Continuing the transformation: charting the path for the future delivery of Veteran emergency care.


Journal

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
ISSN: 1553-2712
Titre abrégé: Acad Emerg Med
Pays: United States
ID NLM: 9418450

Informations de publication

Date de publication:
04 2023
Historique:
revised: 14 01 2023
received: 21 10 2022
accepted: 20 01 2023
medline: 17 5 2023
pubmed: 25 1 2023
entrez: 24 1 2023
Statut: ppublish

Résumé

Important changes in the delivery of Veteran emergency care in the early 2000s in the Department of Veteran Affairs (VA) emergency departments and urgent care clinics substantially elevated the role of emergency medicine (EM) in Veteran health care. Focused on enhancing the quality of care, emergency care visits in both VA and non-VA (community) care locations have nearly doubled from the 1980s to more than 3 million visits in Fiscal Year 2022. Recognizing the need to plan for continued growth and the opportunity to address key research priorities, the VA Office of Emergency Medicine, together with the VA Health Services Research and Development Service, collaborated to convene a State of the Art Conference on Veteran Emergency Medicine (SAVE) in the winter of 2022. The goal of this conference was to identify research gaps and priorities for implementation of policies for three priority groups: geriatric Veterans, Veterans with mental health and substance use complaints, and Veterans presenting to non-VA (community) emergency care sites. In this article we discuss the rationale for the SAVE conference including a brief history of VA EM and the planning process and conclude with next steps for findings from the conference.

Identifiants

pubmed: 36692104
doi: 10.1111/acem.14670
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

232-239

Informations de copyright

© 2023 Society for Academic Emergency Medicine.

