International Workshop on Veterans Affairs

Size: px

Start display at page:

Download "International Workshop on Veterans Affairs"

Thomasine Waters
5 years ago
Views:

1 International Workshop on Veterans Affairs VHA Overview - with a Focus on Medical Service System Especially for Elderly Veterans Madhulika Agarwal MD; MPH Deputy Under Secretary for Health for Policy and Services August 2011

2 Secretary Shinseki s Key Principles People Centric Honor and Serve Veterans and Their Families Embrace VA Core Values of Compassion, Integrity, Respect, and Commitment Engage, Inspire, and Empower Employees Results Driven Ensure Improved Access for All Veterans Provide High-Quality Care and Exceptional Client Relationship Management Leverage Technology and Adapt Business Processes with Agility Demonstrate Leadership, Accountability, and Effective Results Forward Looking Communicate Widely and Effectively and Conduct Systematic Outreach and Collaboration Anticipate Veterans Needs and Be Pro-Active in Meeting Them Develop a VA Culture that Is Forward Looking, Innovative, and Veteran- Focused 2

3 One VA Today s modern VA is a dynamic partnership. We divide our shared mission between three organizations. VA = VHA + VBA + NCA VHA manages one of the largest healthcare systems in the world. VBA supplies compensation and vocational assistance to disabled Veterans. NCA honors Veterans with a final resting place & lasting memorials that commemorate their service to our Nation. 3

4 Vision VHA will continue to be the benchmark of excellence and value in health care and benefits by providing exemplary services that are both patient-centered and evidence-based. This care will be delivered by engaged, collaborative teams in an integrated environment that supports learning, discovery and continuous improvement. It will emphasize prevention and population health and contribute to the Nation s wellbeing through education, research and service in national emergencies. 4

5 Key Contributor to Nation s Health Care Medical Care: Training: Research: In 2011, expects to treat 6 million patients. We are among the largest providers of health professional training in the world. We are among the largest and most productive research organizations in the U.S. Disaster Assistance: We are a principle Federal asset for providing medical assistance in major disasters. Homeless Care: We are the largest direct-care provider for homeless persons in the U.S. 5

6 Hospital System to Health System VA created 21 VISNs to transform VA Health Care from a Hospital System to a Health System. 152 Medical Centers 958 Outpatient Clinics 791 Community-Based 152 Hospital-Based 9 Mobile 6 Independent 270 Vet Centers 96 Domiciliary Residential Rehabilitation Programs FY st Quarter 133 Community Living Centers 6

7 Reaching Rural Veterans VA estimates approximately 43% of all Veterans live in rural areas. VA continues to expand health access to rural Veterans through: Fee basis care Community medical partnerships Home based telehealth Mobile health clinics 7

Preparing the Nation s Health Professionals for Tomorrow VA is the largest civilian employer in the federal government and one of the largest health care employers in the world.

8 Preparing the Nation s Health Professionals for Tomorrow VA is the largest civilian employer in the federal government and one of the largest health care employers in the world. 269,000+ Full-Time VHA Employees 82,000+ Veteran Employees In 2010, clinical traineeships and fellowships were provided to more than 100,000 students in more than 40 professions. VA is the largest provider of health care training in the United States and maintains more than 5,000 individual affiliation agreements at more than 1,200 educational institutions. 8

Influx of younger women Maternity care Mental Health Service-connected disabilities

9 VA s Health Care Expertise Since 2000, the number of women Veterans seeking VA health care services has doubled (300,000) in Influx of younger women Maternity care Mental Health Service-connected disabilities Privacy, safety, convenience Older women (largest sub population of female VA users) Menopausal needs Geriatric Care Inpatient/extended stays 1/30/2012 9

Advancing Science, Enhancing Patient Safety A targeted infection control strategy universally instituted at VA hospitals in 2007 has lowered MRSA infections by more than 60%.

10 Advancing Science, Enhancing Patient Safety A targeted infection control strategy universally instituted at VA hospitals in 2007 has lowered MRSA infections by more than 60%. Rates of Health Care-Associated MRSA Infections (VA Facilities) Intensive Care Units Hospital Wards, Surgical & Rehabilitation Units -62% -45% Source: Results of a Veterans Affairs Initiative to Prevent MRSA Infections, New England Journal of Medicine, April

11 Rich 85-Year Research History The groundbreaking achievements of VA investigators - 70 percent of whom also provide direct patient care - have resulted in three Nobel Prizes, six Lasker Awards, and numerous other distinctions Created the nicotine patch to help people stop smoking Performed the first successful liver transplant Invented the cardiac pacemaker Pinpointed genes for HIV, diabetes, and obesity susceptibility Identified schizophrenia gene and developed unique preventive drug Identified best treatments for numerous health conditions such as colon cancer psychoses, stable angina and high blood pressure Created vaccine for shingles Developed new drugs and treatment for diseases such as AIDS/HIV, diabetes, Alzheimer's, and osteoporosis 11

12 Tomorrow s Innovations VA is changing the way research is conducted and the way medicine is practiced by collecting DNA on 1 million Veterans and linking to Electronic Health Records. These VA research projects hold the promise of significant advancements to improve Veterans lives. Artificial Lens Stem Cells to Reverse Spinal Cord Injury Osseointegration PTSD Drug Development 12

13 Innovating the Brain BrainGate: Computer Activation of Paralyzed Limbs 1. Electrode array (a, b) implanted in the brain (R precentral gyrus)(c) 2. Wired to computer which communicates (d) 3. Activates paralyzed muscles or prosthetic devices 13

14 VA s PACT with Veterans Patient Aligned Care Team (PACT), VA s innovative health care model, emphasizes teams and coordinated care so Veterans are healthier and more satisfied with their health care. 14

