2016 ANNUAL REPORT

TRANSFORMING VETERANSrsquo HEALTH CARE ACCESS QUALITY amp INNOVATION

DIRECTORrsquoS MESSAGE

EXECUTIVE LEADERSHIP (Lndash R)

Robert M Smith MD

DirectorChief Executive Ocer

Cynthia E Abair MHA Associate Director

Carmen Concepcion MSN MHA RN Associate Director Patient Care ServicesNurse Executive

Kathleen Kim MD MPH

Acting Chief of StaMedical Director

Ada YC Clark FACHE MPH VHA-CM

Assistant Director

Every day Veterans look to and trust the VA San Diego Healthcare System (VASDHS) for the care and services they need We are committed to addressing the unique needs of Veterans and providing timely and compassionate care of outstanding quality This year we signicantly improved access to care by expanding appointments into evenings and weekends We also increased use of the Veterans Choice network in areas where we did not have internal capacity We continue to demonstrate strong clinical and patient safety excellence with metrics that are comparable to or better than private sector hospitals We know working ldquosmarterrdquo is the way to improve our eectiveness and we are committed to using new technologies such as telehealth e-screening and other innovations to improve access and Veteran satisfaction

On a personal note while I have been associated with VASDHS for more than 35 years dating back to my own clinical training I only assumed the role of Director last summer To both the Veterans we serve and to our sta I promise that I will listen and work diligently at your side My goal is that both Veterans and sta regard VASDHS as ldquotheir VArdquo and take pride in our accomplishments and reputation

Robert M Smith MD DirectorChief Executive Ocer VA San Diego Healthcare System VA Desert Pacic Healthcare Network

PROFILE The VA San Diego Healthcare System provides a wide range of inpatient and outpatient I CARE

DEPARTMENT OF VETERANS AFFAIRS health services at the medical center in La Jolla at six community clinics located in Chula Vista Escondido Imperial Valley Mission Valley Oceanside Sorrento Valley

VA Core Values and at the Rio Clinic We provide medical surgical mental health geriatric spinal cord injury and Characteristics and advanced rehabilitation services VASDHS has 296 authorized hospital beds including I CARE skilled nursing beds and operates several regional referral programs including cardiovascular

surgery and spinal cord injury Integrity

Commitment We are aliated with the University of California San Diego School of Medicine and provide training for 1440 medical interns residents and fellows as well as 751 other health profession Advocacy trainees in areas such as nursing pharmacy dental and dietetics VASDHS has one of the

Respect largest research programs in the VA nationally with a budget of $413 million 210 principal Excellence investigators and 698 projects

FINANCIAL REPORT amp STATISTICS

BUDGET amp VETERANS SERVED

200 225 250 275 300 325 350 375 400 425 450 475 500 525 550 575 600 625 650 675 700 725 BUDGET DOLLARS (in millions)

Fiscal Year

2016

$708024474

82940

Fiscal Year

2015

$668080975

82695

Fiscal Year

2014

$650824608

NUMBER OF VETERANS SERVED (in thousands)

78989

44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86

BUDGET FY 2016 (10115 ndash 93016) Operating Expenses $708024474

Salaries Wages amp Benets $376011091 Services $135170348 Supplies $100619497 Other Expenses $96223538

STAFFING STATISTICS (FTE = Full Time Equivalent) Employees (FTE) 2988

Physicians (FTE) 259 RNs (FTE) 622 Other (FTE) 2107

EDUCATION STATISTICS Total 2191

Medical Residents amp Students 1440 Other Clinical Trainees 751

VOLUNTEER STATISTICS Volunteers 1553

Volunteer Hours 96979

Donations (cash and non-cash) $1764593

RESEARCH STATISTICS Total Research Funding $41300000

Principal Investigators 210

Research Projects 698

WORKLOAD STATISTICS Medical Center Beds Total (authorized) 296

Acute 134 Community Living Center 43 Spinal Cord Injury 50 Domiciliary 69

Admissions Total 7301 Acute 6763 Community Living Center 262 Domiciliary 276

Patient Days Total 87742 Acute 65616 Community Living Center 5787 Domiciliary 16339

Average Length of Stay Acute 8 Days Community Living Center 18 Days Domiciliary 36 Days

Surgeries Total 4421 Inpatient 1787 Outpatient 2634

Outpatient Visits Total 946741 Chula Vista Clinic 31975 Escondido Clinic 20070 Imperial Valley Clinic 5885 La Jolla Medical Center 633244 Mission Valley Clinic 160624 Oceanside Clinic 94943

Patients 82940

Number of Veterans in San Diego and Imperial Counties Total (estimated) 232910

San Diego 225299 Imperial Valley 7611

ALTERNATIVE REVENUE VASDHS collected $31 million composed of $284 million in Medical Care Cost Funds (MCCF) plus external sharing revenue of $26 million These funds stay at our local facility to enhance services for San Diego Veterans

AWARDS amp ACCOMPLISHMENTS 2016

VHA VISION VHA MISSION bull VHA will continue to be the benchmark of excellence and Honor Americarsquos Veterans by providing

value in health care and benets by providing exemplary exceptional health care that improves services that are both patient-centered and evidence-based their health and well-being

bull This care will be delivered by engaged collaborative teams in an integrated environment that supports learning discovery and continuous improvement

bull It will emphasize prevention and population health and contribute to the Nationrsquos well-being through education research and service in national emergencies

ACCESS QU VA San Diego Healthcare System (VASDHS) received the

2016 Press Ganey National Database of Nursing Quality Indicators (NDNQI) Award for Outstanding Nursing Quality This recognition is awarded annually to the best-performing hospitals in six distinct categories

NDNQIreg AWARD FOR OUTSTANDING NURSING QUALITY (ACADEMIC CATEGORY)

VA San Diego was recognized in the academic category from a field of 194 academic medical centers nationwide The award is determined using a variety of quality measures for nursing such as nursing care hours clinical outcomes and registered nurse satisfaction scores Nursing representatives received the award at a national ceremony held in Orlando Florida on November 3 2016

GREEN AWARDS

ENERGY STAR AWARD VASDHS received the 2016 ENERGY STAR award for the 6th year for our reduced energy usage and the sustained operation of our co-generation plant By implementing new energy efficiency measures such as LED lighting and by generating a large percentage of our own electricity VASDHS was able to maintain low levels of

energy consumption In 2016 only 35 hospitals in the country were ENERGY STAR-certified in recognition of being among the top 25 of hospitals that reduced energy consumption Of those hospitals receiving the ENERGY STAR only three are VA Medical Centers

GREENHEALTH EMERALD AWARD VASDHS was the 2016 winner of the Greenhealth Emerald Award for the organizationrsquos ongoing commitment to improving its environmental performance and in realizing a top standard of excellence in sustainability

VETERANS HEALTH ADMINISTRATION (VHA) COMMUNICATIONS AWARD The VASDHS Public Affairs team received the 2016 VHA first place award for their communication campaign for the Vietnam War 50th Anniversary event held March 29 2016

HEALTHCARE EQUALITY INDEX AWARD The Human Rights Campaign Foundation the educational arm of the countryrsquos largest lesbian gay bisexual and transgender (LGBT) civil rights organization recognized VASDHS as a Leader in the LGBT Healthcare Equality Index 2016

VHA PHARMACISTS AWARD Two VASDHS pharmacists were members of teams receiving the 2015 VA Under Secretary for Health Annual Advancement of Pharmacy Programs Awards Maggie Mendes PharmD received the Excellence in Pharmacy Practice Award (Consolidated Mail-Out Pharmacy) Specialty Pharmacy Initiative Tung Le PharmD received the Pharmacy Benefits Management Innovation Award part of The PhARMD Project (Pharmacists Achieve Results with Medications Documentation)

VHA INNOVATION AWARD VASDHS received the 2016 VHA Diffusion of Excellence Gold Award for their eScreening program The development of eScreening a mobile technology interfacing with VArsquos Computerized Medical Record System for immediate documentation leads to improved care coordination business processes Veteran satisfaction rates and clinical impact

QUALITY amp INNOV VHA SOCIAL WORKER AWARD Deborah Dominick LCSW was given the VHA Under Secretary for Health Award for Excellence in Social Work Leadership As a result of her leadership and tireless work ethic VASDHSrsquos ASPIRE Center is considered a national ldquobest practicerdquo in the rehabilitation of Veterans returning from Iraq and Afghanistan

NURSING DAISY AWARD Twelve VASDHS nurses received the Daisy Award in fiscal year 2016 DAISY is an international non-profit organization that recognizes nurses for their outstanding contributions in providing excellent and compassionate care

2016 NATIONAL VETERANS SUMMER SPORTS CLINIC VASDHS hosted the 9th National Veterans Summer Sports Clinic September 18-23 2016 More than 100 Veterans recovering from injury participated in sports recreational activities and therapy programs

CULTURAL TRANSFORMATION As part of our ongoing Culture of Excellence initiative VASDHS conducted employee training sessions ldquoLeaders Developing Leaders (LDL)rdquo and ldquoReigniting the Spirit of Caringrdquo The LDL team also launched a facility-wide program to improve how our employees greet Veterans

The Relationship-Based Care teams completed approximately 80 projects in 2016 focused on improving the Veteran experience

SAN DIEGO IS NAMED VA CENTER FOR INNOVATION IN 2016 San Diego was named a member of the VA Innovators Network this year The program began nationally as a pilot in 2015 and seeks to build and empower a community of VA employees who are actively engaged in moving the agency forward This community facilitates collaboration and enables colleagues to share ideas challenges and opportunities and to test and validate best practices

SYSTEMS REDESIGN Systems Redesign (SR) and Lean practices enables staff to eliminate work that has less value in patient care and focuses on improving quality safety and efficiency Over 300 staff members completed SRLean process improvement training bull Improvements in clinical areas include

reduction of hospital acquired infections improved access to care and improved patient flow for patients

bull Administrative process improvements include streamlining release of information processes and reducing process times for onboarding of staff

