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https://www.readbyqxmd.com/read/29781656/veterans-experiences-initiating-va-based-mental-health-care
#1
Michelle J Bovin, Christopher J Miller, Christopher J Koenig, Jessica M Lipschitz, Kara A Zamora, Patricia B Wright, Jeffrey M Pyne, James F Burgess
Military veterans who could benefit from mental health services often do not access them. Research has revealed a range of barriers associated with initiating United States Department of Veterans Affairs (VA) care, including those specific to accessing mental health care (e.g., fear of stigmatization). More work is needed to streamline access to VA mental health-care services for veterans. In the current study, we interviewed 80 veterans from 9 clinics across the United States about initiation of VA mental health care to identify barriers to access...
May 21, 2018: Psychological Services
https://www.readbyqxmd.com/read/29778256/hepatitis-c-care-in-the-department-of-veterans-affairs-building-a-foundation-for-success
#2
REVIEW
Pamela S Belperio, Maggie Chartier, Rachel I Gonzalez, Angela M Park, David B Ross, Tim R Morgan, Lisa I Backus
The Department of Veterans Affairs (VA) has made significant progress in treating hepatitis C virus, experiencing more than a 75% reduction in veterans remaining to be treated since the availability of oral direct-acting antivirals. Hepatitis C Innovation Teams use lean process improvement and system redesign, resulting in practice models that address gaps in care. The key to success is creative improvements in veteran access to providers, including expanded use of nonphysician providers, video telehealth, and electronic technologies...
June 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29768309/the-impact-of-a-change-in-the-price-of-va-health-care-on-utilization-of-va-and-medicare-services
#3
Richard E Nelson, Bret Hicken, Megan Vanneman, Chuan-Fen Liu, Randall Rupper
INTRODUCTION: The passage of the Veterans Access, Choice, and Accountability Act of 2014 has expanded the non-Veteran Affairs (VA) care options for eligible US Veterans. In order for these new arrangements to provide the best care possible for Veterans, it is important to understand the relationship between VA and non-VA care options. The purpose of this study was to use another recent VA policy change, one that increased the reimbursement rate that eligible Veterans receive for travel for health care to VA, to understand the use of VA and Medicare services among Medicare-enrolled Veterans...
May 15, 2018: Medical Care
https://www.readbyqxmd.com/read/29762272/differences-in-experiences-with-care-between-homeless-and-nonhomeless-patients-in-veterans-affairs-facilities-with-tailored-and-nontailored-primary-care-teams
#4
Audrey L Jones, Leslie R M Hausmann, Stefan Kertesz, Ying Suo, John P Cashy, Maria K Mor, James H Schaefer, Adi V Gundlapalli, Adam J Gordon
BACKGROUND: Homeless patients describe poor experiences with primary care. In 2012, the Veterans Health Administration (VHA) implemented homeless-tailored primary care teams (Homeless Patient Aligned Care Team, HPACTs) that could improve the primary care experience for homeless patients. OBJECTIVE: To assess differences in primary care experiences between homeless and nonhomeless Veterans receiving care in VHA facilities that had HPACTs available (HPACT facilities) and in VHA facilities lacking HPACTs (non-HPACT facilities)...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29759263/a-bedside-computerized-decision-support-tool-for-intravenous-insulin-infusion-management-in-critically-ill-patients
#5
Evan D Telford, Andrew J Franck, Andrew L Hendrickson, Nicole Maltese Dietrich
Intravenous (IV) insulin infusions using a validated protocol are the recommended method for blood glucose control in critically ill patients. Computerized decision-support tools improve quality over manual paper-based protocols. However, nonproprietary computerized tools targeting the recommended blood glucose range of 140-180 mg/dL are not readily available. A bedside computerized decision-support tool was developed at a US Department of Veterans Affairs health system to assist the nursing staff with the management of patients requiring IV insulin infusion...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29752012/impact-of-multidisciplinary-chart-reviews-on-opioid-dose-reduction-and-monitoring-practices
#6
Julianna Rivich, Jocelyn McCauliff, Allison Schroeder
INTRODUCTION: The Veterans Affairs (VA) Eastern Colorado Health Care System implemented an Opioid Safety Initiative (OSI); this included multidisciplinary chart reviews of patients with chronic, non-malignant pain on high-dose opioid therapy to provide safety recommendations to prescribers through the electronic medical record. Our study objective was to evaluate the impact of these documented recommendations. Outcomes included change in total daily opioid dose, concurrent prescribing of opioids and benzodiazepines, adherence to local VA/Veterans Integrated Service Network (VISN) policy, and monitoring practices...
April 27, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29751746/validating-the-use-of-veterans-affairs-tobacco-health-factors-for-assessing-change-in-smoking-status-accuracy-availability-and-approach
#7
Anne C Melzer, Erika A Pinsker, Barbara Clothier, Siamak Noorbaloochi, Diana J Burgess, Elisheva R Danan, Steven S Fu
BACKGROUND: Accurate smoking status is key for research purposes, but can be costly and difficult to measure. Within the Veteran's Health Administration (VA), smoking status is recorded as part of routine care as "health factors" (HF)-fields that researchers can query through the electronic health record (EHR). Many researchers are interested in using these fields to track changes in smoking status over time, however the validity of this measure for assessing change is unknown...
