American Federation of Government Employees

Dallas VAMC Local 2437 Statement

Dallas, TX - Dallas Veterans Medical Center Director, Jeff Milligan, and
Pharmacy Chief, Ruth Ann, made an executive decision requiring the
Dallas Anticoagulation Clinic to immediately assume the responsibility
of treating an additional 600-1,000 patients being treated with various
blood thinners such as Coumadin. This increase in patient workload
presents dire circumstances as the decision was not accompanied by
an increase in staffing to accommodate the increase in patient care
responsibilities. On any given day, the Anticoagulation staff is already
being required to double-book patients in order to meet the current
demand. Double-booking is a practice whereby a provider will
schedule two patients in a time slot intended for the treatment of one
patient. It is not uncommon for the staff to treat 35-45 more patients
than appointment slots will allow.

The reckless and ill-planned decision to add an additional 600-1,000
patients to a staff who is already working with staffing shortages and
being compelled to treat more patients than they have available
appointments for, not only places the providers at risk but also
jeopardizes patient care. Coumadin is an anticoagulant (blood
thinner) that requires routine monitoring, and in many cases, requires
follow up visits in 3-7 days. The staff and Local Union have
communicated their concerns of the staff not being able to meet the
demands of this dangerous increase in patient load without being
provided additional resources thereby compromising the delivery of
safe and effective care, yet these concerns have fallen on death ears
as the hospital administration has chosen to proceed with
recklessness.

Under the current conditions and existing staffing levels, the
possibility of veterans who are being treated with blood thinners
having a serious or potentially life-threatening event is very
real. Without proper follow up, a veteran receiving a blood thinner
could suffer a fatal bleeding event if the blood is too thin or develop
blood clots if the blood is too thick. An additionally consequence is
the increase stress that is being placed on the staff who is being
required to treat more patients than staffing would safely allow on a
continual and daily basis increasing the possibility of these providers
making mistakes and jeopardizes the health of both patient and
provider. Milligans philosophy is to do more with less which is the
same philosophy he had as the Director of the Valley Coastal Bend VA
Hospital were understaffing was also an issue.