Références

O'Hanlon C, Huang C, Sloss E, et al. Comparing VA and non-VA quality of care: a systematic review. J Gen Intern Med. 2017;32(1):105-121.
Anhang Price R, Sloss EM, Cefalu M, Farmer CM, Hussey PS. Comparing quality of care in veterans affairs and non-veterans affairs settings. J Gen Intern Med. 2018;33(10):1631-1638.
Blay E Jr, DeLancey JO, Hewitt DB, Chung JW, Bilimoria KY. Initial public reporting of quality at veterans affairs vs non-veterans affairs hospitals. JAMA Intern Med. 2017;177(6):882-885.
Trivedi AN, Matula S, Miake-Lye I, Glassman PA, Shekelle P, Asch S. Systematic review: comparison of the quality of medical care in veterans affairs and non-veterans affairs settings. Med Care. 2011;49(1):76-88.
Chan DC, Danesh K, Costantini S, Card D, Taylor L, Studdert DM. Mortality among US veterans after emergency visits to veterans affairs and other hospitals: retrospective cohort study. BMJ. 2022;376:e068099.
Shulkin DJ, Why VA. Health care is different. Fed Pract. 2016;33(5):9-11.
Yano EM, Bair MJ, Carrasquillo O, Krein SL, Rubenstein LV. Patient aligned care teams (PACT): VA's journey to implement patient-centered medical homes. J Gen Intern Med. 2014;29(Suppl 2):S547-S549.
American College of Emergency Physicians. Military emergency medical systems. Ann Emerg Med. 1989;18(2):214-221.
Veterans Health Administration. VHA Directive 2006-051, Standards For Nomenclature and Operations in VHA Facility Emergency Departments. Department of Veterans Affairs; 2006.
Department of Veterans Affairs. Office of Research & Development. Accessed January 2, 2023. https://www.research.va.gov/
Department of Veterans Affairs. VA Cooperative Studies Program (CSP). Accessed January 2, 2023. https://www.research.va.gov/programs/csp/default.cfm
VA Health Services Research & Development Service. Health Services Research & Development: Pre- and Post-Funding Information. Accessed January 3, 2023. https://www.hsrd.research.va.gov/funding/
Department of Veterans Affairs. Million Veteran Program (MVP) Research. Accessed January 2, 2023. https://www.research.va.gov/mvp/research.cfm
VA Enhances Geriatric Emergency Care for Older Veterans [press release]. 2021.
Department of Veterans Affairs. Geriatric Research Education and Clinical Center (GRECC). Accessed January 3, 2023. https://www.va.gov/Grecc/
Veterans Health Administration Emergency Medicine Management Tool. EDIS GeriatricsAgeReport v3. Accessed January 3, 2023. https://reports.vssc.med.va.gov/ReportServer/Pages/ReportViewer.aspx?%2fMgmtReports%2fEDIS%2fEDIS_GeriatricsAgeReport_v3&rs:Command=Render
Cairns C KK, Santo L. National Hospital Ambulatory Medical Care Survey: 2018 emergency department summary tables. NHAMCS Factsheets - EDs Web site. 2022. Accessed December 20, 2022. https://www.cdc.gov/nchs/data/nhamcs/web_tables/2018-ed-web-tables-508.pdf
American College of Emergency Physicians. Geriatric Emergency Department Guidelines. https://www.acep.org/globalassets/sites/geda/documnets/geda-guidelines.pdf
McQuown CM, Snell KT, Abbate LM, Jetter EM, Blatnik JK, Ragsdale LC. Telehealth for geriatric post-emergency department visits to promote age-friendly care. Health Serv Res. 2023;58(Suppl 1):16-25.
Huded JM, Lee A, Song S, et al. Association of a geriatric emergency department program with healthcare outcomes among veterans. J Am Geriatr Soc. 2022;70(2):601-608.
Huded JM, Lee A, McQuown CM, et al. Implementation of a geriatric emergency department program using a novel workforce. Am J Emerg Med. 2021;46:703-707.
Mohr NM, Wu C, Ward MJ, McNaughton CD, Richardson K, Kaboli PJ. Potentially avoidable inter-facility transfer from veterans health administration emergency departments: a cohort study. BMC Health Serv Res. 2020;20(1):110.
Goldman-Mellor S, Olfson M, Lidon-Moyano C, Schoenbaum M. Association of suicide and other mortality with emergency department presentation. JAMA Netw Open. 2019;2(12):e1917571.
MacLean A, Elder GH Jr. Military service in the life course. Annu Rev Sociol. 2007;33:175-196.
VA Office of Mental Health and Suicide Prevention. 2021 National Veteran Suicide Prevention Annual Report. 2021.
VA Suicide Prevention. National Veteran Suicide Prevention Annual Report. 2022.
Matarazzo BB, Eagan A, Landes SJ, et al. The veterans health administration REACH VET program: suicide predictive modeling in practice. Psychiatr Serv. 2023;74(2):206-209.
Bahraini NH, Matarazzo BB, Barry CN, et al. Protocol: examining the effectiveness of an adaptive implementation intervention to improve uptake of the VA suicide risk identification strategy: a sequential multiple assignment randomized trial. Implement Sci. 2020;15(1):58.
Bahraini N, Brenner LA, Barry C, et al. Assessment of rates of suicide risk screening and prevalence of positive screening results among US veterans after implementation of the veterans affairs suicide risk identification strategy. JAMA Netw Open. 2020;3(10):e2022531.
Anderson ES, Rusoja E, Luftig J, et al. Effectiveness of substance use navigation for emergency department patients with substance use disorders: an implementation study. Ann Emerg Med. 2022;S0196-0644(22)01164-7. [Online ahead of print].
Hawk K, Hoppe J, Ketcham E, et al. Consensus recommendations on the treatment of opioid use disorder in the emergency department. Ann Emerg Med. 2021;78(3):434-442.
Dieujuste N, Johnson-Koenke R, Christopher M, et al. Feasibility study of a quasi-experimental regional opioid safety prescribing program in veterans health administration emergency departments. Acad Emerg Med. 2020;27(8):734-741.
Mattick RP, Breen C, Kimber J, Davoli M. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev. 2004;(2):CD002207.
Dieujuste N, Johnson-Koenke R, Celedon M, et al. Provider perceptions of opioid safety measures in VHA emergency departments and urgent care centers. Fed Pract. 2021;38(9):412-419.
Veterans Health Administration. Memorandum Re: Suicide Prevention in Emergency Departments (SPED): Suicide Safety Planning and Follow Up Interventions. Department of Veterans Affairs; 2018.
US Government Accountability Office. GAO-18-281 Veterans Choice Program. 2018.
Panangala SV, Carey MP, Dortch C, Heisler EJ. Veterans Access, Choice, and Accountability Act of 2014 (HR 3230; PL 113-146). Congressional Research Service; 2015.
Department of Veterans Affairs. VA Maintaining Internal Systems And Strengthening Integrated Outside Networks (MISSON) Act. 2018.
U.S. Department of Veterans Affairs VHA, Office of Community Care. Community Emergency Treatment Reporting and Care Coordination. 2021.
VA Office of Community Care. Emergency medical care for Veterans: eligibility and VA payments. Accessed January 2, 2023. https://news.va.gov/48884/emergency-medical-care-veterans-eligibility-va-payments/
Congressional Budget Office. The Veterans Community Care Program: Background and Early Effects. 2021.
Department of Veterans Affairs. Care Optimization in the Emergency Department (CO-ED) Guidebook. 2021.
Ward MJHU, Hastings SN, Timko C, et al. Research and policy recommendations from the SOTA XVI: state of the art conference on VA emergency medicine. Acad Emerg Med. 2022; Under Review.
VA Health Services Research and Develop (HSR&D) Service. HSR&D Research Priorities. 2022. Accessed October 1, 2022. https://www.hsrd.research.va.gov/funding/PriorityDomains.pdf

Auteurs

Michael J Ward (MJ)

Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Chad Kessler (C)

Department of Emergency Medicine, Duke University, Durham, North Carolina, USA.
Durham VA Health Care System VA, Durham, North Carolina, USA.

Erica A Abel (EA)

Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA.
Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.

Justin Ahern (J)

VA Maine Healthcare System, Togus, Maine, USA.
Veterans Rural Health Resource Center-Gainesville (VRHRC-GNV), Gainesville, Florida, USA.

Dawn M Bravata (DM)

HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.
Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Regenstrief Institute, Indianapolis, Indiana, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH