 100 have been performed todate.”

The Transplant Service is a jointventure with Vanderbilt UniversityMedical Center. The facility is theonly one in VA to perform all majororgan transplants.

Five years ago, Fish was diag-nosed with arterial blockages,requiring him to undergo quadruplecoronary artery bypass surgery. In1996, he received the news that hehad acute blockages in the renalarteries.

“While undergoing additionalbypass surgery, my doctors found

that only one of my kidneys wasworking,” recalled Fish. “I latersuffered complete renal failure andlost my single functioning kidney.”

Peritoneal dialysis sustained himas the search began for a new kidney,but Fish’s deteriorating heart pre-vented surgeons from proceedingwith a kidney transplant. His condi-tion led doctors to consider him as acandidate for both a heart andkidney transplant.

Fish, who saw action in Vietnamduring the Tet offensive, was aboutto embark on another battle for hislife. After receiving the originaldiagnosis of heart disease, hechanged jobs, only to learn that hisnew employer would not providemedical insurance.

A resident of Bloomington, Ind.,Fish transferred his care to theIndianapolis VA Medical Center.Other life changes occurred as well,including the birth of his first grand-child.

“The birth of that child, and latera second grandchild, only strength-ened my will to live and hopefullybecome a transplant candidate,” saidFish. The veteran’s worsening healthprompted the Indianapolis VAMC torefer Fish to VA’s transplantationprogram in Nashville.

Fish and his wife Kathy werehopeful when he was placed on thenational organ waiting list. Thathope was tempered, however, byfears about his deteriorating health.

Fish grew weaker with eachpassing day, suffering bouts ofperitonitis and other problemsassociated with congestive heartfailure. At the start of the new yearhe also contracted the flu and wasbedridden for weeks.

But not even the real Y2K bugcould stop a determined Fish. Hewas able to make a scheduled trip toNashville VAMC, where he wasadmitted and remained hospitalizeduntil organs became available.

Although Nashville VAMC andVanderbilt had not previouslyperformed a heart/kidney trans-plant, the medical team there waseager to break new ground. OnFebruary 5, after just one week in thehospital, Fish got the good news thata single donor match was found. Hestill has great difficulty sharing how

he felt at that moment in time.“Knowing you have the chance

for life is tempered by the fact thatyou know someone else has just losthis or her life.”

The former Marine sergeant wasvery lucky. “The most successfulheart/kidney transplants are thosewhere organs come from a singledonor,” said Butler, who is also anassistant professor of medicine atVanderbilt University MedicalCenter.

As Kathy Fish described it, fromthe moment they heard the news,“an army of medical and nursingstaff went into frenzied action, racingto make all the necessary prepara-tions prior to transplantation.”

Fish first received the hearttransplant, and then 12 hours laterreceived the kidney. The dual-organsurgical team was headed up by Drs.Davis Drinkwater and David VanBuren, who performed the heart andkidney transplants, respectively.

On February 19, Fish was re-leased from the hospital. “Bill’s post-operative course was remarkablygood,” said Butler. “His cardiacbiopsies so far have been negative,suggesting good acceptance of thedonor organ by the body.”

Butler believes that heart trans-plantation is a proven and efficaciousmodality of treatment for a selectedgroup of patients with end-stageheart failure. “All doctors shouldkeep transplantation in mind whentreating patients with this kind ofcondition.”

The Transplant Service per-formed 78 transplants (which includeliver, heart, bone marrow andkidney) in 1999, and since January ofthis year, more than 54 transplantshave been conducted.

Now that they have been given anew lease on life, Bill and Kathywant to increase public awarenessabout organ/tissue transplantationand the importance of becoming anorgan donor. A bumper sticker thathangs in the Transplant Service sumsup the Fishs’ new mantra quite well:“Don’t take your organs toheaven…heaven knows we needthem here!” ❏

By Pam HowellNashville VA Medical Center

16 VAnguard

The cremated remains of41 indigent veterans thathad languished in thePhiladelphia morgue wereburied at Indiantown GapNational Cemetery, nearHarrisburg, Pa., after amemorial service arrangedby cemetery staff with OneVA assistance.