CONSTRUCTION

VASDHS COMPLETED THE FOLLOWING RENOVATION PROJECTS bull Research facility (6 South CampD-Pod) bull Community Living Center Single Patient

Rooms (4 South) bull Ambulatory Clinics (Phases 2 amp 2A) bull Surgery Suites and Post Anesthesia Care Unit bull Transition Center (Phase 3) bull Elevator Upgrade bull Front Lobby (Phase 1) bull Emergency Department (Phase 3) bull Nuclear Medicine (4 West) bull Occupational TherapyPhysical Therapy Center

We completed construction of Parking Garage 1

The Chula Vista Clinic moved to a new temporary location

INNOVATION IMPROVING ACCESS TO CARE VASDHS IMPLEMENTED INITIATIVES TO IMPROVE ACCESS bull Started direct appointment scheduling

for Audiology and Optometry bull Added evening and weekend clinics bull Increased our Veterans CHOICE

provider network allowing more Veterans access in the community when the VA cannot meet their needs

bull Conducted Access Stand Down events to review all appointments over 60 days and to make sure Veteransare scheduled promptly

bull Started implementing same-day service to respond to the Veteran and address their needs within one day

ACCESS IMPROVEMENTS IN FISCAL YEAR 2016 bull Reduced the number of Veterans on the electronic wait list by 86

(from 1015 Veterans to 140 Veterans) bull Reduced the number of appointments pending more than 30 days by 21 (from 10816 to 8544)

bull Fiscal Year 2015 vs Fiscal Year 2016 wait times Primary Care 35 days to 27 days Specialty Care 75 days to 76 days Mental Health Care 69 days to 52 days

86 WAIT LIST REDUCTION

1200

1100

1000

900

800

700

600

500

400

300

200

100

0

1015

Number of Veterans on the electronic wait list 140

October 1 2015 September 30 2016

21 REDUCTION IN PENDING APPOINTMENTS

12000

11000

10000

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

October 1 2015 September 30 2016

NUMBER OF HOMELESS VETERANS DROPPED IN 2016 The 2016 annual Point In Time Count conducted by the Regional Task Force on the Homeless reported in May that Veteran homelessness in San Diego decreased by 162 compared to last year with decreases in both sheltered (down 221 ndash this number reflects the 1-year trend the 5-year trend is 228) and unsheltered (down 92 ndash this number reflects the 1-year trend the 5-year trend is 387) among Veterans This improvement is a credit to our Homeless Veterans Outreach team

SHELTERED

UNSHELTERED

221 228

1-YEAR

1-YEAR

5-YEAR

5-YEAR

92 387

percentages decreased overall

FY15 VS FY16 APPOINTMENT WAIT TIMES IN DAYS

8

7

6

5

4

3

2

1

0

FY15 FY16

Primary Care

FY15 FY16

Specialty Care

FY15 FY16

Mental Health

Care

35

75 76

69 52

27

10816

8544

Number of appointments pending more than 30 days

CLINICS VA Chula Vista Clinic 865 Third Avenue Chula Vista CA 91910 (619) 409-1600

VA Escondido Clinic 815 East Pennsylvania Avenue Escondido CA 92025 (760) 466-7020

VA Imperial Valley Clinic 1600 South Imperial Avenue El Centro CA 92243 (760) 352-1506

VA Mission Valley Clinic 8810 Rio San Diego Drive San Diego CA 92108 (619) 400-5000

VA Oceanside Clinic 1300 Rancho del Oro Drive Oceanside CA 92056 (760) 643-2000

VA Sorrento Valley Clinic 10455 Sorrento Valley Road San Diego CA 92121 (858) 657-1980

VA Rio Clinic 8989 Rio San Diego Suite 360 San Diego CA 92108 (619) 228-8000

VA ASPIRE CENTER 2121 San Diego Avenue San Diego CA 92110 (858) 297-8397

VET CENTERS San Diego Vet Center 2790 Truxtun Road Suite 130 San Diego CA 92106 (858) 642-1500

San Marcos Vet Center One Civic Center Drive Suite 150 San Marcos CA 92069 (760) 744-6914

Chula Vista Vet Center 180 Otay Lakes Road Suite 108 Bonita CA 91902 (877) 618-6534

WEB ADDRESSES For more information visit us at wwwsandiegovagov wwwfacebookcomVASanDiego wwwtwittercomVASanDiego

24-HOUR NURSE ADVICE LINE (877) 252-4866

ENROLLMENT amp ELIGIBILITY QUESTIONS (858) 552-7523

APPOINTMENT SCHEDULING (858) 552-7475

MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego CA 92161 (858) 552-8585 (800) 331-VETS (8387)

ACCREDITATION amp CERTIFICATION bull The Joint Commission bull Commission on Accreditation of Rehabilitation

Facilities (CARF) Aspire Center Spinal Cord Injury Medical Rehabilitation Wellness and Vocational Rehabilitation Enhancement Homeless Veterans Programs and Substance Abuse Recovery and Rehabilitation Treatment Program

bull College of American Pathologists bull American College of Radiology (ACR)

Mammography CT and MRI

bull American Association for Accreditation of Laboratory Animal Care (AAALAC)

bull Nuclear Regulatory Commission bull American Association of Blood Banks (AABB) bull US Food and Drug Administration (FDA)

Registered Blood Bank and Mammography Program

bull Clinical Laboratory Improvement Act (CLIA) bull Drug Enforcement Agency (DEA)

GPO

US G

OVERN

MEN

T PRINTIN

G O

FFICE 2016 ndash 000-000

DIRECTORrsquoS MESSAGE

EXECUTIVE LEADERSHIP (Lndash R)

Robert M Smith MD

DirectorChief Executive Ocer

Cynthia E Abair MHA Associate Director

Carmen Concepcion MSN MHA RN Associate Director Patient Care ServicesNurse Executive

Kathleen Kim MD MPH

Acting Chief of StaMedical Director

Ada YC Clark FACHE MPH VHA-CM

Assistant Director

Every day Veterans look to and trust the VA San Diego Healthcare System (VASDHS) for the care and services they need We are committed to addressing the unique needs of Veterans and providing timely and compassionate care of outstanding quality This year we signicantly improved access to care by expanding appointments into evenings and weekends We also increased use of the Veterans Choice network in areas where we did not have internal capacity We continue to demonstrate strong clinical and patient safety excellence with metrics that are comparable to or better than private sector hospitals We know working ldquosmarterrdquo is the way to improve our eectiveness and we are committed to using new technologies such as telehealth e-screening and other innovations to improve access and Veteran satisfaction

On a personal note while I have been associated with VASDHS for more than 35 years dating back to my own clinical training I only assumed the role of Director last summer To both the Veterans we serve and to our sta I promise that I will listen and work diligently at your side My goal is that both Veterans and sta regard VASDHS as ldquotheir VArdquo and take pride in our accomplishments and reputation

Robert M Smith MD DirectorChief Executive Ocer VA San Diego Healthcare System VA Desert Pacic Healthcare Network

PROFILE The VA San Diego Healthcare System provides a wide range of inpatient and outpatient I CARE

DEPARTMENT OF VETERANS AFFAIRS health services at the medical center in La Jolla at six community clinics located in Chula Vista Escondido Imperial Valley Mission Valley Oceanside Sorrento Valley

VA Core Values and at the Rio Clinic We provide medical surgical mental health geriatric spinal cord injury and Characteristics and advanced rehabilitation services VASDHS has 296 authorized hospital beds including I CARE skilled nursing beds and operates several regional referral programs including cardiovascular

surgery and spinal cord injury Integrity

Commitment We are aliated with the University of California San Diego School of Medicine and provide training for 1440 medical interns residents and fellows as well as 751 other health profession Advocacy trainees in areas such as nursing pharmacy dental and dietetics VASDHS has one of the

Respect largest research programs in the VA nationally with a budget of $413 million 210 principal Excellence investigators and 698 projects

FINANCIAL REPORT amp STATISTICS

BUDGET amp VETERANS SERVED

200 225 250 275 300 325 350 375 400 425 450 475 500 525 550 575 600 625 650 675 700 725 BUDGET DOLLARS (in millions)

Fiscal Year

2016

$708024474

82940

Fiscal Year

2015

$668080975

82695

Fiscal Year

2014

$650824608

NUMBER OF VETERANS SERVED (in thousands)

78989

44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86

BUDGET FY 2016 (10115 ndash 93016) Operating Expenses $708024474

Salaries Wages amp Benets $376011091 Services $135170348 Supplies $100619497 Other Expenses $96223538

STAFFING STATISTICS (FTE = Full Time Equivalent) Employees (FTE) 2988

Physicians (FTE) 259 RNs (FTE) 622 Other (FTE) 2107

EDUCATION STATISTICS Total 2191

Medical Residents amp Students 1440 Other Clinical Trainees 751

VOLUNTEER STATISTICS Volunteers 1553

Volunteer Hours 96979

Donations (cash and non-cash) $1764593

RESEARCH STATISTICS Total Research Funding $41300000

Principal Investigators 210

Research Projects 698

WORKLOAD STATISTICS Medical Center Beds Total (authorized) 296

Acute 134 Community Living Center 43 Spinal Cord Injury 50 Domiciliary 69

Admissions Total 7301 Acute 6763 Community Living Center 262 Domiciliary 276

Patient Days Total 87742 Acute 65616 Community Living Center 5787 Domiciliary 16339

Average Length of Stay Acute 8 Days Community Living Center 18 Days Domiciliary 36 Days

Surgeries Total 4421 Inpatient 1787 Outpatient 2634

Outpatient Visits Total 946741 Chula Vista Clinic 31975 Escondido Clinic 20070 Imperial Valley Clinic 5885 La Jolla Medical Center 633244 Mission Valley Clinic 160624 Oceanside Clinic 94943

