2.50
Hdl Handle:
http://hdl.handle.net/10755/166389
Category:
Abstract
Type:
Presentation
Title:
Improve Access to Care for Veterans Integrated Service Networks (VISN) Referrals
Author(s):
Reese, MaryAnne; Jordan, Claudeth
Author Details:
MaryAnne Reese, MSN, RN, at the Michael E. DeBakey VA Medical Center, Houston, TX, email: maryanne.reese@va.gov; Claudeth Jordan, MPH, RN
Abstract:
HEALTHCARE ORGANIZATION DESCRIPTION: Operated by the Department of Veterans Affairs (VA), one of the world's largest integrated healthcare systems, and a member of the Texas Medical Center, the Michael E. DeBakey VA Medical Center (MEDVAMC) serves as the primary healthcare provider for more than 120,000 veterans in southeast Texas. MEDVAMC has 352 hospital beds, a 40-bed Spinal Cord Injury Center and a 120-bed long term care unit. MEDVAMC is one of 163 medical centers operated by the Department of Veterans Affairs through the Veterans Health Administration (VHA). VHA consists of 21 Veterans Integrated Service Networks (VISN). MEDVAMC is part of the South Central VA Health Care Network or VISN 16. VISN 16 serves a veteran population of 1.8 million in an 8 state region that includes Florida, Alabama, Mississippi, Louisiana, Arkansas, Missouri, Oklahoma, and Texas. Since the beginning, VA Nursing Service has been the largest employer of nurses in the country. Today MEDVAMC employs over 600 registered nurses. BACKGROUND OF PRACTICE INNOVATION: Prior to Hurricane Katrina, the VA Medical Center in New Orleans provided specialized services to most of Louisiana, southern Mississippi and Alabama, and Pensacola, Florida. The devastation of Hurricane Katrina forced the permanent closure of the New Orleans VA Medical Center (VAMC), leaving all of the New Orleans and Gulf Cost area veterans without specialized healthcare services. The abrupt closure of the New Orleans VAMC and significant decrease in specialized services greatly increased the number of outpatient referrals to the MEDVAMC (from 1,715 in FY04 to 3,612 in FY07). In response to that demand, MEDVAMC organized the Diagnostic Referral Center (DRC), an RN staffed referral management unit designed to provide access and continuity of care by providing assistance to both patient and provider from referring facility to MEDVAMC and back to the referring facility. PRACTICE INNOVATION PURPOSE: Would a centralized RN staffed consult management unit improve access to care and patient satisfaction? PRACTICE INNOVATION OBJECTIVES: (1) Improve access to care for VISN 16 referrals (2) Create a seamless, efficient, cost-effective patient-centered process for VISN 16 outpatient referrals (3) Improve veteran satisfaction PRACTICE INNOVATION IMPLEMENTATION: The first step in the implementation process was to set up intrafacility consults between the MEDVAMC and all VISN 16 referring facilities. Since 1999 the VA has implemented a universal electronic medical records system allowing providers to view the chart of any VA patient remotely from any facility. Providers within facilities are able to electronically request a consult for a patient through the computerized patient record system (CPRS). To create this interface, the DRC RN Coordinators collaborated with information management personnel at MEDVAMC and all other referring facilities to create the technology to send consults. The next step was to write protocols for the various specialty services outlining all necessary pre and post procedure diagnostic tests and follow-up appointments. The final step was to assure the patient had transportation to and from the sending facility and MEDVAMC as well as overnight lodging, when necessary. The RN coordinator remains in continuous communication with the requesting and MEDVAMC provider and the patient in order to assure everything is in place prior to the procedure. PRACTICE INNOVATION OUTCOMES: Timely access is one of the DRCÆs highest priorities. Initial consult responses are provided within 24 working hours, significantly faster than the national VA benchmark of seven days. The DRC has also initiated a patient satisfaction survey to access the veterans' level of satisfaction related to the improved coordination of care. Based on the survey results assessed from April, 2007, to July, 2007, 90% of the patients were satisfied with the customer service provided the DRC. In order to provide extended DRC hours, the RNs in the DRC decided to self-schedule according to patient needs, staggering duty times to increase operation hours from 7:30 am to 5:30 pm rather than the time frame originally set. CONCLUSIONS: The DRC meets the needs and provides continuity of care for VISN 16 veteran population from initial consult to follow-up care at the unit level. A high level of nurse autonomy and accountability resulted in nurses adjusting their work hours to meet program and patient needs.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2008
Conference Name:
ANCC Magnet Practice Innovations
Conference Host:
American Nurses Credentialing Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleImprove Access to Care for Veterans Integrated Service Networks (VISN) Referralsen_GB
