TY - JOUR. T1 - Performance of endovascular aortic aneurysm repair in high-risk patients. T2 - Results from the Veterans Affairs National Surgical Quality Improvement Program. AU - Bush, Ruth L.. AU - Johnson, Michael L.. AU - Hedayati, Nasim. AU - Henderson, William G.. AU - Lin, Peter H.. AU - Lumsden, Alan B.. PY - 2007/2. Y1 - 2007/2. N2 - Objective: Recent results after endovascular abdominal aortic aneurysm repair (EVAR) have brought into question its value in patients deemed at high-risk for surgical intervention. The Department of Veteran Affairs (VA) National Surgical Quality Improvement Program (NSQIP) is the largest prospectively collected and validated United States surgical database representing current clinical practice. The purpose of our study was to evaluate outcomes after elective EVAR performed in high-risk veterans. Methods: Using NSQIP data from 123 participating VA hospitals, we retrospectively evaluated patients who underwent elective aneurysm repair from May 2001 to ...

Department of Veterans Affairs VHA DIRECTIVE Veterans Health Administration Washington, DC VHA OUTPATIENT SCHEDULING PROCESSES AND PROCEDURES 1. PURPOSE: This Veterans Health Administration

We assessed implementation of precision medicine within the Veterans Health Administration. We analyzed the use of interleukin-28B (IL28B) pharmacogenetic test, which predicts interferon-alpha treatment response in patients with hepatitis C. Patients with favorable CC genotype exhibit a two-fold higher response than patients with less favorable genotypes (CT and TT). Linking IL28B tests to Veterans Health Administration clinical data, we analyzed test use, concordance with guidelines, subsequent interferon-a treatment, and site variations.

The National Comprehensive Cancer Network and the American Society of Clinical Oncology have established guidelines for the treatment and surveillance of colorectal cancer (CRC), respectively. Considering these guidelines, an accurate and efficient method is needed to measure receipt of care. The accuracy and completeness of Veterans Health Administration (VA) administrative data were assessed by comparing them with data manually abstracted during the Colorectal Cancer Care Collaborative (C4) quality improvement initiative for 618 patients with stage I-III CRC. The VA administrative data contained gender, marital, and birth information for all patients but race information was missing for 62.1 % of patients. The percent agreement for demographic variables ranged from 98.1-100 %. The kappa statistic for receipt of treatments ranged from 0.21 to 0.60 and there was a 96.9 % agreement for the date of surgical resection. The percentage of post-diagnosis surveillance events in C4 also in VA administrative

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BACKGROUND: The Veterans Health Administration (VHA) has introduced an integrated electronic medical record, performance measurement, and other system changes directed at improving care. Recent comparisons with other delivery systems have been limited to a small set of indicators.. OBJECTIVE: To compare the quality of VHA care with that of care in a national sample by using a comprehensive quality-of-care measure.. DESIGN: Cross-sectional comparison.. SETTING: 12 VHA health care systems and 12 communities.. PATIENTS: 596 VHA patients and 992 patients identified through random-digit dialing. All were men older than 35 years of age.. MEASUREMENTS: Between 1997 and 2000, quality was measured by using a chart-based quality instrument consisting of 348 indicators targeting 26 conditions. Results were adjusted for clustering, age, number of visits, and medical conditions.. RESULTS: Patients from the VHA scored significantly higher for adjusted overall quality (67% vs. 51%; difference, 16 percentage ...

Although opioids are frequently prescribed for chronic non-cancer pain (CNCP) among Veterans Health Administration (VHA) patients, little has been reported on national opioid prescribing patterns in the VHA. Our objective was to better characterize the dosing and duration of opioid therapy for CNCP in the VHA. We analyzed national VHA administrative and pharmacy data for

Some of these indicators included: The reform also changed the procedure for allocating funds to the various VISNs. Health Benefits for Veterans. ○ Boggle. . (2017). Hawley also promoted resident and teaching fellowships at VA hospitals. policies governing the Department of Veterans Affairs, Veterans Health Administration (VHA), and the Bylaws and Rules hereinafter stated. This study indicates that the VA still has room for improvement with convenience and education regarding womens medical services[22]. To make squares disappear and save space for other squares you have to assemble English words (left, right, up, down) from the falling squares. . (December 2007). That transformation included eliminating underutilized inpatient beds and facilities, expanding outpatient clinics, and restructuring eligibility rules. Privacy policy Yano et al. With a SensagentBox, visitors to your site can access reliable information on over 5 million pages provided by Sensagent.com. As states and cities across ...