May 11, 2018: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29748747/use-of-guideline-recommended-treatments-for-ptsd-among-community-based-providers-in-texas-and-vermont-implications-for-the-veterans-choice-program
#8
Erin P Finley, Michael Mader, Elizabeth K Haro, Polly H Noël, Nancy Bernardy, Craig S Rosen, Mary Bollinger, Hector A Garcia, Kathleen Sherrieb, Mary Jo V Pugh
Implementation of the Veterans Choice Program (VCP) allows Veterans to receive care paid for by the Department of Veterans Affairs (VA) in community settings. However, the quality of that care is unknown, particularly for complex conditions such as posttraumatic stress disorder (PTSD). A cross-sectional survey was conducted of 668 community primary care and mental health providers in Texas and Vermont to describe use of guideline-recommended treatments (GRTs) for PTSD. Relatively, few providers reported using guideline-recommended psychotherapy or prescribing practices...
May 10, 2018: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29747919/temporal-trends-in-coronary-angiography-and-percutaneous-coronary-intervention-insights-from-the-va-clinical-assessment-reporting-and-tracking-program
#9
Stephen W Waldo, Madhura Gokhale, Colin I O'Donnell, Mary E Plomondon, Javier A Valle, Ehrin J Armstrong, Richard Schofield, Stephan D Fihn, Thomas M Maddox
OBJECTIVES: The aim of this study was to evaluate temporal trends in characteristics and outcomes among patients referred for invasive coronary procedures within a national health care system for veterans. BACKGROUND: Coronary angiography and percutaneous coronary intervention remain instrumental diagnostic and therapeutic interventions for coronary artery disease. METHODS: All coronary angiographic studies and interventions performed in U...
May 14, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29746651/the-impact-of-the-veteran-s-affairs-medical-system-on-an-otolaryngology-residency-training-program
#10
Alexander Lanigan, Mark Spaw, Christopher Donaghe, Joseph Brennan
Introduction: The field of otolaryngology has become the leading specialty in the management of head and neck pathology and trauma. Graduate medical education programs tasked to train military head and neck surgeons within the Department of Defense (DoD) maintain certification by ensuring adequate surgical case volume and training. In recent years, surgical case numbers have declined due to an overall healthy active duty patient population and deployments of residency faculty. As such, a novel initiative between the San Antonio Military Medical Center and the South Texas Veteran's Healthcare system was developed to provide seamless care among active duty service members, dependents, retirees, and veterans...
May 9, 2018: Military Medicine
https://www.readbyqxmd.com/read/29745717/factors-contributing-to-the-effective-functioning-of-veterans-mental-health-councils
#11
Sarah Beehler, Sarah A Marsella, Peggy M Henderson, Sandra G Resnick, Mark Meterko
Veterans Mental Health Councils (VMHCs) have been established at many Veterans Affairs (VA) medical centers to promote recovery and improve mental health services. Though research shows that consumer-led advisory councils may produce a number of positive outcomes, the aspects of implementation critical for VMHC effectiveness have not been identified. The purpose of this study was to identify factors influencing effective functioning of VMHC, including contextual factors affecting council success. A key goal was to understand how participants defined effective council functioning...
May 10, 2018: Psychological Services
https://www.readbyqxmd.com/read/29737404/characterization-and-survival-of-patients-with-metastatic-basal-cell-carcinoma-in-the-department-of-veterans-affairs-a-retrospective-electronic-health-record-review
#12
Vanessa W Stevens, David D Stenehjem, Olga V Patterson, Aaron W C Kamauu, Yeun Mi Yim, Robert J Morlock, Scott L DuVall
Available descriptive statistics for patients with metastatic basal cell carcinoma (mBCC) are limited. To describe disease characteristics, treatment patterns, survival outcomes, and prognostic factors of patients with mBCC, we conducted a retrospective review of electronic health records in the Department of Veterans Affairs (VA). The primary outcome was survival. Data were also collected on demographics, comorbidities, medications, and procedures. Median (IQR) age of patients with mBCC (n = 475) was 72...
May 8, 2018: Archives of Dermatological Research
https://www.readbyqxmd.com/read/29736750/a-coaching-by-telephone-intervention-on-engaging-patients-to-address-modifiable-cardiovascular-risk-factors-a-randomized-controlled-trial
#13
Eugene Z Oddone, Jennifer M Gierisch, Linda L Sanders, Angela Fagerlin, Jordan Sparks, Felicia McCant, Carrie May, Maren K Olsen, Laura J Damschroder
BACKGROUND: A large proportion of deaths and chronic illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. OBJECTIVE: To test whether telephone-based health coaching after completion of a comprehensive health risk assessment (HRA) increases patient activation and enrollment in a prevention program compared to HRA completion alone. DESIGN: Two-arm randomized trial at three sites...