Providing that servicefor veterans whose bodieswere unclaimed in Philadel-phia is not new for the staffat Indiantown Gap, but overthe past four years thePhiladelphia Veterans’Advisory Commission andthe medical examiner’soffice suffered a breakdownin their procedures forarranging burials. A recent inquiryfrom a family member led to thediscovery of the remains of 62 men,and a frantic effort by local officialsto have them buried quickly but withdignity and honor at IndiantownGap National Cemetery.

For nearly two weeks, CemeteryDirector Charlene R. Lewis coordi-nated with various VA regionaloffices and Calverton, N.Y., NationalCemetery staff to verify the veteranstatus of the deceased. Of the 45 thatcould be identified from information

pallbearer. In spite of heavyrain, more than 50 veteransfrom several organizationsvolunteered to deliver thehonors they believed thedead had earned throughmilitary service. These same veterans thenacted as surrogate familymembers as the crematedremains were placed in rowson a committal shelter bier,with each veteran’s foldedflag placed upright in front.When prayers and benedic-tions were finished, anhonor guard of five riflemenfrom a VFW post fired threetimes. Approximately 100people were present. Administrative staff

members Dick Orwig, Judy Sticklerand Paul Martin provided cemeteryrepresentation and organized anddirected the morning’s activities. KenArnick and the Indiantown GapNational Cemetery field staffhandled traffic control, transporta-tion and interment. Calverton staffhad helped to get the veteransidentified and burial eligibilityestablished. The VA Regional Officein Philadelphia made eligibilitydetermination a priority for its staff’stime. ❏

available from the medicalexaminer’s office, four of the veter-ans were found to have dishonorabledischarges, but the remaining 41were eligible for burial in a nationalcemetery.

A Pennsylvania National Guardchaplain provided a non-denomina-tional religious service. Three WorldWar II veterans read each of the 41names aloud as their boxed remainswere lifted from a funeral home vanand delivered, along with a foldedflag, into the hands of a veteran

Tom Shea, of VFW Post 23 in Lebanon, Pa., presents a burial flagto Jack Schuyler, nephew of one of the deceased veterans honoredduring the memorial service.

HaroldGracey, VA’sPrincipalDeputy Assis-tant Secretaryfor Informationand Technologyand acting ChiefInformationOfficer (CIO),retired at theend of May topursue a job

opportunity in the private sector.As the Department’s acting CIO,

Gracey oversaw the operation ofVA’s computer systems and telecom-munication networks for medicalinformation, veterans benefitspayments, life insurance programsand financial management systems.He was responsible for a wide areanetwork interconnecting three

centralized data centers, 172 medicalcenters, 58 benefits offices, more than600 outpatient clinics, more than 200vet centers and VA Central Office.

Gracey previously served as theDepartment’s Chief of Staff fromJanuary 1994 to June 1998. In thatposition, he served as chief advisorto the Secretary on policy mattersand worked with the Secretary andDeputy Secretary in managing theday-to-day operations of the Depart-ment. He also was VA’s liaison withthe White House Chief of Staff andchiefs of staff of other executive-branch departments.

He joined VA in 1983 as a pro-gram analysis officer with the Officeof Information Resources Manage-ment and in 1985 became the directorof the Plans and Contracts Service ofthe forerunner to the VeteransBenefits Administration. He was

41 Indigent Veterans Receive Honorable Burials

VA’s IT Chief Retires to Pursue Private Sector Opportunity

Gracey

named Executive Assistant to theChief Benefits Director (now calledUnder Secretary) in 1988 and Chiefof Staff in 1990. Gracey began hisfederal career in 1970 as a manage-ment intern with the Department ofthe Army.

The 1996 Information TechnologyManagement Reform Act mandatedthat every major federal agencyappoint a CIO to oversee technologyinvestments and development.Gracey was the first to serve in thatcapacity at VA.