Patients 82940

Number of Veterans in San Diego and Imperial Counties Total (estimated) 232910

San Diego 225299 Imperial Valley 7611

ALTERNATIVE REVENUE VASDHS collected $31 million composed of $284 million in Medical Care Cost Funds (MCCF) plus external sharing revenue of $26 million These funds stay at our local facility to enhance services for San Diego Veterans

AWARDS amp ACCOMPLISHMENTS 2016

VHA VISION VHA MISSION bull VHA will continue to be the benchmark of excellence and Honor Americarsquos Veterans by providing

value in health care and benets by providing exemplary exceptional health care that improves services that are both patient-centered and evidence-based their health and well-being

bull This care will be delivered by engaged collaborative teams in an integrated environment that supports learning discovery and continuous improvement

bull It will emphasize prevention and population health and contribute to the Nationrsquos well-being through education research and service in national emergencies

ACCESS QU VA San Diego Healthcare System (VASDHS) received the

2016 Press Ganey National Database of Nursing Quality Indicators (NDNQI) Award for Outstanding Nursing Quality This recognition is awarded annually to the best-performing hospitals in six distinct categories

NDNQIreg AWARD FOR OUTSTANDING NURSING QUALITY (ACADEMIC CATEGORY)

VA San Diego was recognized in the academic category from a field of 194 academic medical centers nationwide The award is determined using a variety of quality measures for nursing such as nursing care hours clinical outcomes and registered nurse satisfaction scores Nursing representatives received the award at a national ceremony held in Orlando Florida on November 3 2016

GREEN AWARDS

ENERGY STAR AWARD VASDHS received the 2016 ENERGY STAR award for the 6th year for our reduced energy usage and the sustained operation of our co-generation plant By implementing new energy efficiency measures such as LED lighting and by generating a large percentage of our own electricity VASDHS was able to maintain low levels of

energy consumption In 2016 only 35 hospitals in the country were ENERGY STAR-certified in recognition of being among the top 25 of hospitals that reduced energy consumption Of those hospitals receiving the ENERGY STAR only three are VA Medical Centers

GREENHEALTH EMERALD AWARD VASDHS was the 2016 winner of the Greenhealth Emerald Award for the organizationrsquos ongoing commitment to improving its environmental performance and in realizing a top standard of excellence in sustainability

VETERANS HEALTH ADMINISTRATION (VHA) COMMUNICATIONS AWARD The VASDHS Public Affairs team received the 2016 VHA first place award for their communication campaign for the Vietnam War 50th Anniversary event held March 29 2016

HEALTHCARE EQUALITY INDEX AWARD The Human Rights Campaign Foundation the educational arm of the countryrsquos largest lesbian gay bisexual and transgender (LGBT) civil rights organization recognized VASDHS as a Leader in the LGBT Healthcare Equality Index 2016

VHA PHARMACISTS AWARD Two VASDHS pharmacists were members of teams receiving the 2015 VA Under Secretary for Health Annual Advancement of Pharmacy Programs Awards Maggie Mendes PharmD received the Excellence in Pharmacy Practice Award (Consolidated Mail-Out Pharmacy) Specialty Pharmacy Initiative Tung Le PharmD received the Pharmacy Benefits Management Innovation Award part of The PhARMD Project (Pharmacists Achieve Results with Medications Documentation)

VHA INNOVATION AWARD VASDHS received the 2016 VHA Diffusion of Excellence Gold Award for their eScreening program The development of eScreening a mobile technology interfacing with VArsquos Computerized Medical Record System for immediate documentation leads to improved care coordination business processes Veteran satisfaction rates and clinical impact

QUALITY amp INNOV VHA SOCIAL WORKER AWARD Deborah Dominick LCSW was given the VHA Under Secretary for Health Award for Excellence in Social Work Leadership As a result of her leadership and tireless work ethic VASDHSrsquos ASPIRE Center is considered a national ldquobest practicerdquo in the rehabilitation of Veterans returning from Iraq and Afghanistan

NURSING DAISY AWARD Twelve VASDHS nurses received the Daisy Award in fiscal year 2016 DAISY is an international non-profit organization that recognizes nurses for their outstanding contributions in providing excellent and compassionate care

2016 NATIONAL VETERANS SUMMER SPORTS CLINIC VASDHS hosted the 9th National Veterans Summer Sports Clinic September 18-23 2016 More than 100 Veterans recovering from injury participated in sports recreational activities and therapy programs

CULTURAL TRANSFORMATION As part of our ongoing Culture of Excellence initiative VASDHS conducted employee training sessions ldquoLeaders Developing Leaders (LDL)rdquo and ldquoReigniting the Spirit of Caringrdquo The LDL team also launched a facility-wide program to improve how our employees greet Veterans

The Relationship-Based Care teams completed approximately 80 projects in 2016 focused on improving the Veteran experience

SAN DIEGO IS NAMED VA CENTER FOR INNOVATION IN 2016 San Diego was named a member of the VA Innovators Network this year The program began nationally as a pilot in 2015 and seeks to build and empower a community of VA employees who are actively engaged in moving the agency forward This community facilitates collaboration and enables colleagues to share ideas challenges and opportunities and to test and validate best practices

SYSTEMS REDESIGN Systems Redesign (SR) and Lean practices enables staff to eliminate work that has less value in patient care and focuses on improving quality safety and efficiency Over 300 staff members completed SRLean process improvement training bull Improvements in clinical areas include

reduction of hospital acquired infections improved access to care and improved patient flow for patients

bull Administrative process improvements include streamlining release of information processes and reducing process times for onboarding of staff

CONSTRUCTION

VASDHS COMPLETED THE FOLLOWING RENOVATION PROJECTS bull Research facility (6 South CampD-Pod) bull Community Living Center Single Patient

Rooms (4 South) bull Ambulatory Clinics (Phases 2 amp 2A) bull Surgery Suites and Post Anesthesia Care Unit bull Transition Center (Phase 3) bull Elevator Upgrade bull Front Lobby (Phase 1) bull Emergency Department (Phase 3) bull Nuclear Medicine (4 West) bull Occupational TherapyPhysical Therapy Center

We completed construction of Parking Garage 1

The Chula Vista Clinic moved to a new temporary location

INNOVATION IMPROVING ACCESS TO CARE VASDHS IMPLEMENTED INITIATIVES TO IMPROVE ACCESS bull Started direct appointment scheduling

for Audiology and Optometry bull Added evening and weekend clinics bull Increased our Veterans CHOICE

provider network allowing more Veterans access in the community when the VA cannot meet their needs

bull Conducted Access Stand Down events to review all appointments over 60 days and to make sure Veteransare scheduled promptly

bull Started implementing same-day service to respond to the Veteran and address their needs within one day

ACCESS IMPROVEMENTS IN FISCAL YEAR 2016 bull Reduced the number of Veterans on the electronic wait list by 86

(from 1015 Veterans to 140 Veterans) bull Reduced the number of appointments pending more than 30 days by 21 (from 10816 to 8544)

bull Fiscal Year 2015 vs Fiscal Year 2016 wait times Primary Care 35 days to 27 days Specialty Care 75 days to 76 days Mental Health Care 69 days to 52 days

86 WAIT LIST REDUCTION

1200

1100

1000

900

800

700

600

500

400

300

200

100

0

1015

Number of Veterans on the electronic wait list 140

October 1 2015 September 30 2016

21 REDUCTION IN PENDING APPOINTMENTS

12000

11000

10000

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

October 1 2015 September 30 2016

NUMBER OF HOMELESS VETERANS DROPPED IN 2016 The 2016 annual Point In Time Count conducted by the Regional Task Force on the Homeless reported in May that Veteran homelessness in San Diego decreased by 162 compared to last year with decreases in both sheltered (down 221 ndash this number reflects the 1-year trend the 5-year trend is 228) and unsheltered (down 92 ndash this number reflects the 1-year trend the 5-year trend is 387) among Veterans This improvement is a credit to our Homeless Veterans Outreach team

SHELTERED

UNSHELTERED

221 228

1-YEAR

1-YEAR

5-YEAR

5-YEAR

92 387

percentages decreased overall

FY15 VS FY16 APPOINTMENT WAIT TIMES IN DAYS

8

7

6

5

4

3

2

1

0

FY15 FY16

Primary Care

FY15 FY16

Specialty Care

FY15 FY16

Mental Health

Care

35

75 76

69 52

27

10816

8544

Number of appointments pending more than 30 days

CLINICS VA Chula Vista Clinic 865 Third Avenue Chula Vista CA 91910 (619) 409-1600

VA Escondido Clinic 815 East Pennsylvania Avenue Escondido CA 92025 (760) 466-7020

VA Imperial Valley Clinic 1600 South Imperial Avenue El Centro CA 92243 (760) 352-1506

VA Mission Valley Clinic 8810 Rio San Diego Drive San Diego CA 92108 (619) 400-5000

VA Oceanside Clinic 1300 Rancho del Oro Drive Oceanside CA 92056 (760) 643-2000

VA Sorrento Valley Clinic 10455 Sorrento Valley Road San Diego CA 92121 (858) 657-1980

VA Rio Clinic 8989 Rio San Diego Suite 360 San Diego CA 92108 (619) 228-8000

VA ASPIRE CENTER 2121 San Diego Avenue San Diego CA 92110 (858) 297-8397

VET CENTERS San Diego Vet Center 2790 Truxtun Road Suite 130 San Diego CA 92106 (858) 642-1500

San Marcos Vet Center One Civic Center Drive Suite 150 San Marcos CA 92069 (760) 744-6914

Chula Vista Vet Center 180 Otay Lakes Road Suite 108 Bonita CA 91902 (877) 618-6534

WEB ADDRESSES For more information visit us at wwwsandiegovagov wwwfacebookcomVASanDiego wwwtwittercomVASanDiego

24-HOUR NURSE ADVICE LINE (877) 252-4866

ENROLLMENT amp ELIGIBILITY QUESTIONS (858) 552-7523

APPOINTMENT SCHEDULING (858) 552-7475

MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego CA 92161 (858) 552-8585 (800) 331-VETS (8387)

