James J. Peters Veterans Affairs Medical Center
Honoring the past and providing health care to the current generation. This multilevel, tertiary health care center is fully accredited by the Joint Commission on Accreditation of Healthcare Organization and comprises 311 authorized beds and an additional 120 bed extended-care facility.
In 1921 the Treasury Department purchased property at 130 West Kingsbridge Road, Bronx, New York, from the Archdiocese of New York. The property was purchased for use by the U.S. Public Health Service as a hospital for ex-service patients suffering from mental and nervous disorders. On April 20, 1922, the property was turned over to the newly formed U.S. Veterans’ Bureau by Executive Order and thereby became the first veteran’s hospital in New York City. By adding several buildings throughout the years, the Bureau made the Bronx hospital the second largest VA facility in the nation, with a total of 1,663 beds. More recently, a nine-floor replacement facility was built through the late 1970s and dedicated in 1981. The modern replacement hospital, now one of 153 Medical Centers in the Department of Veterans Affairs health care network, includes an adjoining two-floor nursing home and a five-floor Research Building. The Bronx VA Medical Center is a part of VA Network 3 (VISN 3), which includes facilities in Brooklyn, Castle Point, Manhattan, Montrose, Northport, St. Albans (Queens) and East Orange and Lyons, N.J.
On September 26, 2005, the Bronx VA Medical Center was officially named the James J. Peters VA Medical Center (JJPVAMC) by virtue of Public Law 108-422 and in honor of Army veteran and disabled advocate James J. Peters, whose efforts on behalf of paralyzed veterans brought significant advances in the treatment and understanding of spinal cord injuries.
This multilevel, tertiary health care center is fully accredited by the Joint Commission on Accreditation of Healthcare Organization (JCAHO) and comprises 311 authorized beds and an additional 120 bed extended care facility. With an enrolled population of over 53,500 patients in FY 07, the medical center provided quality care in more than 299,000 outpatient visits and over 5,000 inpatient admissions.
It should be noted that the JJPVAMC is classified as a Clinical Referral Level 1c Facility. It is a teaching hospital, providing a full range of patient care services, with state-of-the-art technology as well as education and research. Comprehensive health care is provided through primary care, tertiary car, and long-term care in areas of medicine, surgery, psychiatry, physical medicine and rehabilitation, neurology, oncology, dentistry, geriatrics, and extended care. The JJPVAMC outpatient clinics provide subspecialty care in virtually every conceivable medical discipline, from audiology to urology.
Specialized Services and Referral Centers
The JJPVAMC functions as the regional referral point for spinal cord injury (SCI) patients from VISN’s 2 (Conn.), 3 (N.Y./N.J.) and 4 (Pa.) as well as a referrals from DoD new SCI patients.
The JJPVAMC is the designated network referral center for polytrauma/traumatic brain injury (TBI) patients. The Bronx VAMC also serves VA Hudson Valley Health Care System patients with acute care needs and referrals to subspecialty clinics. Additionally, the Bronx VAMC serves as home to the Network 3 Telephone Triage service. This system, staffed by registered nurses and available 24-hours a day, provides telephone helpline service for veteran patients of 36 VA medical centers in VISN’s 3, 4, 6, 19 and 8 (for emergency back up only). This VA telephone care program is nationally accredited.
A hemodialysis unit, for treatment of chronic and acute renal disease is offered, as is a radiation therapy service designated as a center for consultation and referral of complicated cancer cases.
In an effort to reduce waiting times and improve accessibility to service, the JJPVAMC has been implementing an advanced clinical access program. Advanced access is implemented in all primary care and many specialty clinics and allows patients to call the clinic to make a same day or next day appointment.
Sites of Care
The JJPVAMC provides a broad range of inpatient and outpatient health care services to a veteran population from the Bronx, Westchester and Rockland Counties, Northern New Jersey, and the New York metropolitan area. In addition, the facility supports four community-based outpatient clinics (CBOC’s) in Yonkers, White Plains, South Bronx, and Queens serving Bronx, Northern Queens and Westchester counties.
Affiliations and Training
Affiliations are maintained with the Mount Sinai School of Medicine, The Hospital for Special Surgery and the Columbia Presbyterian School of Medicine. Fully integrated residency programs exist in general surgery and medicine and their subspecialties, psychiatry, general dentistry, oral surgery, rehabilitation medicine, urology, neurology and pathology. Bronx VA offers graduate and postgraduate training programs in dietetics, psychology, social work, speech pathology, pharmacy, podiatry, rehabilitation therapies and health care administration.
Research
Research at The JJPVAMC is world-renowned. Its investigators have been recognized for numerous noteworthy projects and they have received several national and international awards, including the Nobel Prize. A separate research building, built in 1985, is attached to the main clinical setting and has been recognized for achievements in research dealing with Viral Oncogenesis, AIDS, prosthetic devices for spinal cord injuries (SCI), metabolic alterations in SCI patients, Alzheimer’s disease, psychiatry, renal research and disorders associated with alcoholism, tobacco, and digestion.
Most recently, Bronx Researcher, Dr. John Eng, whose mentor was Nobel Laureate Rosalyn Yalow at the Bronx VA, isolated and patented exendin-4 which was developed as treatment for diabetes mellitus. It was approved by FDA in April 2005 and given the generic name exenatide. It is now being widely marketed as Byetta, a ground-breaking treatment for Type 2 diabetes mellitus. The drug produces improved blood glucose control in diabetics with the added benefit of weight reduction. It has already been used by over 700,000 patients. A spinal cord tissue bank and a brain bank have been established.