At a farewell gathering held inVA Central Office, Secretary ofVeterans Affairs Togo D. West, Jr.,presented Gracey with the Excep-tional Service Award, VA’s highesthonor. He received numerous otherawards during his 30-year federalcareer. Gracey will join a startupInternet company, fedbid.com. ❏

June/July 2000 17

MEDICALadvances

Gainesville VAMC Researchers DiscoverPumping Iron Benefits Elderly Patients

Researchers from the Gainesville, Fla., VA Medical Centerand the University of Florida (UF) have discovered that pump-ing iron can help restore some independence in even the mostincapacitated elderlypatients by boostingtheir strength to thepoint where they canperform some of thesimpler tasks of dailylife. The study,appearing in theMarch issue of theArchives of PhysicalMedicine and Rehabili-tation, shows howexercise can reversemuscle weakness,reducing the fre-quency of falls andother accidents thatrequire hospital stays.

“There’s been alittle bit of fear that youmight harm olderpeople who are thisfrail, that if you pushthem too hard they’ll either strain a muscle, have a heart attack,get short of breath or that something else might happen tothem,” said Dr. John Meuleman, associate director of theGainesville VAMC’s Geriatric Research, Education and ClinicCenter and associate professor of internal medicine at UF’sCollege of Medicine. “Our study strongly suggests you can pushthese people without injury or adverse outcomes, and that theyreally enjoy doing it and get a lot stronger. It makes a big impacton the quality of their lives.”

The average age of the study participants was 75 and eachinitially needed help performing one or more of 13 simple dailyliving activities like walking, bathing, dressing or eating. Abouthalf of the 58 participants were randomly assigned to theweight-training group, the other half to the control group. Theweight-training group lifted weights three times a week and didaerobic exercise twice a week for a period of four to eightweeks. The control group did not exercise.

Although few of the participants could do the aerobicexercise, the weightlifting led to some impressive results—about a 20 percent overall increase in arm and leg strength. Ayear after wrapping up the exercise program, researcherslooked at which group, the training group or the control group,required more frequent hospitalization. They found that thosewho were in the training group required fewer visits to VA

hospitals, had shorter lengths of hospitalization and also hadfewer deaths than those in the control group.

Study Shows High Fiber Diet HelpsControl Type 2 Diabetes

A study conducted by researchers from the VA North TexasHealth Care System and the University of Texas SouthwesternMedical Center (UT/SW) shows a high-fiber diet is moreeffective than the moderate-fiber diet currently recommendedby the American Diabetes Association (ADA) in controlling Type2, or adult onset, diabetes. The study appears in the May 11issue of the New England Journal of Medicine. A high-fiber dietis currently recommended for prevention of heart disease andcertain types of cancer. “Now add control of diabetes to the list,”said Dr. Abhimanyu Garg, director of the Diabetes Clinic at theDallas VA Medical Center, professor of Internal Medicine at UT/SW and principal author of the study.

In the study, researchers compared a diet consisting of theADA-recommended daily amount of fiber—25 grams—withanother diet consisting of twice that amount in 13 adults withType 2 diabetes. Each person followed either the 25 grams-a-day or the 50 grams-a-day diet for six weeks and then switchedto the other diet for another six weeks.

The researchers found that the high-fiber diet was signifi-cantly more effective in lowering blood sugar and insulinconcentrations. The high-fiber diet was also more effective atlowering blood cholesterol levels, triglyceride levels and very-low-density lipoprotein cholesterol concentrations. “The findingconcerning blood cholesterol was expected,” reported Garg,“but the surprising findings were that the high-fiber diet im-proved glucose control and the triglyceride concentration.”

Findings Encourage ResearchersBattling Fetal Alcohol Syndrome

VA Boston Healthcare System and Harvard Medical Schoolresearchers have reported in the Proceedings of the NationalAcademy of Sciences that certain long-chain alcohol moleculescan block the harmful effects of short-chain alcohols likeethanol—the kind found in alcoholic beverages—on nerve cellgrowth and development. It’s an encouraging discovery to thosebattling fetal alcohol syndrome, the leading preventable causeof mental retardation in the United States.

“The findings may lead eventually to medications thatreduce the damaging effects of alcohol in both fetal develop-ment and in adults,” said Michael Charness, M.D., chief ofNeurology at the VA Boston Healthcare System and anassociate professor in the Department of Neurology, HarvardMedical School.