ACCREDITATION amp CERTIFICATION bull The Joint Commission bull Commission on Accreditation of Rehabilitation

Facilities (CARF) Aspire Center Spinal Cord Injury Medical Rehabilitation Wellness and Vocational Rehabilitation Enhancement Homeless Veterans Programs and Substance Abuse Recovery and Rehabilitation Treatment Program

bull College of American Pathologists bull American College of Radiology (ACR)

Mammography CT and MRI

bull American Association for Accreditation of Laboratory Animal Care (AAALAC)

bull Nuclear Regulatory Commission bull American Association of Blood Banks (AABB) bull US Food and Drug Administration (FDA)

Registered Blood Bank and Mammography Program

bull Clinical Laboratory Improvement Act (CLIA) bull Drug Enforcement Agency (DEA)

GPO

US G

OVERN

MEN

T PRINTIN

G O

FFICE 2016 ndash 000-000

FINANCIAL REPORT amp STATISTICS

BUDGET amp VETERANS SERVED

200 225 250 275 300 325 350 375 400 425 450 475 500 525 550 575 600 625 650 675 700 725 BUDGET DOLLARS (in millions)

Fiscal Year

2016

$708024474

82940

Fiscal Year

2015

$668080975

82695

Fiscal Year

2014

$650824608

NUMBER OF VETERANS SERVED (in thousands)

78989

44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86

BUDGET FY 2016 (10115 ndash 93016) Operating Expenses $708024474

Salaries Wages amp Benets $376011091 Services $135170348 Supplies $100619497 Other Expenses $96223538

STAFFING STATISTICS (FTE = Full Time Equivalent) Employees (FTE) 2988

Physicians (FTE) 259 RNs (FTE) 622 Other (FTE) 2107

EDUCATION STATISTICS Total 2191

Medical Residents amp Students 1440 Other Clinical Trainees 751

VOLUNTEER STATISTICS Volunteers 1553

Volunteer Hours 96979

Donations (cash and non-cash) $1764593

RESEARCH STATISTICS Total Research Funding $41300000

Principal Investigators 210

Research Projects 698

WORKLOAD STATISTICS Medical Center Beds Total (authorized) 296

Acute 134 Community Living Center 43 Spinal Cord Injury 50 Domiciliary 69

Admissions Total 7301 Acute 6763 Community Living Center 262 Domiciliary 276

Patient Days Total 87742 Acute 65616 Community Living Center 5787 Domiciliary 16339

Average Length of Stay Acute 8 Days Community Living Center 18 Days Domiciliary 36 Days

Surgeries Total 4421 Inpatient 1787 Outpatient 2634

Outpatient Visits Total 946741 Chula Vista Clinic 31975 Escondido Clinic 20070 Imperial Valley Clinic 5885 La Jolla Medical Center 633244 Mission Valley Clinic 160624 Oceanside Clinic 94943

Patients 82940

Number of Veterans in San Diego and Imperial Counties Total (estimated) 232910

San Diego 225299 Imperial Valley 7611

ALTERNATIVE REVENUE VASDHS collected $31 million composed of $284 million in Medical Care Cost Funds (MCCF) plus external sharing revenue of $26 million These funds stay at our local facility to enhance services for San Diego Veterans

AWARDS amp ACCOMPLISHMENTS 2016

VHA VISION VHA MISSION bull VHA will continue to be the benchmark of excellence and Honor Americarsquos Veterans by providing

value in health care and benets by providing exemplary exceptional health care that improves services that are both patient-centered and evidence-based their health and well-being

bull This care will be delivered by engaged collaborative teams in an integrated environment that supports learning discovery and continuous improvement

bull It will emphasize prevention and population health and contribute to the Nationrsquos well-being through education research and service in national emergencies

ACCESS QU VA San Diego Healthcare System (VASDHS) received the

2016 Press Ganey National Database of Nursing Quality Indicators (NDNQI) Award for Outstanding Nursing Quality This recognition is awarded annually to the best-performing hospitals in six distinct categories

NDNQIreg AWARD FOR OUTSTANDING NURSING QUALITY (ACADEMIC CATEGORY)

VA San Diego was recognized in the academic category from a field of 194 academic medical centers nationwide The award is determined using a variety of quality measures for nursing such as nursing care hours clinical outcomes and registered nurse satisfaction scores Nursing representatives received the award at a national ceremony held in Orlando Florida on November 3 2016

GREEN AWARDS

ENERGY STAR AWARD VASDHS received the 2016 ENERGY STAR award for the 6th year for our reduced energy usage and the sustained operation of our co-generation plant By implementing new energy efficiency measures such as LED lighting and by generating a large percentage of our own electricity VASDHS was able to maintain low levels of

energy consumption In 2016 only 35 hospitals in the country were ENERGY STAR-certified in recognition of being among the top 25 of hospitals that reduced energy consumption Of those hospitals receiving the ENERGY STAR only three are VA Medical Centers

GREENHEALTH EMERALD AWARD VASDHS was the 2016 winner of the Greenhealth Emerald Award for the organizationrsquos ongoing commitment to improving its environmental performance and in realizing a top standard of excellence in sustainability

VETERANS HEALTH ADMINISTRATION (VHA) COMMUNICATIONS AWARD The VASDHS Public Affairs team received the 2016 VHA first place award for their communication campaign for the Vietnam War 50th Anniversary event held March 29 2016

HEALTHCARE EQUALITY INDEX AWARD The Human Rights Campaign Foundation the educational arm of the countryrsquos largest lesbian gay bisexual and transgender (LGBT) civil rights organization recognized VASDHS as a Leader in the LGBT Healthcare Equality Index 2016

VHA PHARMACISTS AWARD Two VASDHS pharmacists were members of teams receiving the 2015 VA Under Secretary for Health Annual Advancement of Pharmacy Programs Awards Maggie Mendes PharmD received the Excellence in Pharmacy Practice Award (Consolidated Mail-Out Pharmacy) Specialty Pharmacy Initiative Tung Le PharmD received the Pharmacy Benefits Management Innovation Award part of The PhARMD Project (Pharmacists Achieve Results with Medications Documentation)

VHA INNOVATION AWARD VASDHS received the 2016 VHA Diffusion of Excellence Gold Award for their eScreening program The development of eScreening a mobile technology interfacing with VArsquos Computerized Medical Record System for immediate documentation leads to improved care coordination business processes Veteran satisfaction rates and clinical impact

QUALITY amp INNOV VHA SOCIAL WORKER AWARD Deborah Dominick LCSW was given the VHA Under Secretary for Health Award for Excellence in Social Work Leadership As a result of her leadership and tireless work ethic VASDHSrsquos ASPIRE Center is considered a national ldquobest practicerdquo in the rehabilitation of Veterans returning from Iraq and Afghanistan

NURSING DAISY AWARD Twelve VASDHS nurses received the Daisy Award in fiscal year 2016 DAISY is an international non-profit organization that recognizes nurses for their outstanding contributions in providing excellent and compassionate care

2016 NATIONAL VETERANS SUMMER SPORTS CLINIC VASDHS hosted the 9th National Veterans Summer Sports Clinic September 18-23 2016 More than 100 Veterans recovering from injury participated in sports recreational activities and therapy programs

CULTURAL TRANSFORMATION As part of our ongoing Culture of Excellence initiative VASDHS conducted employee training sessions ldquoLeaders Developing Leaders (LDL)rdquo and ldquoReigniting the Spirit of Caringrdquo The LDL team also launched a facility-wide program to improve how our employees greet Veterans

The Relationship-Based Care teams completed approximately 80 projects in 2016 focused on improving the Veteran experience

SAN DIEGO IS NAMED VA CENTER FOR INNOVATION IN 2016 San Diego was named a member of the VA Innovators Network this year The program began nationally as a pilot in 2015 and seeks to build and empower a community of VA employees who are actively engaged in moving the agency forward This community facilitates collaboration and enables colleagues to share ideas challenges and opportunities and to test and validate best practices

SYSTEMS REDESIGN Systems Redesign (SR) and Lean practices enables staff to eliminate work that has less value in patient care and focuses on improving quality safety and efficiency Over 300 staff members completed SRLean process improvement training bull Improvements in clinical areas include

reduction of hospital acquired infections improved access to care and improved patient flow for patients

bull Administrative process improvements include streamlining release of information processes and reducing process times for onboarding of staff

CONSTRUCTION

VASDHS COMPLETED THE FOLLOWING RENOVATION PROJECTS bull Research facility (6 South CampD-Pod) bull Community Living Center Single Patient

Rooms (4 South) bull Ambulatory Clinics (Phases 2 amp 2A) bull Surgery Suites and Post Anesthesia Care Unit bull Transition Center (Phase 3) bull Elevator Upgrade bull Front Lobby (Phase 1) bull Emergency Department (Phase 3) bull Nuclear Medicine (4 West) bull Occupational TherapyPhysical Therapy Center

We completed construction of Parking Garage 1

The Chula Vista Clinic moved to a new temporary location

INNOVATION IMPROVING ACCESS TO CARE VASDHS IMPLEMENTED INITIATIVES TO IMPROVE ACCESS bull Started direct appointment scheduling

for Audiology and Optometry bull Added evening and weekend clinics bull Increased our Veterans CHOICE

provider network allowing more Veterans access in the community when the VA cannot meet their needs

bull Conducted Access Stand Down events to review all appointments over 60 days and to make sure Veteransare scheduled promptly

bull Started implementing same-day service to respond to the Veteran and address their needs within one day

ACCESS IMPROVEMENTS IN FISCAL YEAR 2016 bull Reduced the number of Veterans on the electronic wait list by 86

(from 1015 Veterans to 140 Veterans) bull Reduced the number of appointments pending more than 30 days by 21 (from 10816 to 8544)

bull Fiscal Year 2015 vs Fiscal Year 2016 wait times Primary Care 35 days to 27 days Specialty Care 75 days to 76 days Mental Health Care 69 days to 52 days

