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VA Medical Center director sets high standards

By Elizabeth Cook
ecook@salisburypost.com
SALISBURY — Here’s the Hefner VA Medical Center by the numbers:
Counties served: 24.
Acres: 155.
Beds: 295.
Employees: 2,008.
Unique patients in 2010: 84,925.
Outpatient visits in 2010: 661,422.
Square footage, including clinics: 1.2 million.
Annual construction budget: $24 million.
Director: One.
This story is about that one — Paul M. Russo, who arrived on the Hefner VA campus on Brenner Avenue last August.
Russo, 53, is a low-key person, short on words but clear in his actions.
A look around his office reveals his interests. There are pictures of his college rugby teams, wife Karen, their dogs, his godchild.
Russo is the kind of leader who will roll up his sleeves and lead a 2K walk to promote employee wellness on a 90-plus-degree day.
And he’s the kind of leader who listens to employees and takes into account what they say, according to Essie Hogue, president of the local chapter of the American Federation of Government.
“He follows through; he follows up,” she says.
• • •
Russo’s mission is clear.
“It’s an honor and a privilege to serve veterans,” he says during an interview. “Veterans deserve the very best health care. That’s what we strive for.”
Anything less, he says, is unacceptable.
A few years ago, local veterans feared they might get something less — or less accessible.
In September 2008, Veterans Affairs announced plans to eliminate emergency and inpatient services at the Hefner VA and make it a community-based outpatient clinic, with local vets getting other care at local hospitals.
Carolyn Adams, then director of the center, suddenly had a hornet’s nest on her hands, with scared workers, furious veterans and skeptical politicians buzzing about the change.
Veterans protested. “We fought for you,” said one of their signs, “now fight for us.”
Employees felt blindsided.
Congressman Mel Watt, D-12, called the timing of the announcement in the last months of the Bush administration “very, very suspect.”
After a few months of stinging reaction, Veterans Affairs backed down. Tempers cooled. Veterans felt reassured.
But damage had been done to morale among VA employees.
• • •
Hogue, the union local president, says that changed with Russo’s arrival last August.
“It’s like stepping out of darkness into light,” she says.
Russo exchanged emails with her after he was named to the post. When he arrived in Salisbury, he held an employee meeting right away, and he has followed up with town hall meetings.
“Mr. Russo is all over this place,” says Hogue. “He met with me more the first month he was here than the former director did the whole time she was here.”
That was three years.
Employees feel they have a voice in decisions and are informed about what’s going on, Hogue says.
Russo is a quiet man and may appear meek, she says, “but he’s very strong in his beliefs. … He makes decisions that are just for veterans, and he cares about employees.”
He has a sense of humor, she says. “But he’s no-nonsense when it comes to serious things.”
• • •
Russo’s career with Veterans Affairs began 29 years ago, when he became a staff dietitian at the Buffalo, N.Y., veterans’ hospital.
He had just graduated from State University of New York College at Buffalo with a degree in clinical nutrition.
He rose through the ranks, completing management programs and earning a master’s degree in health services administration along the way.
He landed in Salisbury — his eighth VA Medical Center — after a six-year stint in West Palm Beach, Fla., where he was associate director.
Did he think during his dietitian days that he would rise to become director of a facility with more than 2,000 employees?
“No,” Russo says. “When you’re right out of college, you’re pretty happy to be employed.”
But he had a hint of what lay ahead. “My boss said to me, ‘You could be a director one day.’ I remember distinctly.”
It took 28 years for the prediction to come through.
“Patience is a virtue,” Russo says.
• • •
So is speed, when it comes to caring for veterans.
The 2008 restructuring is history. “That was a previous administration,” Russo says.
“From my point of view, we’re going forward to meet the demands of the population.
“Let me tell you, in two years’ time there’s been a lot of change.”
A large influx of veterans into the region and expanded eligibility led to a 24 percent jump in enrollment — which is now about 287,000.
“That in and of itself is supporting the need to retain the medical-surgical services that we have,” he says.
The other important development, he says, is that the hospital demonstrated it could be efficient. Last year, medical admissions increased 50 percent and surgical admissions went up 46 percent — without increasing the number of beds.
Now, Russo says, the center is in an expansion mode, not contraction.
• • •
The sounds of construction ring out across the VA’s sprawling campus, signs of that growth.
A new, 12-bed hospice is going up adjacent to the geriatric care building.
Across campus, mental health facilities are undergoing a major overhaul.
And oncology — something not offered at the Hefner VA before — will be available late this summer, with 24 chairs in chemotherapy.
“It makes absolute perfect sense now,” Russo says.
So does expanding the call center that fields veterans’ questions and helps them schedule appointments.
The center gets as many as 8,000 calls a day. When Russo arrived last year, the call abandonment rate — when the caller quits and hangs up — was 40 to 50 percent.
“That’s horrible,” he says.
He added seven full-time positions, giving the center 15.
The abandonment rate has fallen to 10 percent, he says, “which is still not where I want to be but it’s a heck of a lot better.”
He plans to have focus groups of veterans give feedback on their experiences at the VA.
“I’m really proud of the staff. They work hard and show great commitment. We’ve just got to tighten up in certain areas and continue to meet the needs of the veterans.”
• • •
Fifteen people report directly to Russo. He tries to get out of the office to walk around campus and talk to veterans and staff.
“Communication is critical. Visibility is critical,” he says. “Mission to me is everything.”
But he has a life outside of work.
The framed rugby unit patches on his office wall show the sport was more than a college hobby.
He went on to become a referee and will be referee coordinator for a 100-team Canadian-American rugby tournament coming up at Saranac Lake, N.Y., next month.
Also on his office wall is a photo of a flag flying over the USS Arizona at Pearl Harbor, a photo he took while in Hawaii.
Russo’s father was not into team sports, so they spent time together hunting — and plan to go deer hunting together in November in New York.
He met his wife, Karen, when they were both working at a VA medical center in Bay Pines, Fla.
It was in Bay Pines that he won the VA secretary’s Hands and Heart Award for his work as a dietitian in oncology. “When you work with cancer patients, you get to know them for a long time.”
The Russos bought a house in Forest Glen off N.C. 150 and settled in last December, along with their shih tzu, Ralph.
From there, Karen still works as a nurse for the Bay Pines hospital, managing cases via Internet.
In his off hours, Russo says he likes to stay active, walk and read. But as the one person most responsible for the Hefner VA Medical Center, he has to keep his focus.
“In a job like this, you always continue learning,” Russo says. “Health care changes at a rapid pace.”
More can be found on the VA’s website, www.salisbury.va.gov/
 

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