Standardizing Care Coordination Within the Department of Veterans Affairs

Greenstone, Clinton L.; Peppiatt, Jennifer; Cunningham, Kristin; Hosenfeld, Christina; Lucatorto, Michelle; Rubin, Michael; Weede, Adrienne

doi:10.1007/s11606-019-04997-6

Cited by 41 publications

(51 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This VA CITC contact represents an important relational coordination component which has been identified as key to cross-organization coordination; 32 in this pilot, it has contributed to the reduction of patient burden in tangible ways such as removing the need to miss work to attend to care management logistics. As VA develops its own models of coordination for community-purchased care led by the Office of Community Care, 33 perhaps there are opportunities to assimilate aspects of the current program to improve coordination between VA and the community, whether the veteran presents in VA or a communitybased care setting.…”

Section: Discussionmentioning

confidence: 99%

Behavioral Health Screening and Care Coordination for Rural Veterans in a Federally Qualified Health Center

Howren

Kazmerzak²,

Pruin

et al. 2021

J Behav Health Serv Res

View full text Add to dashboard Cite

Many rural veterans receive care in community settings but could benefit from VA services for certain needs, presenting an opportunity for coordination across systems. This article details the Collaborative Systems of Care (CSC) program, a novel, nurse-led care coordination program identifying and connecting veterans presenting for care in a Federally Qualified Health Center to VA behavioral health and other services based upon the veteran's preferences and eligibility. The CSC program systematically identifies veteran patients, screens for common behavioral health issues, explores VA eligibility for interested veterans, and facilitates coordination with VA to improve healthcare access. While the present program focuses on behavioral health, there is a unique emphasis on assisting veterans with the eligibility and enrollment process and coordinating

show abstract

Section: Discussionmentioning

confidence: 99%

Behavioral Health Screening and Care Coordination for Rural Veterans in a Federally Qualified Health Center

Howren

Kazmerzak²,

Pruin

et al. 2021

J Behav Health Serv Res

View full text Add to dashboard Cite

show abstract

“…In other cases, our veteran respondents noted that a trusted clinician (eg, a mental health provider, nurse, or primary care provider) undertook this role. Other ongoing work is attempting to address this issue by comprehensively specifying care coordination roles and responsibilities 21,35,36 . Challenges in this domain were lessened in circumstances when the care being delivered within and outside of VA required little ongoing coordination (eg, primary care in 1 setting and dental care in the other).…”

Section: Discussionmentioning

confidence: 99%

Veteran Perspectives on Care Coordination Between Veterans Affairs and Community Providers: A Qualitative Analysis

Miller

Shin

Pugatch

et al. 2020

The Journal of Rural Health

View full text Add to dashboard Cite

Objective To investigate veteran perspectives on challenges in care coordination between US Department of Veterans Affairs (VA) clinics and community providers in rural areas. Methods We completed qualitative interviews with a geographically diverse sample of 51 veterans who had used both VA and community health care services. Interviews were audio‐recorded and transcribed verbatim. We used directed content analysis (informed by previous work with VA and community staff) to elucidate findings, while remaining attentive to emergent themes. Results We report results in 5 key domains related to interorganizational care coordination: organizational mechanisms, organizational culture, relational practices, contextual factors, and the role of the Third‐Party Administrators responsible for scheduling and payment for community services. Veterans described successes and challenges in interorganizational coordination across these domains, while also reporting a variety of workarounds and mitigation strategies. Conclusions Veterans living in rural areas face myriad challenges when using health care services both within and outside of VA. In the absence of strong mechanisms for ensuring coordination and communication between health care providers at different institutions, veterans themselves may carry the primary burden for coordinating their care. Our results suggest the utility of both structural and relational approaches to enhancing interorganizational care coordination in these settings.

show abstract

“…32,33 In addition, the VA has adopted a patientcentered medical home (PCMH) approach to primary care which may reduce variation between men and women providers. [34][35][36][37] Our study design cannot unpack the influence of these individual components, including the use of electronic reminders and quarterly feedback, the ability to create registries for patient conditions to identify which patients are not meeting the benchmark, or the influence of patient-centered medical homes.…”

Section: Discussionmentioning

confidence: 99%

Does Provider Gender Affect the Quality of Primary Care?

2020

View full text Add to dashboard Cite

BACKGROUND: Women providers have a more patientcentered communication style than men, and some studies have found women primary care providers are more likely to meet quality performance measures. OBJECTIVE: To explore gender differences in the quality of primary care process and outcome measures. DESIGN: Retrospective analysis of primary care performance data from 1 year (2018)(2019). PARTICIPANTS: A total of 586 primary care providers (311 women and 275 men) who cared for 241,428 primary care patients at 96 primary care clinics at 8 Veterans Affairs (VA) medical centers. MAIN MEASURES: Our primary outcome was a composite quality measure that averaged all thirty-four primary care performance measures that assessed performance in cancer screening, diabetes care, cardiovascular care, tobacco counseling, risky alcohol screening, immunizations, HIV testing, opiate care, and continuity. Our secondary outcomes were performance on each of the 34 measures. KEY RESULTS: There was no difference in the average performance on our composite measure between men and women (75.8% vs. 76.6%, p = 0.17). Among the 34 primary care quality measures collected, there was no difference between male and female providers' performance. Using a more conservative cut-point, women were more likely to screen at-risk diabetic patients for hypoglycemia and document follow-up on risky alcohol behavior noted during patient check-in. These differences were clinically small and likely due to chance, given the multiple measures evaluated in this study. CONCLUSIONS: We found little evidence of difference in the performance on primary care quality measures between male and female providers.

show abstract

Standardizing Care Coordination Within the Department of Veterans Affairs

Cited by 41 publications

References 10 publications

Behavioral Health Screening and Care Coordination for Rural Veterans in a Federally Qualified Health Center

Behavioral Health Screening and Care Coordination for Rural Veterans in a Federally Qualified Health Center

Veteran Perspectives on Care Coordination Between Veterans Affairs and Community Providers: A Qualitative Analysis

Does Provider Gender Affect the Quality of Primary Care?

Contact Info

Product

Resources

About