The discovery occurred when Charness and HarvardMedical School Instructor Michael Wilkemeyer, Ph.D., studiedthe effects of alcohol molecules of various sizes and shapes onnerve cell adhesion. Cell adhesion is critical to normal humannervous system development. They found that smaller alcoholmolecules with fewer than five carbons (including ethanol)inhibit cell adhesion with increasing potency but that the effectabruptly ceases between four-carbon butanol and five-carbonpentanol. The researchers then introduced longer chainalcohols such as pentanol and octanol and found that the nervecells clumped together—a complete reversal of ethanol’s anti-adhesive effects. ❏

Trish Kline, an occupational therapist atthe Gainesville, Fla., VA Medical Center,supervises veteran Charles Porter, 70, ofSteinhatchee, while he works out on aweight resistance machine similar to oneused in a University of Florida/VA studyof how exercise affects the frail elderly.

18 VAnguard

HONORSand awards

Physician Executive E.Jackson Allison, Jr., M.D., ofthe Syracuse, N.Y., VAMedical Center, was desig-

nated as aFellow bythe Orderof theInterna-tionalFederationforEmer-gency

Medicine for his ongoingcontributions to the advance-ment of emergency medicineinternationally. Allison, alongwith 21 other newly desig-nated Fellows from aroundthe world, was recognized atthe 8th International Confer-ence on Emergency Medicine,held in Boston. He hastraveled extensively toadvance emergency medicinethrough education, researchand enhancing access topatient care. One of hisprojects is to promote an HIV/AIDS awareness campaign inAfrica through the use ofpublic service radio musicalmessages that he writes andperforms.

The Denver, Colo., VARegional Office received anExcellence in GovernmentAward for exceeding cus-tomer service goals byreducing the number ofabandoned calls and blockedcalls on its toll-free telephonelines. During FY 1999, theregional office’s VeteransService Center and the LoanGuaranty Division handledmore than 238,000 telephonecalls, an increase overprevious years thanks tomajor improvements intelephone service. The

Denver Federal ExecutiveBoard presented the award atthe annual Public ServiceRecognition Week awardsprogram.

Larry Reynolds, acounselor with VocationalRehabilitation & Employment(VR&E) Service at the DesMoines, Iowa VA RegionalOffice, was named IowaVeterans Small BusinessAdvocate for the year 2000.Governor Tom Vilsackpresented the award onbehalf of the Small BusinessAdministration (SBA).Reynolds’ commitment to themission of the VR&E division,where he also serves as theEmployment ServicesCoordinator, is knownthroughout the HawkeyeState. Also recognized by theSBA for his work with disabledveterans was Bruce V.Holderead, VR&E officer inthe Cleveland, Ohio, VARegional Office. A U.S. AirForce and Air National Guardveteran, Holderead wasnamed the 2000 OhioVeterans Small BusinessAdvocate of the Year.

Two long-time VAscientists were recentlyhonored at the 96th Interna-tional Conference of theAmerican Thoracic Societyheld in Toronto, Canada.Joseph H. Bates, M.D.,former chief of MedicalService at the Little Rock,Ark., VA Medical Center,received the Society’sTrudeau Medal for hiscontributions in the control,prevention and treatment oflung disease. Sami Said,M.D., associate chief of stafffor Research and Develop-

ment at the Northport, N.Y.,VA Medical Center, deliveredthe Society’s prestigiousAmberson Lecture.

Victor Gordan, M.D., aPrimary Care physician at theManchester, N.H., VAMedical Center, was selectedto receive the VolunteerClinical Faculty Award for2000 by student members ofthe Alpha Omega Alphachapter of the DartmouthMedical School. Gordan wasrecognized by both studentsand faculty for his dedicationto teaching ambulatorymedicine to students at theVA medical center.

Nicholas P. Lang, M.D.,chief of Surgical Service atthe Central ArkansasVeterans Healthcare System(Little Rock) was namedpresidentof theSouthwest-ernSurgicalCongressduring itsrecentannualmeeting. Anative of Arkansas, Lang is aprofessor of surgery at theUniversity of Arkansas forMedical Sciences and amember of the ArkansasCancer Research Centerstaff. The SouthwesternSurgical Congress is a non-profit organization withmembers in 16 statesorganized to stimulate andpromote the progress ofsurgery.