dc.contributor.authorReese, MaryAnneen_US
dc.contributor.authorJordan, Claudethen_US
dc.author.detailsMaryAnne Reese, MSN, RN, at the Michael E. DeBakey VA Medical Center, Houston, TX, email: maryanne.reese@va.gov; Claudeth Jordan, MPH, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/166389-
dc.description.abstractHEALTHCARE ORGANIZATION DESCRIPTION: Operated by the Department of Veterans Affairs (VA), one of the world's largest integrated healthcare systems, and a member of the Texas Medical Center, the Michael E. DeBakey VA Medical Center (MEDVAMC) serves as the primary healthcare provider for more than 120,000 veterans in southeast Texas. MEDVAMC has 352 hospital beds, a 40-bed Spinal Cord Injury Center and a 120-bed long term care unit. MEDVAMC is one of 163 medical centers operated by the Department of Veterans Affairs through the Veterans Health Administration (VHA). VHA consists of 21 Veterans Integrated Service Networks (VISN). MEDVAMC is part of the South Central VA Health Care Network or VISN 16. VISN 16 serves a veteran population of 1.8 million in an 8 state region that includes Florida, Alabama, Mississippi, Louisiana, Arkansas, Missouri, Oklahoma, and Texas. Since the beginning, VA Nursing Service has been the largest employer of nurses in the country. Today MEDVAMC employs over 600 registered nurses. BACKGROUND OF PRACTICE INNOVATION: Prior to Hurricane Katrina, the VA Medical Center in New Orleans provided specialized services to most of Louisiana, southern Mississippi and Alabama, and Pensacola, Florida. The devastation of Hurricane Katrina forced the permanent closure of the New Orleans VA Medical Center (VAMC), leaving all of the New Orleans and Gulf Cost area veterans without specialized healthcare services. The abrupt closure of the New Orleans VAMC and significant decrease in specialized services greatly increased the number of outpatient referrals to the MEDVAMC (from 1,715 in FY04 to 3,612 in FY07). In response to that demand, MEDVAMC organized the Diagnostic Referral Center (DRC), an RN staffed referral management unit designed to provide access and continuity of care by providing assistance to both patient and provider from referring facility to MEDVAMC and back to the referring facility. PRACTICE INNOVATION PURPOSE: Would a centralized RN staffed consult management unit improve access to care and patient satisfaction? PRACTICE INNOVATION OBJECTIVES: (1) Improve access to care for VISN 16 referrals (2) Create a seamless, efficient, cost-effective patient-centered process for VISN 16 outpatient referrals (3) Improve veteran satisfaction PRACTICE INNOVATION IMPLEMENTATION: The first step in the implementation process was to set up intrafacility consults between the MEDVAMC and all VISN 16 referring facilities. Since 1999 the VA has implemented a universal electronic medical records system allowing providers to view the chart of any VA patient remotely from any facility. Providers within facilities are able to electronically request a consult for a patient through the computerized patient record system (CPRS). To create this interface, the DRC RN Coordinators collaborated with information management personnel at MEDVAMC and all other referring facilities to create the technology to send consults. The next step was to write protocols for the various specialty services outlining all necessary pre and post procedure diagnostic tests and follow-up appointments. The final step was to assure the patient had transportation to and from the sending facility and MEDVAMC as well as overnight lodging, when necessary. The RN coordinator remains in continuous communication with the requesting and MEDVAMC provider and the patient in order to assure everything is in place prior to the procedure. PRACTICE INNOVATION OUTCOMES: Timely access is one of the DRCÆs highest priorities. Initial consult responses are provided within 24 working hours, significantly faster than the national VA benchmark of seven days. The DRC has also initiated a patient satisfaction survey to access the veterans' level of satisfaction related to the improved coordination of care. Based on the survey results assessed from April, 2007, to July, 2007, 90% of the patients were satisfied with the customer service provided the DRC. In order to provide extended DRC hours, the RNs in the DRC decided to self-schedule according to patient needs, staggering duty times to increase operation hours from 7:30 am to 5:30 pm rather than the time frame originally set. CONCLUSIONS: The DRC meets the needs and provides continuity of care for VISN 16 veteran population from initial consult to follow-up care at the unit level. A high level of nurse autonomy and accountability resulted in nurses adjusting their work hours to meet program and patient needs.en_US
dc.date.available2011-10-27T15:32:37Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T15:32:37Z-
dc.conference.date2008en_US
dc.conference.nameANCC Magnet Practice Innovationsen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host for further details regarding this item.-
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