86 WAIT LIST REDUCTION

1200

1100

1000

900

800

700

600

500

400

300

200

100

0

1015

Number of Veterans on the electronic wait list 140

October 1 2015 September 30 2016

21 REDUCTION IN PENDING APPOINTMENTS

12000

11000

10000

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

October 1 2015 September 30 2016

NUMBER OF HOMELESS VETERANS DROPPED IN 2016 The 2016 annual Point In Time Count conducted by the Regional Task Force on the Homeless reported in May that Veteran homelessness in San Diego decreased by 162 compared to last year with decreases in both sheltered (down 221 ndash this number reflects the 1-year trend the 5-year trend is 228) and unsheltered (down 92 ndash this number reflects the 1-year trend the 5-year trend is 387) among Veterans This improvement is a credit to our Homeless Veterans Outreach team

SHELTERED

UNSHELTERED

221 228

1-YEAR

1-YEAR

5-YEAR

5-YEAR

92 387

percentages decreased overall

FY15 VS FY16 APPOINTMENT WAIT TIMES IN DAYS

8

7

6

5

4

3

2

1

0

FY15 FY16

Primary Care

FY15 FY16

Specialty Care

FY15 FY16

Mental Health

Care

35

75 76

69 52

27

10816

8544

Number of appointments pending more than 30 days

CLINICS VA Chula Vista Clinic 865 Third Avenue Chula Vista CA 91910 (619) 409-1600

VA Escondido Clinic 815 East Pennsylvania Avenue Escondido CA 92025 (760) 466-7020

VA Imperial Valley Clinic 1600 South Imperial Avenue El Centro CA 92243 (760) 352-1506

VA Mission Valley Clinic 8810 Rio San Diego Drive San Diego CA 92108 (619) 400-5000

VA Oceanside Clinic 1300 Rancho del Oro Drive Oceanside CA 92056 (760) 643-2000

VA Sorrento Valley Clinic 10455 Sorrento Valley Road San Diego CA 92121 (858) 657-1980

VA Rio Clinic 8989 Rio San Diego Suite 360 San Diego CA 92108 (619) 228-8000

VA ASPIRE CENTER 2121 San Diego Avenue San Diego CA 92110 (858) 297-8397

VET CENTERS San Diego Vet Center 2790 Truxtun Road Suite 130 San Diego CA 92106 (858) 642-1500

San Marcos Vet Center One Civic Center Drive Suite 150 San Marcos CA 92069 (760) 744-6914

Chula Vista Vet Center 180 Otay Lakes Road Suite 108 Bonita CA 91902 (877) 618-6534

WEB ADDRESSES For more information visit us at wwwsandiegovagov wwwfacebookcomVASanDiego wwwtwittercomVASanDiego

24-HOUR NURSE ADVICE LINE (877) 252-4866

ENROLLMENT amp ELIGIBILITY QUESTIONS (858) 552-7523

APPOINTMENT SCHEDULING (858) 552-7475

MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego CA 92161 (858) 552-8585 (800) 331-VETS (8387)

ACCREDITATION amp CERTIFICATION bull The Joint Commission bull Commission on Accreditation of Rehabilitation

Facilities (CARF) Aspire Center Spinal Cord Injury Medical Rehabilitation Wellness and Vocational Rehabilitation Enhancement Homeless Veterans Programs and Substance Abuse Recovery and Rehabilitation Treatment Program

bull College of American Pathologists bull American College of Radiology (ACR)

Mammography CT and MRI

bull American Association for Accreditation of Laboratory Animal Care (AAALAC)

bull Nuclear Regulatory Commission bull American Association of Blood Banks (AABB) bull US Food and Drug Administration (FDA)

Registered Blood Bank and Mammography Program

bull Clinical Laboratory Improvement Act (CLIA) bull Drug Enforcement Agency (DEA)

GPO

US G

OVERN

MEN

T PRINTIN

G O

FFICE 2016 ndash 000-000

AWARDS amp ACCOMPLISHMENTS 2016

VHA VISION VHA MISSION bull VHA will continue to be the benchmark of excellence and Honor Americarsquos Veterans by providing

value in health care and benets by providing exemplary exceptional health care that improves services that are both patient-centered and evidence-based their health and well-being

bull This care will be delivered by engaged collaborative teams in an integrated environment that supports learning discovery and continuous improvement

bull It will emphasize prevention and population health and contribute to the Nationrsquos well-being through education research and service in national emergencies

ACCESS QU VA San Diego Healthcare System (VASDHS) received the

2016 Press Ganey National Database of Nursing Quality Indicators (NDNQI) Award for Outstanding Nursing Quality This recognition is awarded annually to the best-performing hospitals in six distinct categories

NDNQIreg AWARD FOR OUTSTANDING NURSING QUALITY (ACADEMIC CATEGORY)

VA San Diego was recognized in the academic category from a field of 194 academic medical centers nationwide The award is determined using a variety of quality measures for nursing such as nursing care hours clinical outcomes and registered nurse satisfaction scores Nursing representatives received the award at a national ceremony held in Orlando Florida on November 3 2016

GREEN AWARDS

ENERGY STAR AWARD VASDHS received the 2016 ENERGY STAR award for the 6th year for our reduced energy usage and the sustained operation of our co-generation plant By implementing new energy efficiency measures such as LED lighting and by generating a large percentage of our own electricity VASDHS was able to maintain low levels of

energy consumption In 2016 only 35 hospitals in the country were ENERGY STAR-certified in recognition of being among the top 25 of hospitals that reduced energy consumption Of those hospitals receiving the ENERGY STAR only three are VA Medical Centers

GREENHEALTH EMERALD AWARD VASDHS was the 2016 winner of the Greenhealth Emerald Award for the organizationrsquos ongoing commitment to improving its environmental performance and in realizing a top standard of excellence in sustainability

VETERANS HEALTH ADMINISTRATION (VHA) COMMUNICATIONS AWARD The VASDHS Public Affairs team received the 2016 VHA first place award for their communication campaign for the Vietnam War 50th Anniversary event held March 29 2016

HEALTHCARE EQUALITY INDEX AWARD The Human Rights Campaign Foundation the educational arm of the countryrsquos largest lesbian gay bisexual and transgender (LGBT) civil rights organization recognized VASDHS as a Leader in the LGBT Healthcare Equality Index 2016

VHA PHARMACISTS AWARD Two VASDHS pharmacists were members of teams receiving the 2015 VA Under Secretary for Health Annual Advancement of Pharmacy Programs Awards Maggie Mendes PharmD received the Excellence in Pharmacy Practice Award (Consolidated Mail-Out Pharmacy) Specialty Pharmacy Initiative Tung Le PharmD received the Pharmacy Benefits Management Innovation Award part of The PhARMD Project (Pharmacists Achieve Results with Medications Documentation)

VHA INNOVATION AWARD VASDHS received the 2016 VHA Diffusion of Excellence Gold Award for their eScreening program The development of eScreening a mobile technology interfacing with VArsquos Computerized Medical Record System for immediate documentation leads to improved care coordination business processes Veteran satisfaction rates and clinical impact

QUALITY amp INNOV VHA SOCIAL WORKER AWARD Deborah Dominick LCSW was given the VHA Under Secretary for Health Award for Excellence in Social Work Leadership As a result of her leadership and tireless work ethic VASDHSrsquos ASPIRE Center is considered a national ldquobest practicerdquo in the rehabilitation of Veterans returning from Iraq and Afghanistan

NURSING DAISY AWARD Twelve VASDHS nurses received the Daisy Award in fiscal year 2016 DAISY is an international non-profit organization that recognizes nurses for their outstanding contributions in providing excellent and compassionate care

2016 NATIONAL VETERANS SUMMER SPORTS CLINIC VASDHS hosted the 9th National Veterans Summer Sports Clinic September 18-23 2016 More than 100 Veterans recovering from injury participated in sports recreational activities and therapy programs

CULTURAL TRANSFORMATION As part of our ongoing Culture of Excellence initiative VASDHS conducted employee training sessions ldquoLeaders Developing Leaders (LDL)rdquo and ldquoReigniting the Spirit of Caringrdquo The LDL team also launched a facility-wide program to improve how our employees greet Veterans

The Relationship-Based Care teams completed approximately 80 projects in 2016 focused on improving the Veteran experience

SAN DIEGO IS NAMED VA CENTER FOR INNOVATION IN 2016 San Diego was named a member of the VA Innovators Network this year The program began nationally as a pilot in 2015 and seeks to build and empower a community of VA employees who are actively engaged in moving the agency forward This community facilitates collaboration and enables colleagues to share ideas challenges and opportunities and to test and validate best practices

SYSTEMS REDESIGN Systems Redesign (SR) and Lean practices enables staff to eliminate work that has less value in patient care and focuses on improving quality safety and efficiency Over 300 staff members completed SRLean process improvement training bull Improvements in clinical areas include

reduction of hospital acquired infections improved access to care and improved patient flow for patients

bull Administrative process improvements include streamlining release of information processes and reducing process times for onboarding of staff

CONSTRUCTION

VASDHS COMPLETED THE FOLLOWING RENOVATION PROJECTS bull Research facility (6 South CampD-Pod) bull Community Living Center Single Patient

Rooms (4 South) bull Ambulatory Clinics (Phases 2 amp 2A) bull Surgery Suites and Post Anesthesia Care Unit bull Transition Center (Phase 3) bull Elevator Upgrade bull Front Lobby (Phase 1) bull Emergency Department (Phase 3) bull Nuclear Medicine (4 West) bull Occupational TherapyPhysical Therapy Center