The Council of Ministersof the State of Lebanonpresented Dr. Rabih O.Darouiche, a staff physicianfor Spinal Cord Injury andInfectious Disease at theHouston VA Medical Center,with the “National Order ofCedars” for his outstandingscientific achievements. Hewas also presented the Year

2000 Albert O. Bernstein,M.D., Award by the MedicalSociety of the State of NewYork. Both honors stem fromhis research into the preven-tion of infections resultingfrom the use of medicaldevices such as catheters.Darouiche successfullydemonstrated that a centralvenous catheter coatedinternally and externally withtwo particular drugs(minocycline and rifampin)was more likely to protectagainst potentially deadlybloodstream infections.

Ronald J. Zabransky, aninternationally recognizedmicrobiologist and chief ofMicrobiology at the Cleve-land, Ohio, VA MedicalCenter, was recently electedCouncilor-at-Large for theAmerican Society for Microbi-ology. The 42,000-membersociety is the world’s largestprofessional biologicalorganization.

The Battle Creek, Mich.,VA Medical Center’s 75thAnniversary Committeereceived an Apollo Award ofExcellence from the MichiganHealthcare CommunicatorsAssociation for their 75thAnniversary entry in theSpecial Projects category.Their entry included acommemorative anniversarynewsletter, historical timeline,video documentary andseveral special events heldduring the year-long celebra-tion.

Registered nurses KathiBrophy, Susan Sucharskiand Vicki Trnavsky, from theErie, Pa., VA MedicalCenter, were recentlyhonored as outstandingnurses by the Erie CountyCouncil of Nursing as “NursesWho Make a Difference” for2000. Only 25 nurses fromthroughout the county areselected for this honor eachyear. ❏

Allison

Lang

June/July 2000 19

you heardHAVE

VA’s annual InformationTechnology Conference(ITC) is scheduled for August7-11 at the convention centerin Austin, Texas. As in pastyears, a broad range ofsessions are planned to helpVA employees maximize theirknowledge and use of VA’svital IT systems. As an addedtwist this year, the AustralianDepartment of VeteransAffairs is scheduled toparticipate, providing insightinto how another country usesinformation technology tobetter serve its veterans.Registration for the confer-ence opens on June 20 forhands-on sessions and June27 for other sessions. Hotelreservations can be madebeginning on June 12. Formore information, visit the ITCIntranet site atvaww.aac.va.gov/itc, call theITC staff at (512) 326-6025, orsend an e-mail toVAITC@mail.va.gov.

The third annual Adminis-trative ProfessionalsTraining (APT) Conference,held recently in Silver Spring,Md., drew more than 100participants representing awide range of administrativesupport staff positions ingrades 1-9. The two-dayconference was designed tosupport the competencies thatform the foundation of VA’sHigh Performance Develop-ment Model (HPDM). Ahighlight was the workshop,“Strategic Career PlanningWorkshop: Building on YourStrengths through Self-Discovery.” The facilitators,Drs. Jim Sampson and JanetLenz of Florida StateUniversity’s Center for theStudy of Technology in

Counseling and CareerDevelopment, helped theparticipants identify careeroptions and design a realisticplan of action for discoveringand reaching their fullpotential. The APT confer-ence was sponsored by theOffice of Human ResourcesManagement, VHA’s Em-ployee Education System,VBA’s Office of Training, theOffice of Resolution Manage-ment and the Office ofAdministration.

The Detroit VA MedicalCenter recently became thefirst in the nation to host anorganizational ethics work-shop. Designed for VISN 11(Ann Arbor, Mich.) executiveleadership and ethics advisorycommittee members, theworkshop provided anopportunity to review thestrategies for addressingethical issues facing VAhealth care facilities. Theprimary speaker was WilliamA. Nelson, Ph.D., EthicsEducation coordinator for theVA National Center for Ethics.Also presenting was SusanD. Goold, M.D., of the AnnArbor VA Medical Centerand associate director forEthics and Health Policy atthe University of MichiganMedical School. The work-shop emphasized proceduraljustice and the ethicalcharacter traits of integrity,courage, humility andtolerance.

