Access to Pain Care From Compensation Clinics: A Relational Coordination Perspective.

Journal

Federal practitioner : for the health care professionals of the VA, DoD, and PHS
ISSN: 1078-4497
Titre abrégé: Fed Pract
Pays: United States
ID NLM: 9500574

Informations de publication

Date de publication:
Jul 2020
Historique:
entrez: 10 9 2020
pubmed: 11 9 2020
medline: 11 9 2020
Statut: ppublish

Résumé

The Compensation and Pension (C&P) determination process is a potential gateway to accessing pain treatment in the Veterans Health Administration (VHA). However, attitudes about C&P as a gateway and about collaboration with C&P clinics among VHA staff are unknown. In preparation for an initiative to link veterans seeking compensation for musculoskeletal disorders to treatment, clinical and administrative staff from the 8 VHA medical centers in New England were invited to complete a relational coordination survey that examined how different workgroups collaborate (communication and relationships) to provide pain care to veterans. A subset of those staff also participated in a semistructured interview about pain treatment referral practices within their medical centers. VHA staff were from primary care, administration, pain management, and C&P teams. Eighty-three VHA staff were invited to complete the relational coordination survey; 66 completed the survey and 39 participated in the semistructured interview. Most C&P staff interviewed thought of the compensation examination as a forensic process and that C&P-based efforts to engage veterans might interfere with the examination or were not their responsibility. However, some examiners described their efforts to determine new veterans' eligibility for VHA care and to connect them to specific treatments. VHA staff reported that there was little communication between the C&P team and other teams. The survey results supported this finding. The C&P group's relational coordination composite scores were lower than any other workgroup. Outreach to veterans at New England C&P clinics was inconsistent, and C&P teams rated low on a measure of coordination with workgroups involved in pain treatment. Compensation examinations appear to be underused opportunities to help veterans access treatment. C&P-based treatment engagement is feasible; it is being done by some Compensation teams.

Sections du résumé

BACKGROUND BACKGROUND
The Compensation and Pension (C&P) determination process is a potential gateway to accessing pain treatment in the Veterans Health Administration (VHA). However, attitudes about C&P as a gateway and about collaboration with C&P clinics among VHA staff are unknown.
METHODS METHODS
In preparation for an initiative to link veterans seeking compensation for musculoskeletal disorders to treatment, clinical and administrative staff from the 8 VHA medical centers in New England were invited to complete a relational coordination survey that examined how different workgroups collaborate (communication and relationships) to provide pain care to veterans. A subset of those staff also participated in a semistructured interview about pain treatment referral practices within their medical centers. VHA staff were from primary care, administration, pain management, and C&P teams.
RESULTS RESULTS
Eighty-three VHA staff were invited to complete the relational coordination survey; 66 completed the survey and 39 participated in the semistructured interview. Most C&P staff interviewed thought of the compensation examination as a forensic process and that C&P-based efforts to engage veterans might interfere with the examination or were not their responsibility. However, some examiners described their efforts to determine new veterans' eligibility for VHA care and to connect them to specific treatments. VHA staff reported that there was little communication between the C&P team and other teams. The survey results supported this finding. The C&P group's relational coordination composite scores were lower than any other workgroup.
CONCLUSION CONCLUSIONS
Outreach to veterans at New England C&P clinics was inconsistent, and C&P teams rated low on a measure of coordination with workgroups involved in pain treatment. Compensation examinations appear to be underused opportunities to help veterans access treatment. C&P-based treatment engagement is feasible; it is being done by some Compensation teams.

Identifiants

PMID: 32908339 PMC: PMC7473717
pubmed: 32908339
pii: fp-37-7-336
pmc: PMC7473717

Types de publication

Journal Article

Langues

eng

Pagination

336-342

Subventions

Organisme : NCCIH NIH HHS
ID : UH3 AT009758
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States

Informations de copyright

Copyright © 2020 Frontline Medical Communications Inc., Parsippany, NJ, USA.

Déclaration de conflit d'intérêts

Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.