15 Renowned Electronic Records Over 2 billion orders Clinical Health Data Repository (CHDR) 95% Computerized Provider Order Entry Facilitates claims processing, quality and legal reviews Innovations in Government Award

16 My HealtheVet A personal My HealtheVet account provides Veterans with a variety of online tools to manage their health care. Communicate with Participating Patient Aligned Care Team Members View Medical Appointments Refill Prescriptions Download and Share Personal Health Information 16

17 Meeting Specific Veterans Needs VA focuses on providing health care services that are uniquely related to Veterans health or special needs. Traumatic Brain Injury (TBI) Post-Traumatic Stress Disorder (PTSD) Readjustment Counseling Polytrauma 17

18 Managing Chronic Diseases Teleretinal Imaging Home-Telehealth Clinical Videoconferencing Between Hospital and CBOCs 18

19 VA Mental Health Care System Comprehensive system of mental health care, covering inpatient, outpatient, and residential treatment settings Transformation of VA mental health care initiated in 2005 Emphasis on evidence-based and recovery-oriented MH services More than 4,500 VA staff trained in evidence-based psychotherapies Expanded MH care access and capacity Increase in MH staff by over 7,000 since 2005 National implementation of telemental health services to expand reach of effective services Launched Veterans Crisis Hotline, which has led over 16,000 saves Nationally integrated MH services in: Primary care clinics Geriatrics settings Home-Based Primary Care Nursing homes ( Community Living Centers ) Developed and implemented an evidence-based psychosocial intervention for managing challenging dementia-related behaviors 19

20 VA Long Term Care Programs The Department of Veterans Affairs (VA) offers a spectrum of geriatric and extended care services to Veterans enrolled in its health care system The spectrum of long term care services includes non-institutional and institutional services All VA s medical centers provide home and community based outpatient long-term care programs Patient-focused approach supports the wishes of most Veterans to live at home in their own communities for as long as possible All VA medical centers offer a range of outpatient home and community based long-term care options. These patient-centric approaches support the wishes of most Veterans with disabilities to remain home and in their own communities as long as possible. 20

21 Nursing Home Care VA provides nursing home care through three venues: 133 VA owned and operated Community Living Centers (CLCs), formally known as VA Nursing Homes; Community Nursing Homes; or State Veterans Homes. VA contracts with over 2,500 Community Nursing Homes. The State Veterans Home program is growing and currently encompasses 138 nursing homes in 50 states and Puerto Rico. In fiscal year 2010, approximately 72% of VA s institutional nursing home care occurred in community and State Veterans homes. On any given day this year, more than 35,000 Veterans will receive institutional long term care through one of three venues: VA Community Living Centers (CLC), formerly known as VA Nursing Homes; Community Nursing Homes; or State Veterans Homes. 21

22 Programs to Innovate & Improve LTC Medical Foster Home Program (MFH) Medical Foster Home is a type of Community Residential Care (CRC) home chosen by the Veteran who is unable to live independently, as a preferred means to receive family-style living with room, board and personal care Veteran-Directed Home & Community Based Services Program The VD-HCBS program provides Veterans of all ages the opportunity to receive home and community based services in a consumer-directed fashion that enables them to avoid nursing home placement and continue to live in their homes and communities. Geriatric Research, Education and Clinical Centers (GRECC) These centers increase the basic knowledge of aging for health care providers and improve the quality of care through the development of improved models of clinical services and a wide variety of educational activities targeting VA staff and trainees from the full range of health disciplines. 22

23 Programs to Innovate & Improve LTC Hospice and Palliative Care (HPC) Collectively represent comfort-oriented and supportive services provided in the home, community, outpatient, or inpatient settings for persons with advanced life-limiting disease. It is a program that incorporates the physical, psychological, emotional, social, and spiritual needs of our Veterans. This program is designed to focus on the quality of life and comfort for a Veteran with an advanced disease that is life-limiting. Hospice and Palliative Care supports a balance of comfort measures, interventions and provides bereavement care to the Veteran's family. Culture Transformation The Office of Geriatrics and Extended Care initiated 59 innovative pilots of patient centered non-institutional extended care and to augment the Veteran-Directed Home and Community-Based Care program. These resources enhance options for Veterans choosing to receive their extended care in the home and community rather than in an institution. These innovative models are part of the overall transformation of how we will provide to Veterans in the future. Innovative models include: Transitional Care/Care Management, Dementia Case Management, Geriatric Primary and Specialty Care, Hospice and Palliative Care, Hospital at Home, Frontier Home Care, Mobile Adult Day Health Care, LTC Tutorial, Acute Care for the Elderly, Programs for All-Inclusive Care for the Elderly, Veteran Directed Care. 23

Supporting Caregivers Over 50% of Caregivers experience medium to high levels of stress as a results of the demands of their role as a Caregiver.

24 Supporting Caregivers Over 50% of Caregivers experience medium to high levels of stress as a results of the demands of their role as a Caregiver. VA offers Caregivers all this and more: Caregiver Support Line Education and Training Family Support Services In-Home Care Respite Care Aid & Attendance Compensation Home Adaptation Automobile Modification Transportation Assistance 24

25 VA Mission To care for him who shall have borne the battle and for his widow and his orphan Abraham Lincoln 25

Lucille Beck, PhD Chief Consultant, Rehabilitation and Prosthetic Services Veterans Health Administration Department of Veterans Affairs

How to Facilitate Rehabilitation Care Lucille Beck, PhD Chief Consultant, Rehabilitation and Prosthetic Services Veterans Health Administration Department of Veterans Affairs The only victor in war is