May 7, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29731118/post-traumatic-stress-disorder-and-heart-failure-in-men-within-the-veteran-affairs-health-system
#14
Marat Fudim, Lukasz P Cerbin, Srikant Devaraj, Tarek Ajam, Sunil V Rao, Masoor Kamalesh
Patients with post-traumatic stress disorder (PTSD) are at risk of multiple co-morbidities and are more likely to develop incident heart failure with reduced ejection fraction (HFrEF). The relation of PTSD with clinical outcomes in HFrEF is not established. US veterans diagnosed with HFrEF from January 2007 to January 2015 and treated nationwide in the Veterans Affairs (VA) Health System were included in the study. Patients with HFrEF were identified through International Classification of Diseases, Ninth Revision (ICD-9) codes...
April 11, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29730247/health-expenditure-growth-under-single-payer-systems-comparing-south-korea-and-taiwan
#15
Shou-Hsia Cheng, Hyun-Hyo Jin, Bong-Min Yang, Robert H Blank
OBJECTIVE: Achieving universal health coverage has been an important goal for many countries worldwide. However, the rapid growth of health expenditures has challenged all nations, both those with and without such universal coverage. Single-payer systems are considered more efficient for administrative affairs and may be more effective for containing costs than multipayer systems. However, South Korea, which has a typical single-payer scheme, has almost the highest growth rate in health expenditures among industrialized countries...
May 3, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29728148/an-evidence-based-co-occurring-disorder-intervention-in-va-homeless-programs-outcomes-from-a-hybrid-iii-trial
#16
David A Smelson, Matthew Chinman, Gordon Hannah, Thomas Byrne, Sharon McCarthy
BACKGROUND: Evidence-based treatment for co-occurring disorders is needed within programs that serve homeless Veterans to assist with increasing engagement in care and to prevent future housing loss. A specialized co-occurring disorders treatment engagement intervention called Maintaining Independence and Sobriety Through Systems Integration, Outreach and Networking - Veterans Edition (MISSION-Vet) was implemented within the Housing and Urban Development - Veterans Affairs Supportive Housing (HUD-VASH) Programs with and without an implementation strategy called Getting To Outcomes (GTO)...
May 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29723021/promising-practices-in-vocational-services-for-the-community-reintegration-of-returning-veterans-the-individual-placement-and-support-model-and-beyond
#17
Nancy J Wewiorski, Jay A Gorman, Arielle A J Scoglio, Seiya Fukuda, Erin Reilly, Lisa Mueller, Maureen O'Connor, Walter E Penk, Charles E Drebing
Supporting returning veterans' job-seeking, hiring, and retention issues has become an essential goal for effective community reintegration. Given both the particular strengths and challenges associated with veterans transitioning from military to civilian life, multiple models for supported employment have become integrated into Veterans Affairs health care facilities across the nation. In this article, we review the state of vocational rehabilitation for veterans, with a particular focus on individual placement and support-supported employment (IPS-SE), the current vocational services model that is considered the gold standard of vocational rehabilitation...
May 2018: Psychological Services
https://www.readbyqxmd.com/read/29723016/family-focused-interventions-and-resources-for-veterans-and-their-families
#18
Michelle D Sherman, Jessica L Larsen
Accelerated by the decreasing military presence in Iraq and Afghanistan, many military members are currently transitioning out of active duty into civilian life. Many of these new veterans have recently experienced combat deployment(s), and some are struggling with the aftermath of combat exposure, separation from family, and reintegration stressors. These challenges often follow these military families as they enter the civilian world, a time with its own major life changes vocationally, socially, and interpersonally...
May 2018: Psychological Services
https://www.readbyqxmd.com/read/29719884/evaluation-of-multimedia-medication-reconciliation-software-a-randomized-controlled-single-blind-trial-to-measure-diagnostic-accuracy-for-discrepancy-detection
#19
Blake J Lesselroth, Kathleen Adams, Victoria L Church, Stephanie Tallett, Yelizaveta Russ, Jack Wiedrick, Christopher Forsberg, David A Dorr
BACKGROUND:  The Veterans Affairs Portland Healthcare System developed a medication history collection software that displays prescription names and medication images. OBJECTIVE:  This article measures the frequency of medication discrepancy reporting using the medication history collection software and compares with the frequency of reporting using a paper-based process. This article also determines the accuracy of each method by comparing both strategies to a best possible medication history...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29718082/integration-of-neuropsychological-services-in-a-va-hiv-primary-care-clinic
#20
Moira C Dux, Terry Lee-Wilk
The Department of Veteran Affairs (VA) is the largest health care provider for individuals with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), with >28,000 Veterans with HIV/AIDS enrolled in care. Advances in medical treatment have improved the life-limiting effects of the disease, though many chronic symptoms persist. Comprehensive care is critical to manage the diverse constellation of symptoms. However, many patients face challenges to receiving optimal care due to limited resources, mistrust of health care providers, and/or co-occurring medical, psychiatric, and substance use disorders...
May 1, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
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