In order to reduce the costof medical services and avoidthe unnecessary duplicationof facilities, staff and equip-ment, more than 100 VAfacilities are teaming up withthe Department of Defense

(DoD) on several informationtechnology projects. Toaddress automation issuesresulting from these sharingagreements, the VHA Officeof Information (OI) estab-lished an organization for VA/DoD Information Managementand Technology Sharing,located at the Washington OIField Office. Projects currentlyunderway include: the Pre-discharge Physical Examina-tion Program (P2EP)—whichcombines the military separa-tion physical with the VAcompensation and pensionphysical exam, and theGovernment Computer-basedPatient Records project—which involves creating atechnology framework thatenables the sharing of clinicalinformation between VA, DoDand the Indian Health Service.

What killed composerLudwig Van Beethoven? It’s aquestion that has puzzledhistorians and researchers formore than a century. Andnow, thanks to researchconducted by MichaelDonnenberg, M.D., a staffphysician at the BaltimoreVA Medical Center andassociate professor at theUniversity of Maryland Schoolof Medicine, that mystery hasfinally been solved. “Syphilisis a disease that best explainsBeethoven’s three mostprominent symptoms at histime of death: his deafness,eye condition and liverfailure,” says Donnenberg.His findings, published in theApril 15 edition of the Ameri-can Journal of Medicine, werepresented to more than 200medical students, physiciansand history buffs at an annualclinical pathological confer-ence sponsored by the VAMaryland Health Care Systemand the University of Mary-land School of Medicine.

Several employees fromthe Murfreesboro, Tenn., VAMedical Center contributed to

a recently published textbooktitled Evaluation of Dysphagiain Adults: Expanding theDiagnostic Options. The bookprovides answers to questionsclinicians may have whentreating patients with dysph-agia, a condition character-ized by difficulty in swallow-ing. Russell H. Mills, Ph.D.,chief of Audiology andSpeech Pathology at themedical center, served asboth editor and a contributorto the text. Mills is nationallyrecognized for his extensiveresearch and published worksin the fields of dysphagia andcomputer applications in therehabilitation of patients withstroke and head injuries.Virginia Zachary, RD, andBryan Kobylik, MSN, co-authored chapters related tonutrition, infection control anddysphagia. The book wasdeveloped to increase thedepth of knowledge regardingcore diagnostic methods andto familiarize clinicians withsome of the most promisingnew diagnostic optionsavailable.

The Nashville VAMedical Center is hoping itsnew Geriatric Research,Education and Clinical Centerwill advance knowledge aboutthe elderly and improve carefor seniors. Comprised ofresearchers from the Nash-ville and MurfreesboroVAMCs, Vanderbilt UniversityMedical Center and MeharryMedical College, the centerwill focus on issues affectingseniors such as vascularbiology, disease preventionand drug reaction in elderlypatients. Funded by a $7million VA grant, the center isone of only 20 in the country.“It is a veterans-focusedproject. But what we learn willbe beneficial to all seniors,”said Dr. Robert Dittus,assistant chief of MedicalService at the NashvilleVAMC and director of the newcenter. ❏

20 VAnguard

HEROES✩ ✩ ✩ ✩ ✩

The day started as a fun-filled afternoon at the localYMCA swimming pool, but italmost turned tragic for ayoung 11-year old girl. Shewanted to learn how to swim,so when a friend offered toteach her, she jumped at theopportunity. Together, theyventured out to the deep endof the pool, but just as theyreached the deeper water, thelesson turned into a strugglefor survival. The girl becamefrightened and began drag-ging her friend underwater.He pulled free and quicklyswam to the side of the pool.Unable to stay afloat byherself, she slowly sank to thebottom. Luckily, GrandIsland, Neb., VA MedicalCenter Police Officer KyleHughes also happened to beat the pool with his family thatafternoon. He realized that thegirl was in serious trouble andsprang into action. He quicklydove into the pool and pulledthe girl to safety. Her familywanted to put a thank-younote in the local newspaperand offered Hughes rewardmoney, but he refused both.