We completed construction of Parking Garage 1

The Chula Vista Clinic moved to a new temporary location

INNOVATION IMPROVING ACCESS TO CARE VASDHS IMPLEMENTED INITIATIVES TO IMPROVE ACCESS bull Started direct appointment scheduling

for Audiology and Optometry bull Added evening and weekend clinics bull Increased our Veterans CHOICE

provider network allowing more Veterans access in the community when the VA cannot meet their needs

bull Conducted Access Stand Down events to review all appointments over 60 days and to make sure Veteransare scheduled promptly

bull Started implementing same-day service to respond to the Veteran and address their needs within one day

ACCESS IMPROVEMENTS IN FISCAL YEAR 2016 bull Reduced the number of Veterans on the electronic wait list by 86

(from 1015 Veterans to 140 Veterans) bull Reduced the number of appointments pending more than 30 days by 21 (from 10816 to 8544)

bull Fiscal Year 2015 vs Fiscal Year 2016 wait times Primary Care 35 days to 27 days Specialty Care 75 days to 76 days Mental Health Care 69 days to 52 days

86 WAIT LIST REDUCTION

1200

1100

1000

900

800

700

600

500

400

300

200

100

0

1015

Number of Veterans on the electronic wait list 140

October 1 2015 September 30 2016

21 REDUCTION IN PENDING APPOINTMENTS

12000

11000

10000

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

October 1 2015 September 30 2016

NUMBER OF HOMELESS VETERANS DROPPED IN 2016 The 2016 annual Point In Time Count conducted by the Regional Task Force on the Homeless reported in May that Veteran homelessness in San Diego decreased by 162 compared to last year with decreases in both sheltered (down 221 ndash this number reflects the 1-year trend the 5-year trend is 228) and unsheltered (down 92 ndash this number reflects the 1-year trend the 5-year trend is 387) among Veterans This improvement is a credit to our Homeless Veterans Outreach team

SHELTERED

UNSHELTERED

221 228

1-YEAR

1-YEAR

5-YEAR

5-YEAR

92 387

percentages decreased overall

FY15 VS FY16 APPOINTMENT WAIT TIMES IN DAYS

8

7

6

5

4

3

2

1

0

FY15 FY16

Primary Care

FY15 FY16

Specialty Care

FY15 FY16

Mental Health

Care

35

75 76

69 52

27

10816

8544

Number of appointments pending more than 30 days

CLINICS VA Chula Vista Clinic 865 Third Avenue Chula Vista CA 91910 (619) 409-1600

VA Escondido Clinic 815 East Pennsylvania Avenue Escondido CA 92025 (760) 466-7020

VA Imperial Valley Clinic 1600 South Imperial Avenue El Centro CA 92243 (760) 352-1506

VA Mission Valley Clinic 8810 Rio San Diego Drive San Diego CA 92108 (619) 400-5000

VA Oceanside Clinic 1300 Rancho del Oro Drive Oceanside CA 92056 (760) 643-2000

VA Sorrento Valley Clinic 10455 Sorrento Valley Road San Diego CA 92121 (858) 657-1980

VA Rio Clinic 8989 Rio San Diego Suite 360 San Diego CA 92108 (619) 228-8000

VA ASPIRE CENTER 2121 San Diego Avenue San Diego CA 92110 (858) 297-8397

VET CENTERS San Diego Vet Center 2790 Truxtun Road Suite 130 San Diego CA 92106 (858) 642-1500

San Marcos Vet Center One Civic Center Drive Suite 150 San Marcos CA 92069 (760) 744-6914

Chula Vista Vet Center 180 Otay Lakes Road Suite 108 Bonita CA 91902 (877) 618-6534

WEB ADDRESSES For more information visit us at wwwsandiegovagov wwwfacebookcomVASanDiego wwwtwittercomVASanDiego

24-HOUR NURSE ADVICE LINE (877) 252-4866

ENROLLMENT amp ELIGIBILITY QUESTIONS (858) 552-7523

APPOINTMENT SCHEDULING (858) 552-7475

MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego CA 92161 (858) 552-8585 (800) 331-VETS (8387)

ACCREDITATION amp CERTIFICATION bull The Joint Commission bull Commission on Accreditation of Rehabilitation

Facilities (CARF) Aspire Center Spinal Cord Injury Medical Rehabilitation Wellness and Vocational Rehabilitation Enhancement Homeless Veterans Programs and Substance Abuse Recovery and Rehabilitation Treatment Program

bull College of American Pathologists bull American College of Radiology (ACR)

Mammography CT and MRI

bull American Association for Accreditation of Laboratory Animal Care (AAALAC)

bull Nuclear Regulatory Commission bull American Association of Blood Banks (AABB) bull US Food and Drug Administration (FDA)

Registered Blood Bank and Mammography Program

bull Clinical Laboratory Improvement Act (CLIA) bull Drug Enforcement Agency (DEA)

GPO

US G

OVERN

MEN

T PRINTIN

G O

FFICE 2016 ndash 000-000

ACCESS QU VA San Diego Healthcare System (VASDHS) received the

2016 Press Ganey National Database of Nursing Quality Indicators (NDNQI) Award for Outstanding Nursing Quality This recognition is awarded annually to the best-performing hospitals in six distinct categories

NDNQIreg AWARD FOR OUTSTANDING NURSING QUALITY (ACADEMIC CATEGORY)

VA San Diego was recognized in the academic category from a field of 194 academic medical centers nationwide The award is determined using a variety of quality measures for nursing such as nursing care hours clinical outcomes and registered nurse satisfaction scores Nursing representatives received the award at a national ceremony held in Orlando Florida on November 3 2016

GREEN AWARDS

ENERGY STAR AWARD VASDHS received the 2016 ENERGY STAR award for the 6th year for our reduced energy usage and the sustained operation of our co-generation plant By implementing new energy efficiency measures such as LED lighting and by generating a large percentage of our own electricity VASDHS was able to maintain low levels of

energy consumption In 2016 only 35 hospitals in the country were ENERGY STAR-certified in recognition of being among the top 25 of hospitals that reduced energy consumption Of those hospitals receiving the ENERGY STAR only three are VA Medical Centers

GREENHEALTH EMERALD AWARD VASDHS was the 2016 winner of the Greenhealth Emerald Award for the organizationrsquos ongoing commitment to improving its environmental performance and in realizing a top standard of excellence in sustainability

VETERANS HEALTH ADMINISTRATION (VHA) COMMUNICATIONS AWARD The VASDHS Public Affairs team received the 2016 VHA first place award for their communication campaign for the Vietnam War 50th Anniversary event held March 29 2016

HEALTHCARE EQUALITY INDEX AWARD The Human Rights Campaign Foundation the educational arm of the countryrsquos largest lesbian gay bisexual and transgender (LGBT) civil rights organization recognized VASDHS as a Leader in the LGBT Healthcare Equality Index 2016

VHA PHARMACISTS AWARD Two VASDHS pharmacists were members of teams receiving the 2015 VA Under Secretary for Health Annual Advancement of Pharmacy Programs Awards Maggie Mendes PharmD received the Excellence in Pharmacy Practice Award (Consolidated Mail-Out Pharmacy) Specialty Pharmacy Initiative Tung Le PharmD received the Pharmacy Benefits Management Innovation Award part of The PhARMD Project (Pharmacists Achieve Results with Medications Documentation)

VHA INNOVATION AWARD VASDHS received the 2016 VHA Diffusion of Excellence Gold Award for their eScreening program The development of eScreening a mobile technology interfacing with VArsquos Computerized Medical Record System for immediate documentation leads to improved care coordination business processes Veteran satisfaction rates and clinical impact

QUALITY amp INNOV VHA SOCIAL WORKER AWARD Deborah Dominick LCSW was given the VHA Under Secretary for Health Award for Excellence in Social Work Leadership As a result of her leadership and tireless work ethic VASDHSrsquos ASPIRE Center is considered a national ldquobest practicerdquo in the rehabilitation of Veterans returning from Iraq and Afghanistan

NURSING DAISY AWARD Twelve VASDHS nurses received the Daisy Award in fiscal year 2016 DAISY is an international non-profit organization that recognizes nurses for their outstanding contributions in providing excellent and compassionate care

2016 NATIONAL VETERANS SUMMER SPORTS CLINIC VASDHS hosted the 9th National Veterans Summer Sports Clinic September 18-23 2016 More than 100 Veterans recovering from injury participated in sports recreational activities and therapy programs

CULTURAL TRANSFORMATION As part of our ongoing Culture of Excellence initiative VASDHS conducted employee training sessions ldquoLeaders Developing Leaders (LDL)rdquo and ldquoReigniting the Spirit of Caringrdquo The LDL team also launched a facility-wide program to improve how our employees greet Veterans

The Relationship-Based Care teams completed approximately 80 projects in 2016 focused on improving the Veteran experience

SAN DIEGO IS NAMED VA CENTER FOR INNOVATION IN 2016 San Diego was named a member of the VA Innovators Network this year The program began nationally as a pilot in 2015 and seeks to build and empower a community of VA employees who are actively engaged in moving the agency forward This community facilitates collaboration and enables colleagues to share ideas challenges and opportunities and to test and validate best practices

SYSTEMS REDESIGN Systems Redesign (SR) and Lean practices enables staff to eliminate work that has less value in patient care and focuses on improving quality safety and efficiency Over 300 staff members completed SRLean process improvement training bull Improvements in clinical areas include

reduction of hospital acquired infections improved access to care and improved patient flow for patients

bull Administrative process improvements include streamlining release of information processes and reducing process times for onboarding of staff

CONSTRUCTION

VASDHS COMPLETED THE FOLLOWING RENOVATION PROJECTS bull Research facility (6 South CampD-Pod) bull Community Living Center Single Patient

Rooms (4 South) bull Ambulatory Clinics (Phases 2 amp 2A) bull Surgery Suites and Post Anesthesia Care Unit bull Transition Center (Phase 3) bull Elevator Upgrade bull Front Lobby (Phase 1) bull Emergency Department (Phase 3) bull Nuclear Medicine (4 West) bull Occupational TherapyPhysical Therapy Center

We completed construction of Parking Garage 1

The Chula Vista Clinic moved to a new temporary location

INNOVATION IMPROVING ACCESS TO CARE VASDHS IMPLEMENTED INITIATIVES TO IMPROVE ACCESS bull Started direct appointment scheduling

for Audiology and Optometry bull Added evening and weekend clinics bull Increased our Veterans CHOICE

provider network allowing more Veterans access in the community when the VA cannot meet their needs

bull Conducted Access Stand Down events to review all appointments over 60 days and to make sure Veteransare scheduled promptly

bull Started implementing same-day service to respond to the Veteran and address their needs within one day

ACCESS IMPROVEMENTS IN FISCAL YEAR 2016 bull Reduced the number of Veterans on the electronic wait list by 86

(from 1015 Veterans to 140 Veterans) bull Reduced the number of appointments pending more than 30 days by 21 (from 10816 to 8544)

bull Fiscal Year 2015 vs Fiscal Year 2016 wait times Primary Care 35 days to 27 days Specialty Care 75 days to 76 days Mental Health Care 69 days to 52 days

86 WAIT LIST REDUCTION

1200

1100

1000

900

800

700

600

500

400

300

200

100

0

1015

Number of Veterans on the electronic wait list 140

October 1 2015 September 30 2016

21 REDUCTION IN PENDING APPOINTMENTS

12000

11000

10000

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

October 1 2015 September 30 2016

NUMBER OF HOMELESS VETERANS DROPPED IN 2016 The 2016 annual Point In Time Count conducted by the Regional Task Force on the Homeless reported in May that Veteran homelessness in San Diego decreased by 162 compared to last year with decreases in both sheltered (down 221 ndash this number reflects the 1-year trend the 5-year trend is 228) and unsheltered (down 92 ndash this number reflects the 1-year trend the 5-year trend is 387) among Veterans This improvement is a credit to our Homeless Veterans Outreach team

SHELTERED

UNSHELTERED

221 228

1-YEAR

1-YEAR

5-YEAR

5-YEAR

92 387

percentages decreased overall

FY15 VS FY16 APPOINTMENT WAIT TIMES IN DAYS

8

7

6

5

4

3

2

1

0

FY15 FY16

Primary Care

FY15 FY16

Specialty Care

FY15 FY16

Mental Health

Care

35

75 76

69 52

27

10816

8544

Number of appointments pending more than 30 days

CLINICS VA Chula Vista Clinic 865 Third Avenue Chula Vista CA 91910 (619) 409-1600

VA Escondido Clinic 815 East Pennsylvania Avenue Escondido CA 92025 (760) 466-7020

VA Imperial Valley Clinic 1600 South Imperial Avenue El Centro CA 92243 (760) 352-1506

VA Mission Valley Clinic 8810 Rio San Diego Drive San Diego CA 92108 (619) 400-5000

VA Oceanside Clinic 1300 Rancho del Oro Drive Oceanside CA 92056 (760) 643-2000

VA Sorrento Valley Clinic 10455 Sorrento Valley Road San Diego CA 92121 (858) 657-1980

VA Rio Clinic 8989 Rio San Diego Suite 360 San Diego CA 92108 (619) 228-8000

VA ASPIRE CENTER 2121 San Diego Avenue San Diego CA 92110 (858) 297-8397

VET CENTERS San Diego Vet Center 2790 Truxtun Road Suite 130 San Diego CA 92106 (858) 642-1500

San Marcos Vet Center One Civic Center Drive Suite 150 San Marcos CA 92069 (760) 744-6914

Chula Vista Vet Center 180 Otay Lakes Road Suite 108 Bonita CA 91902 (877) 618-6534

WEB ADDRESSES For more information visit us at wwwsandiegovagov wwwfacebookcomVASanDiego wwwtwittercomVASanDiego

24-HOUR NURSE ADVICE LINE (877) 252-4866

ENROLLMENT amp ELIGIBILITY QUESTIONS (858) 552-7523

APPOINTMENT SCHEDULING (858) 552-7475

MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego CA 92161 (858) 552-8585 (800) 331-VETS (8387)

ACCREDITATION amp CERTIFICATION bull The Joint Commission bull Commission on Accreditation of Rehabilitation

Facilities (CARF) Aspire Center Spinal Cord Injury Medical Rehabilitation Wellness and Vocational Rehabilitation Enhancement Homeless Veterans Programs and Substance Abuse Recovery and Rehabilitation Treatment Program

bull College of American Pathologists bull American College of Radiology (ACR)

Mammography CT and MRI

bull American Association for Accreditation of Laboratory Animal Care (AAALAC)

bull Nuclear Regulatory Commission bull American Association of Blood Banks (AABB) bull US Food and Drug Administration (FDA)

Registered Blood Bank and Mammography Program

bull Clinical Laboratory Improvement Act (CLIA) bull Drug Enforcement Agency (DEA)

GPO

US G

OVERN

MEN

T PRINTIN

G O

FFICE 2016 ndash 000-000

QUALITY amp INNOV VHA SOCIAL WORKER AWARD Deborah Dominick LCSW was given the VHA Under Secretary for Health Award for Excellence in Social Work Leadership As a result of her leadership and tireless work ethic VASDHSrsquos ASPIRE Center is considered a national ldquobest practicerdquo in the rehabilitation of Veterans returning from Iraq and Afghanistan

NURSING DAISY AWARD Twelve VASDHS nurses received the Daisy Award in fiscal year 2016 DAISY is an international non-profit organization that recognizes nurses for their outstanding contributions in providing excellent and compassionate care

2016 NATIONAL VETERANS SUMMER SPORTS CLINIC VASDHS hosted the 9th National Veterans Summer Sports Clinic September 18-23 2016 More than 100 Veterans recovering from injury participated in sports recreational activities and therapy programs

CULTURAL TRANSFORMATION As part of our ongoing Culture of Excellence initiative VASDHS conducted employee training sessions ldquoLeaders Developing Leaders (LDL)rdquo and ldquoReigniting the Spirit of Caringrdquo The LDL team also launched a facility-wide program to improve how our employees greet Veterans

The Relationship-Based Care teams completed approximately 80 projects in 2016 focused on improving the Veteran experience

SAN DIEGO IS NAMED VA CENTER FOR INNOVATION IN 2016 San Diego was named a member of the VA Innovators Network this year The program began nationally as a pilot in 2015 and seeks to build and empower a community of VA employees who are actively engaged in moving the agency forward This community facilitates collaboration and enables colleagues to share ideas challenges and opportunities and to test and validate best practices

SYSTEMS REDESIGN Systems Redesign (SR) and Lean practices enables staff to eliminate work that has less value in patient care and focuses on improving quality safety and efficiency Over 300 staff members completed SRLean process improvement training bull Improvements in clinical areas include

reduction of hospital acquired infections improved access to care and improved patient flow for patients

bull Administrative process improvements include streamlining release of information processes and reducing process times for onboarding of staff

CONSTRUCTION

VASDHS COMPLETED THE FOLLOWING RENOVATION PROJECTS bull Research facility (6 South CampD-Pod) bull Community Living Center Single Patient

Rooms (4 South) bull Ambulatory Clinics (Phases 2 amp 2A) bull Surgery Suites and Post Anesthesia Care Unit bull Transition Center (Phase 3) bull Elevator Upgrade bull Front Lobby (Phase 1) bull Emergency Department (Phase 3) bull Nuclear Medicine (4 West) bull Occupational TherapyPhysical Therapy Center

We completed construction of Parking Garage 1

The Chula Vista Clinic moved to a new temporary location

INNOVATION IMPROVING ACCESS TO CARE VASDHS IMPLEMENTED INITIATIVES TO IMPROVE ACCESS bull Started direct appointment scheduling

for Audiology and Optometry bull Added evening and weekend clinics bull Increased our Veterans CHOICE

provider network allowing more Veterans access in the community when the VA cannot meet their needs

bull Conducted Access Stand Down events to review all appointments over 60 days and to make sure Veteransare scheduled promptly

bull Started implementing same-day service to respond to the Veteran and address their needs within one day

ACCESS IMPROVEMENTS IN FISCAL YEAR 2016 bull Reduced the number of Veterans on the electronic wait list by 86

(from 1015 Veterans to 140 Veterans) bull Reduced the number of appointments pending more than 30 days by 21 (from 10816 to 8544)

bull Fiscal Year 2015 vs Fiscal Year 2016 wait times Primary Care 35 days to 27 days Specialty Care 75 days to 76 days Mental Health Care 69 days to 52 days

86 WAIT LIST REDUCTION

1200

1100

1000

900

800

700

600

500

400

300

200

100

0

1015

Number of Veterans on the electronic wait list 140

October 1 2015 September 30 2016

21 REDUCTION IN PENDING APPOINTMENTS

12000

11000

10000

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

October 1 2015 September 30 2016

NUMBER OF HOMELESS VETERANS DROPPED IN 2016 The 2016 annual Point In Time Count conducted by the Regional Task Force on the Homeless reported in May that Veteran homelessness in San Diego decreased by 162 compared to last year with decreases in both sheltered (down 221 ndash this number reflects the 1-year trend the 5-year trend is 228) and unsheltered (down 92 ndash this number reflects the 1-year trend the 5-year trend is 387) among Veterans This improvement is a credit to our Homeless Veterans Outreach team

SHELTERED

UNSHELTERED

221 228

1-YEAR

1-YEAR

5-YEAR

5-YEAR

92 387

percentages decreased overall

FY15 VS FY16 APPOINTMENT WAIT TIMES IN DAYS

8

7

6

5

4

3

2

1

0

FY15 FY16

Primary Care

FY15 FY16

Specialty Care

FY15 FY16

Mental Health

Care

35

75 76

69 52

27

10816

8544

Number of appointments pending more than 30 days

CLINICS VA Chula Vista Clinic 865 Third Avenue Chula Vista CA 91910 (619) 409-1600

VA Escondido Clinic 815 East Pennsylvania Avenue Escondido CA 92025 (760) 466-7020

VA Imperial Valley Clinic 1600 South Imperial Avenue El Centro CA 92243 (760) 352-1506

VA Mission Valley Clinic 8810 Rio San Diego Drive San Diego CA 92108 (619) 400-5000

VA Oceanside Clinic 1300 Rancho del Oro Drive Oceanside CA 92056 (760) 643-2000

VA Sorrento Valley Clinic 10455 Sorrento Valley Road San Diego CA 92121 (858) 657-1980

VA Rio Clinic 8989 Rio San Diego Suite 360 San Diego CA 92108 (619) 228-8000

VA ASPIRE CENTER 2121 San Diego Avenue San Diego CA 92110 (858) 297-8397

VET CENTERS San Diego Vet Center 2790 Truxtun Road Suite 130 San Diego CA 92106 (858) 642-1500

San Marcos Vet Center One Civic Center Drive Suite 150 San Marcos CA 92069 (760) 744-6914

Chula Vista Vet Center 180 Otay Lakes Road Suite 108 Bonita CA 91902 (877) 618-6534

WEB ADDRESSES For more information visit us at wwwsandiegovagov wwwfacebookcomVASanDiego wwwtwittercomVASanDiego

24-HOUR NURSE ADVICE LINE (877) 252-4866

ENROLLMENT amp ELIGIBILITY QUESTIONS (858) 552-7523

APPOINTMENT SCHEDULING (858) 552-7475

MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego CA 92161 (858) 552-8585 (800) 331-VETS (8387)

ACCREDITATION amp CERTIFICATION bull The Joint Commission bull Commission on Accreditation of Rehabilitation

Facilities (CARF) Aspire Center Spinal Cord Injury Medical Rehabilitation Wellness and Vocational Rehabilitation Enhancement Homeless Veterans Programs and Substance Abuse Recovery and Rehabilitation Treatment Program

bull College of American Pathologists bull American College of Radiology (ACR)

Mammography CT and MRI

bull American Association for Accreditation of Laboratory Animal Care (AAALAC)

bull Nuclear Regulatory Commission bull American Association of Blood Banks (AABB) bull US Food and Drug Administration (FDA)

Registered Blood Bank and Mammography Program

bull Clinical Laboratory Improvement Act (CLIA) bull Drug Enforcement Agency (DEA)

GPO

US G

OVERN

MEN

T PRINTIN

G O

FFICE 2016 ndash 000-000

INNOVATION IMPROVING ACCESS TO CARE VASDHS IMPLEMENTED INITIATIVES TO IMPROVE ACCESS bull Started direct appointment scheduling

for Audiology and Optometry bull Added evening and weekend clinics bull Increased our Veterans CHOICE

provider network allowing more Veterans access in the community when the VA cannot meet their needs

bull Conducted Access Stand Down events to review all appointments over 60 days and to make sure Veteransare scheduled promptly

bull Started implementing same-day service to respond to the Veteran and address their needs within one day

ACCESS IMPROVEMENTS IN FISCAL YEAR 2016 bull Reduced the number of Veterans on the electronic wait list by 86

(from 1015 Veterans to 140 Veterans) bull Reduced the number of appointments pending more than 30 days by 21 (from 10816 to 8544)

bull Fiscal Year 2015 vs Fiscal Year 2016 wait times Primary Care 35 days to 27 days Specialty Care 75 days to 76 days Mental Health Care 69 days to 52 days

86 WAIT LIST REDUCTION

1200

1100

1000

900

800

700

600

500

400

300

200

100

0

1015

Number of Veterans on the electronic wait list 140

October 1 2015 September 30 2016

21 REDUCTION IN PENDING APPOINTMENTS

12000

11000

10000

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

October 1 2015 September 30 2016

NUMBER OF HOMELESS VETERANS DROPPED IN 2016 The 2016 annual Point In Time Count conducted by the Regional Task Force on the Homeless reported in May that Veteran homelessness in San Diego decreased by 162 compared to last year with decreases in both sheltered (down 221 ndash this number reflects the 1-year trend the 5-year trend is 228) and unsheltered (down 92 ndash this number reflects the 1-year trend the 5-year trend is 387) among Veterans This improvement is a credit to our Homeless Veterans Outreach team

SHELTERED

UNSHELTERED

221 228

1-YEAR

1-YEAR

5-YEAR

5-YEAR

92 387

percentages decreased overall

FY15 VS FY16 APPOINTMENT WAIT TIMES IN DAYS

8

7

6

5

4

3

2

1

0

FY15 FY16

Primary Care

FY15 FY16

Specialty Care

FY15 FY16

Mental Health

Care

35

75 76

69 52

27

10816

8544

Number of appointments pending more than 30 days

CLINICS VA Chula Vista Clinic 865 Third Avenue Chula Vista CA 91910 (619) 409-1600

VA Escondido Clinic 815 East Pennsylvania Avenue Escondido CA 92025 (760) 466-7020

VA Imperial Valley Clinic 1600 South Imperial Avenue El Centro CA 92243 (760) 352-1506

VA Mission Valley Clinic 8810 Rio San Diego Drive San Diego CA 92108 (619) 400-5000

VA Oceanside Clinic 1300 Rancho del Oro Drive Oceanside CA 92056 (760) 643-2000

VA Sorrento Valley Clinic 10455 Sorrento Valley Road San Diego CA 92121 (858) 657-1980

VA Rio Clinic 8989 Rio San Diego Suite 360 San Diego CA 92108 (619) 228-8000

VA ASPIRE CENTER 2121 San Diego Avenue San Diego CA 92110 (858) 297-8397

VET CENTERS San Diego Vet Center 2790 Truxtun Road Suite 130 San Diego CA 92106 (858) 642-1500

San Marcos Vet Center One Civic Center Drive Suite 150 San Marcos CA 92069 (760) 744-6914

Chula Vista Vet Center 180 Otay Lakes Road Suite 108 Bonita CA 91902 (877) 618-6534

WEB ADDRESSES For more information visit us at wwwsandiegovagov wwwfacebookcomVASanDiego wwwtwittercomVASanDiego

24-HOUR NURSE ADVICE LINE (877) 252-4866

ENROLLMENT amp ELIGIBILITY QUESTIONS (858) 552-7523

APPOINTMENT SCHEDULING (858) 552-7475

MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego CA 92161 (858) 552-8585 (800) 331-VETS (8387)

ACCREDITATION amp CERTIFICATION bull The Joint Commission bull Commission on Accreditation of Rehabilitation

Facilities (CARF) Aspire Center Spinal Cord Injury Medical Rehabilitation Wellness and Vocational Rehabilitation Enhancement Homeless Veterans Programs and Substance Abuse Recovery and Rehabilitation Treatment Program

bull College of American Pathologists bull American College of Radiology (ACR)

Mammography CT and MRI

bull American Association for Accreditation of Laboratory Animal Care (AAALAC)

bull Nuclear Regulatory Commission bull American Association of Blood Banks (AABB) bull US Food and Drug Administration (FDA)

Registered Blood Bank and Mammography Program

bull Clinical Laboratory Improvement Act (CLIA) bull Drug Enforcement Agency (DEA)

GPO

US G

OVERN

MEN

T PRINTIN

G O

FFICE 2016 ndash 000-000

CLINICS VA Chula Vista Clinic 865 Third Avenue Chula Vista CA 91910 (619) 409-1600

VA Escondido Clinic 815 East Pennsylvania Avenue Escondido CA 92025 (760) 466-7020

VA Imperial Valley Clinic 1600 South Imperial Avenue El Centro CA 92243 (760) 352-1506

VA Mission Valley Clinic 8810 Rio San Diego Drive San Diego CA 92108 (619) 400-5000

VA Oceanside Clinic 1300 Rancho del Oro Drive Oceanside CA 92056 (760) 643-2000

VA Sorrento Valley Clinic 10455 Sorrento Valley Road San Diego CA 92121 (858) 657-1980

VA Rio Clinic 8989 Rio San Diego Suite 360 San Diego CA 92108 (619) 228-8000

VA ASPIRE CENTER 2121 San Diego Avenue San Diego CA 92110 (858) 297-8397

VET CENTERS San Diego Vet Center 2790 Truxtun Road Suite 130 San Diego CA 92106 (858) 642-1500

San Marcos Vet Center One Civic Center Drive Suite 150 San Marcos CA 92069 (760) 744-6914

Chula Vista Vet Center 180 Otay Lakes Road Suite 108 Bonita CA 91902 (877) 618-6534

WEB ADDRESSES For more information visit us at wwwsandiegovagov wwwfacebookcomVASanDiego wwwtwittercomVASanDiego

24-HOUR NURSE ADVICE LINE (877) 252-4866

ENROLLMENT amp ELIGIBILITY QUESTIONS (858) 552-7523

APPOINTMENT SCHEDULING (858) 552-7475

MEDICAL CENTER VA San Diego Healthcare System 3350 La Jolla Village Drive San Diego CA 92161 (858) 552-8585 (800) 331-VETS (8387)

ACCREDITATION amp CERTIFICATION bull The Joint Commission bull Commission on Accreditation of Rehabilitation

Facilities (CARF) Aspire Center Spinal Cord Injury Medical Rehabilitation Wellness and Vocational Rehabilitation Enhancement Homeless Veterans Programs and Substance Abuse Recovery and Rehabilitation Treatment Program

bull College of American Pathologists bull American College of Radiology (ACR)

Mammography CT and MRI

bull American Association for Accreditation of Laboratory Animal Care (AAALAC)

bull Nuclear Regulatory Commission bull American Association of Blood Banks (AABB) bull US Food and Drug Administration (FDA)

Registered Blood Bank and Mammography Program

bull Clinical Laboratory Improvement Act (CLIA) bull Drug Enforcement Agency (DEA)

GPO

US G

OVERN

MEN

T PRINTIN

G O

FFICE 2016 ndash 000-000