In addition, the Bronx VA supports accredited research programs in their Geriatric Research Education Clinical Center (GRECC), the Mental Illness Research Education Clinical Center (MIRECC) and the Rehabilitation Research and Development Center.
Homeless Veterans
As a member of the Greater New York/New Jersey Consortium on Homelessness, the JJPVAMC has been proactive in its efforts to assist homeless veterans. In collaboration with New York City and New York State they have been actively involved in making timely referrals and providing staff and services at three area shelters. In addition, the JJPVAMC provides a medical health van that visits areas where the homeless veterans congregate. They also provide transportation for homeless veterans who may be in need of medical or mental health treatment.
Because unemployment (or the lack of steady employment) is at the root of many homeless situations, the JJPVAMC has developed one of the nation’s largest and most successful compensated work therapy programs. This program, coordinated through the Bronx VA by the Community Support Services division, assists veterans in transitioning from homelessness to gainful employment. Transitional, affordable housing is also coordinated for these veterans. In FY07, more than 360 veterans found gainful employment and housing through this program. These veterans earned over $800,000 in compensation and began the transition to a better, more stable living situation.
VA-DoD Sharing Issues
The Bronx VAMC is a provider under the TRICARE Military Health Care program, which provides medical services to active duty servicemembers and their families. The Bronx VAMC also partners with the Department of Defense through local and national VA-DoD Sharing agreements, including providing medical services to Reservists through the FEDS-HEAL program.
The Bronx VAMC Office of Administrative Medicine, with assistance from other patient care centers, frequently provides physical examinations and immunizations for guard and reserve forces both pre and post deployment.
VA and Technology
Not unique to the James J. Peters VA Medical Center, but certainly a hallmark of VA health care in the last decade, is the utilization of a fully-integrated electronic medical records system. The Computerized Medical Record System (CPRS) is a highly secure, heavily encrypted, system that was spear-headed by Veterans Health Administration (VHA) and allows VA clinicians access to any VA patient’s complete medical records, from any VA location, 24 hours a day.
In conjunction with CPRS, the VA has also developed a superior computer imaging system, called Vista Imaging. This unique application allows providers to store and receive clinical images whose resolution is so fine that they are referred to as “diagnostic quality.” Doctors no longer have to go to radiology to view an X-ray or MRI.
The James J. Peters utilizes a prescription-by-phone system, called MUMPS Audiofax. Veterans with outstanding refills or regular mediations can call a toll free number, 24 hours a day, to renew their prescription and have it sent directly to their homes. During regular business hours, patients can also speak to a pharmacist about any questions they may have about their medications. In the last fiscal year alone, the JJPVAMC pharmacy filled 438,067 prescriptions and mailed 264,292 prescriptions to the homes of enrolled veterans.
Telemedicine—The Veterans Health Administration (VHA) has implemented a national Care Coordination Home Telehealth program (CCHT). Utilizing electronic equipment situated in the patient’s home, clinicians are able to monitor vital signs, view real-time images and incorporate data into the patient’s CPRS health record.
CCHT programs are targeted at the two to three percent of patients who utilize 30 percent of costs and are frequent clinic attendees and require urgent hospital admissions. These programs in VHA have demonstrated reduced hospital admissions, clinic and emergency room visits. As of November 2007, there are 31,570 patients enrolled in this program nationally.
Bar Code Medication Administration (BCMA) is another landmark technology, implemented nationwide in all VA hospitals. This program, utilizing patient bar-coded wristbands and wireless medication carts with bar code readers, helps to prevent medication errors; the leading cause of accidental death in hospitals. Nurses making medication rounds will view the patient’s chart in CPRS and then turn to the wireless medication cart (stocked by pharmacy each day). Using the scanner from the cart, the Nurse will scan the barcode on the medicine and the barcode on the patient’s wrist, to ensure the proper medication and dosage.
Outreach to Operation Enduring Freedom and Operation Iraqi Freedom Veterans
The JJPVAMC has been very aggressive in its outreach to Operation Enduring Freedom and Operation Iraqi Freedom veterans. Efforts include developing treatment groups for both men and woman and providing unit-based mental health “stand-downs” for returning units. The JJPVAMC routinely provides health screenings for reserve and guard units preparing to deploy overseas and participates in Post Deployment Health Reassessment (PDHRA) screenings and referrals for returning units. The JJPVAMC has developed a special combat veteran health screening that is being offered to all returnees in our catchment area.
In mid-December, the JJPVAMC held a new returnee Welcome Home and Job Fair that provided job placement assistance and direct referrals for over 200 enrolled returnees. That event featured over 30 different employer tables and seminars from some of the regions foremost speakers on job placement and entrepreneurship.
Through FY 07, more than 2,800 OIF/OEF veterans have been enrolled for care and treated at this facility. It should be noted that the James J. Peters VAMC has the nation’s highest percentage of enrollments among OIF/OEF veterans at 62.3 percent. Network 3 has the highest VISN enrollment percentage in the country at 56.6 percent. While we will always strive to do more, it is clear that the JJPVAMC is making good progress in addressing the needs of our nation’s very newest veterans. Like those veterans that preceded them, we consider their care our most sacred obligation. ♦