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When Avinash Pradhan,M.D., a service line managerfor Specialty and Diagnosticsat the Central AlabamaVeterans Health CareSystem (CAVHCS), heardabout a medication advisoryfrom Janssen Pharmaceuti-cals, he took it upon himself tospread the word throughoutVA. The advisory warned of270 significant cardiac events,including 70 deaths, reportednationwide in patients takingthe medication Propulsid(cisapride). Pradhan began by

warning both clinical staffmembers and patientsreceiving the medication inthe CAVHCS. He then notifiedVISN 7 (Atlanta) headquar-ters, which subsequentlycontacted VA Central Office inWashington, D.C. Thanks toPradhan’s actions, news ofthe advisory reached VAclinicians quickly and this mayhave prevented additionaladverse events amongpatients taking the medica-tion.

In early April, Alan“Buck” Rogers, a licensedpractical nurse at the Okla-homa City, Okla., VAMedical Center, discovered ayoung woman lying in themiddle of the street. She wasunconscious and bleedingfrom the head, so Rogersstopped to render first aid. Hebegan by calling 911, but theemergency operator placedhim on hold. Rogers couldn’twaste any time. He called theVA emergency number andspoke with operator JerryYoung. He quickly explainedthe situation and asked Youngto call for an ambulance. Theambulance arrived shortlyafterwards and transportedthe woman to a nearbyhospital.

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Lala Cornelius, M.D., aresident at the Murfreesboro,Tenn., VA Medical Centerand Meharry Medical College,recently assisted theMurfreesboro Noon RotaryClub when a Russian visitor tothe club needed medicalattention. The visitor, here ona joint U.S.-Russian endeavor

that allows Russian entrepre-neurs to visit the UnitedStates to learn more aboutbusiness operations in theircareer fields, spoke noEnglish. So, several VAemployees who belong to theclub turned to Cornelius, anative of Russia, for help. Aconsultation was arrangedand Cornelius accompaniedthe visitor to ensure that heunderstood his treatmentoptions. A treatment wasdetermined and the next day,a local orthopedist fit thepatient with orthopedic shoesand supports. Thanks to theinvolvement of Cornelius, theman received help for a footcondition that would havehampered his mobility for therest of his life.

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Professional skill, team-work and compassioncharacterized the response ofstaff at the New Mexico VAHealth Care System’sArtesia Community BasedOutpatient Clinic to a call

Joseph L. Moore, 64,former director of the VAChicago Health Care System,died April 29 of lung cancer.He served as director of theLakeside VA Medical Centerand the VA Chicago HealthCare System from 1979 to1998, where his achievementsincluded overseeing theintegration of Lakeside andWest Side VA Medical Centers into the VA ChicagoHealth Care System in 1996.

Moore retired from VA in 1998 after 43 years offederal service. He received many honors during hisVA career, including the Presidential DistinguishedExecutive Rank Award in 1986. He also was honoredby the city of Chicago, which named a section of EastHuron Street—where Lakeside VAMC is located—Joseph L. Moore Way.

He began his VA career as a GS-1 clerk/typistand rose through the ranks to VAMC director. Heserved as assistant director at several VA medicalcenters before being appointed director at Lakeside.

In Memoriam

from a distressed veteran. Itdidn’t take long for VA socialworker Gayle Morgan to getto her phone and realize thatthe veteran who said he washolding a loaded gun to hishead was deadly serious. AsMorgan spoke with thepatient, she discovered hewas at his home in Roswell,N.M. She talked with him foran hour and forty-five min-utes, and during their conver-sation two other clinicpersonnel, Charlotte Schiel,contract L.P.N., and RobbieHarwell, L.P.N., called theRoswell Police Departmentand relayed informationbetween Morgan and thepolice. Morgan eventuallytalked the patient intodropping his gun and steppingoutside to surrender to policeand the Emergency MedicalSystem (EMS) team awaitinghim. Police later told Morganthey feared the crisis couldhave turned into a hostagesituation after they discoveredthe patient’s wife was also inthe house. ❏

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Moore