Data for FY24 shows that Otolaryngology at the VA St. Louis Health Care System had the highest productivity of the nearly 100 otolaryngology sections in the nation.
WashU Medicine providers that offer comprehensive clinical and surgical care at the VA St. Louis Health Care System include Section Chief Paul Zolkind, MD, Matthew Shew, MD, and Jarrett Walsh, MD. Others who take call or assist with surgical cases include John Chi, MD, MSPH, Nedim Durakovic, MD, Allison Ogden, MD, and Emily Spataro, MD. One chief and one junior resident also rotate through the service.
Productivity reflects the number of relative value units or RVUs per full time provider, a standard measure used in medical billing that reflects the time, effort and expertise required of specific services. Head and neck surgeon Zolkind, MD, attributes the section’s success to several factors.
“Our nursing team and physician’s assistant have been very instrumental in improving clinic efficiency,” he said. “They have managed to not only minimize clinic wait times, they have also improved utilization of our OR time and helped reduce the time between a patient’s clinic visit and their surgery.”
That team includes Physician Assistant Renee Mueth, Nurse Navigator Kaleigh Gibson, and Case Manager Joyce Zee-cheng.
According to Zolkind, changes in subspecialty services have also contributed to growth in productivity by offering a greater range of otolaryngology procedures. Most notable among these are the addition of a rhinologist (Walsh) and efforts by Shew to make the VA a Center of Excellence for cochlear implantation. Veterans now travel from across Missouri and neighboring states to receive cochlear implants in St. Louis. The team of clinic providers also includes a strong core of audiologists.
The improvements are the result of a sustained and dedicated effort to offer high quality, veteran-focused clinical and surgical patient care. Otolaryngology section productivity has shown steady and significant increases each year with a nearly 300% increase in productivity from pre-covid levels.
For Zolkind, the improvement highlights the importance of a critical mission.
“We feel a tremendous sense of pride and responsibility taking care of our nation’s Veterans,” he said. “Our goal is to continue to grow the program and services offered while maintaining a clear focus on high quality, patient-centered care.”