scholarly journals Improving Outpatient Diabetes Care

2011 ◽  
Vol 27 (3) ◽  
pp. 233-240 ◽  
Author(s):  
Susan Kirsh ◽  
Michael Hein ◽  
Leonard Pogach ◽  
Gordon Schectman ◽  
Lauren Stevenson ◽  
...  

More than 20% of patients in the Veterans Health Administration (VHA) have diabetes; therefore, disseminating “best practices” in outpatient diabetes care is paramount. The authors’ goal was to identify such practices and the factors associated with their development. First, a national VHA diabetes registry with 2008 data identified clinical performance based on the percentage of patients with an A1c >9%. Facilities (n = 140) and community-based outpatient clinics (n = 582) were included and stratified into high, mid, and low performers. Semistructured telephone interviews (31) and site visits (5) were conducted. Low performers cited lack of teamwork between physicians and nurses and inadequate time to prepare. Better performing sites reported supportive clinical teams sharing work, time for non-face-to-face care, and innovative practices to address local needs. A knowledge management model informed our process. Notable differences between performance levels exist. “Best practices” will be disseminated across the VHA as the VHA Patient-Centered Medical Home model is implemented.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 796-796
Author(s):  
Becky Powers ◽  
Kathryn Nearing ◽  
Studi Dang ◽  
William Hung ◽  
Hillary Lum

Abstract Providing interprofessional geriatric care via telehealth is a unique clinical skillset that differs from providing face-to-face care. The lack of clear guidance on telehealth best practices for providing care to older adults and their care partners has created a systems-based practice educational gap. For several years, GRECC Connect has provided interprofessional telehealth visits to older adults, frequently training interprofessional learners in the process. Using our interprofessional telehealth expertise, the GRECC Connect Education Workgroup created telehealth competencies for the delivery of care to older adults and care partners for interprofessional learners. Competencies incorporate key telehealth, interprofessional and geriatric domains, and were informed by diverse stakeholders within the Veterans Health Administration. During this symposium, comments will be solicited from attendees. Once finalized, these competencies will drive the development of robust curricula and evaluation measures aimed at training the next generation of interprofessional providers to expertly care for older adults via telehealth.


2021 ◽  
Vol 10 ◽  
pp. 216495612110226
Author(s):  
Kavitha P Reddy ◽  
Tamara M Schult ◽  
Alison M Whitehead ◽  
Barbara G Bokhour

The Veterans Health Administration (VHA) is implementing a Whole Health System (WHS) of care that empowers and equips Veterans to take charge of their health and well-being and live their lives to the fullest, and increasingly leaders recognize the need and value in implementing a similar approach to support the health and well-being of employees. The purpose of this paper is to do the following: 1) provide an overview of the WHS of care in VHA and applicability in addressing employee resiliency; 2) provide a brief history of employee well-being efforts in VHA to date; 3) share new priorities from VHA leadership as they relate to Employee Whole Health strategy and implementation; and 4) provide a summary of the impacts of WHS of care delivery on employees. The WHS of care utilizes all therapeutic, evidence-based approaches to support self-care goals and personal health planning. Extending these approaches to employees builds upon 10 years of foundational work supporting employee health and well-being in VHA. In 2017, one facility in each of the 18 Veterans Integrated Service Networks (VISNs) in VHA was selected to participate in piloting the WHS of care with subsequent evaluation by VA’s Center for Evaluating Patient-Centered Care (EPCC). Early outcomes, from an employee perspective, suggest involvement in the delivery of the WHS of care and personal use of the whole health approach have a meaningful impact on the well-being of employees and how they experience the workplace. During the COVID-19 pandemic, VHA has continued to support employees through virtual resources to support well-being and resiliency. VHA's shift to this patient-centered model is supporting not only Veteran care but also employee health and well-being at a time when increased support is needed.


2013 ◽  
Vol 2 (1) ◽  
pp. 11-25 ◽  
Author(s):  
Elizabeth Sternke ◽  
Nicholas Burrus ◽  
Virginia Daggett ◽  
Laurie Plue ◽  
Katherine Carlson ◽  
...  

Despite many advances in stroke care treatment, there is substantial room for improvement in quality of care for stroke patients. In an attempt to disseminate up-to-date quality information and evidence-based best practices of stroke care, the Veterans Health Administration (VHA)and the VHA Stroke QUERI implemented an innovative web-based toolkit tailored for providers and program planners interested in improving stroke care quality. This study evaluated the VA Stroke QUERI Toolkit to determine its most useful aspects and those that require improvement. In-depth qualitative interviews (n = 48) were conducted with a geographically dispersed sample of clinicians and program planners throughout the VHA system. Findings suggest the Stroke QUERI toolkit was perceived as an effective, efficient and user-friendly site but knowledge of the toolkit continues to be initiated and shared mainly through individuals and small groups. To achieve greater impact a comprehensive set of strategies designed to encourage broader uptake is required.


2019 ◽  
Vol 57 (2) ◽  
pp. 461
Author(s):  
Randall Gale ◽  
Karleen Giannitrapani ◽  
Caroline Gray ◽  
Luisa Manfredi ◽  
Joy Goebel ◽  
...  

2020 ◽  
Vol 13 (4) ◽  
pp. 44-56
Author(s):  
Lesa Lorusso ◽  
Nam-Kyu Park ◽  
Sheila Bosch ◽  
I. Magaly Freytes ◽  
Ronald Shorr ◽  
...  

Objectives: To evaluate the diffusion of multisensory environments (MSEs) as an innovation at the Veterans Health Administration (VHA) and gather feedback regarding staff perceptions of barriers to uptake and effectiveness of MSEs for Veterans with dementia. Background: Responding to the need for nonpharmacological behavioral interventions, VHA funded the first MSE for Veterans with dementia in 2010. The room incorporated LED color-changing lights, bubble tubes, vibroacoustic furniture, music, and aromatherapy, and the success of this patient-centered sensory room fueled national rollouts in 2013 and 2015. Method: A qualitative interview approach was used. Thirty-two staff members participated from 12 of the 53 sites producing 21 individual interviews and 1 group interview with 11 participants. Results were analyzed by a team of eight researchers using the rapid qualitative inquiry method to identify common themes and major insights. Results: Important insights emerged with regard to staff members’ perceptions about the effectiveness of MSE therapy as well as barriers to uptake and suggested strategies for overcoming those barriers (e.g., empowering a champion, developing a clear maintenance plan). Conclusions: The findings from this research indicate MSEs are perceived as effective in improving behavior for Veterans with dementia and represent an innovation that has been well-diffused within the VHA, with great potential for future clinical applications.


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