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Auteurs

Marc I Rosen (MI)

is the Director of Addictions Firm, is the Chief of Psychology, is the Director of Clinical Health Psychology, is the Associate Director, Methods and Biostatistics Core, PRIME Center; all at VA Connecticut Healthcare System in West Haven. is the Associate Chief of Staff for Research at the VA Central Western Massachusetts Healthcare System in Leeds. Marc Rosen and Steve Martino are Professors of Psychiatry, John Sellinger is an Assistant Professor of Psychiatry, and is a Research Associate, all at Yale University in New Haven, Connecticut. Kristin Mattocks is an Associate Professor of Population and Quantitative Health Sciences at the University of Massachusetts Medical School in Worcester.

Steve Martino (S)

is the Director of Addictions Firm, is the Chief of Psychology, is the Director of Clinical Health Psychology, is the Associate Director, Methods and Biostatistics Core, PRIME Center; all at VA Connecticut Healthcare System in West Haven. is the Associate Chief of Staff for Research at the VA Central Western Massachusetts Healthcare System in Leeds. Marc Rosen and Steve Martino are Professors of Psychiatry, John Sellinger is an Assistant Professor of Psychiatry, and is a Research Associate, all at Yale University in New Haven, Connecticut. Kristin Mattocks is an Associate Professor of Population and Quantitative Health Sciences at the University of Massachusetts Medical School in Worcester.

John Sellinger (J)

is the Director of Addictions Firm, is the Chief of Psychology, is the Director of Clinical Health Psychology, is the Associate Director, Methods and Biostatistics Core, PRIME Center; all at VA Connecticut Healthcare System in West Haven. is the Associate Chief of Staff for Research at the VA Central Western Massachusetts Healthcare System in Leeds. Marc Rosen and Steve Martino are Professors of Psychiatry, John Sellinger is an Assistant Professor of Psychiatry, and is a Research Associate, all at Yale University in New Haven, Connecticut. Kristin Mattocks is an Associate Professor of Population and Quantitative Health Sciences at the University of Massachusetts Medical School in Worcester.

Christina M Lazar (CM)

is the Director of Addictions Firm, is the Chief of Psychology, is the Director of Clinical Health Psychology, is the Associate Director, Methods and Biostatistics Core, PRIME Center; all at VA Connecticut Healthcare System in West Haven. is the Associate Chief of Staff for Research at the VA Central Western Massachusetts Healthcare System in Leeds. Marc Rosen and Steve Martino are Professors of Psychiatry, John Sellinger is an Assistant Professor of Psychiatry, and is a Research Associate, all at Yale University in New Haven, Connecticut. Kristin Mattocks is an Associate Professor of Population and Quantitative Health Sciences at the University of Massachusetts Medical School in Worcester.

Brenda T Fenton (BT)

is the Director of Addictions Firm, is the Chief of Psychology, is the Director of Clinical Health Psychology, is the Associate Director, Methods and Biostatistics Core, PRIME Center; all at VA Connecticut Healthcare System in West Haven. is the Associate Chief of Staff for Research at the VA Central Western Massachusetts Healthcare System in Leeds. Marc Rosen and Steve Martino are Professors of Psychiatry, John Sellinger is an Assistant Professor of Psychiatry, and is a Research Associate, all at Yale University in New Haven, Connecticut. Kristin Mattocks is an Associate Professor of Population and Quantitative Health Sciences at the University of Massachusetts Medical School in Worcester.

Kristin Mattocks (K)

is the Director of Addictions Firm, is the Chief of Psychology, is the Director of Clinical Health Psychology, is the Associate Director, Methods and Biostatistics Core, PRIME Center; all at VA Connecticut Healthcare System in West Haven. is the Associate Chief of Staff for Research at the VA Central Western Massachusetts Healthcare System in Leeds. Marc Rosen and Steve Martino are Professors of Psychiatry, John Sellinger is an Assistant Professor of Psychiatry, and is a Research Associate, all at Yale University in New Haven, Connecticut. Kristin Mattocks is an Associate Professor of Population and Quantitative Health Sciences at the University of Massachusetts Medical School in Worcester.

Classifications MeSH