By JOEL KUPERSMITH, MD. The waitlist scandals of 2014 opened a broad discussion on the future of the Veterans Health Administration (VHA). The immediate Congressional response was an Act that funded the Choice Program whereby VHA enrollees could obtain care in the community under certain circumstances. The same Act also mandated the blue ribbon Commission on Care Report and VAs Consolidation Plan, both of which had wide-ranging plans to change VHA as have similar documents by veteran service organizations (VSOs).. A central component of these plans and proposals are options for community providers to care for VHA enrollees. Although VA had only 90 days to implement the Choice Program and it has had administrative difficulties, 1 million of the 9 million VHA enrollees have received part of their care in the community via the Choice Program. Scattered programs have outsourced VHA care in the past, but a community care option is now a basic expectation for VHA enrollees, a major reform in the ...

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the U.S. government.. Financial Support: This article is based on research conducted by the Minneapolis Evidence-based Synthesis Program and was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative.. Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1027.. Requests for Single Reprints: Nancy Greer, PhD, Minneapolis Veterans Affairs Health Care System, One Veterans Drive, Mail Code 152, Minneapolis, MN 55417; e-mail, [email protected] Current Author Addresses: Drs. Greer and Wilt, Mr. MacDonald, Mr. Fitzgerald, and Mr. Rutks: Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, One Veterans Drive, Mail ...

Acknowledgment: The authors thank Megan Van Noord for help with the literature search and retrieval and Liz Wing for editorial assistance.. Grant Support: By the Veterans Affairs Office of Academic Affiliations (fellowship support TPM 21-022; Dr. Duan-Porter) and the Veterans Health Administration Health Services Research & Development (Career Development Award 13-263; Dr. Goldstein).. Disclosures: Dr. Duan-Porter reports grants from the U.S. Department of Veterans Affairs during the conduct of the study. Dr. Goldstein reports grants from U.S. Department of Veterans Affairs and Veterans Affairs Health Services Research & Development Service during the conduct of the study. Dr. Clowse reports other support (funding from the U.S. Department of Veterans Affairs to members of the author group) during the conduct of the study and personal fees (UCB Pharma) and grants (Pfizer and Janssen) outside the submitted work. Dr. Allen LaPointe reports other support (Center for Health Services Research in ...

Health reform increased Medicaid enrollment, but was not associated with Veterans Health Administration and private insurance enrollment among Massachusetts veterans.

As part of the Department of Veterans Affairs National Initiative, we recently started benchmarking our facilitys energy use through the EPA s Portfolio Manager. We applied for the ENERGY STAR as a part of our continuing effort to publicize our energy saving activities to our community and the nation and received the ENERGY STAR in 2006. As a part of the VAs national program, we report our energy consumption data to the Department of Veterans Affairs national database on a quarterly basis. Our focus on including energy efficiency in all retrofits and construction has increased over the years. We plan to continue our energy efficiency efforts to maximize benefits from our energy intensive systems. Several projects are in the works including the replacement of a HVAC chiller for the dermatology department (a $110,000 investment with a 2.5 year expected payback period) and connecting the lighting systems with the building automation system ...

Lawmakers on Capitol Hill mulling legislation to extend a program that lets veterans seek health care in the private sector have revived their longstanding complaints about long wait times for care at the Veterans Health Administration facilities. Veterans Affairs Secretary David Shulkin and Dr. Baligh Yehia, the agencys assistant under secretary, appeared before the House Committee on Veterans Affairs to testify on HR 369, a bill that would allow the Veterans Access, Choice, and Accountability Act to continue past its sunset date of August 2017. In 2014, after revelations of wait-time problems at some Veterans Health Administration (VHA) facilities, Congress created the three-year Choice program allowing eligible veterans to seek care in the private sector if they live 40 miles from a VHA facility or have to wait for more than 30 days for an appointment. The bill would let the VHA spend what remains of the initial $10 billion (about $1 billion) allocated to Choice on care in the private ...

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Learn about veterans health care benefits such as eligibility and enrollment, medical services and medication, VA medical programs, counseling services and vocational services

New Mexico Veterans Administration (VA) Health Care System, Health Care. 1501 San Pedro Dr SE Albuquerque, NM 87108. (505) 256-5790

Cost issues. Various options are available for purchasing ATDM services. The automated system used in the current study and the prior county clinic study was a Teleminder Model IV automated telephone-messaging computer produced by Decision Systems (Los Altos, CA). Vendors such as Decision Systems sell computer equipment to health care providers who then develop and manage the ATDM system with occasional technical support from the vendor. The cost for such a system is ∼$15-25 per patient annually, including the costs of computer programming and database management but excluding the services impact on nursing care costs. Other vendors develop Web-based automated telephone-messaging services according to a health systems specifications, manage patient calls, and process patients health data for providers. These services often are priced in units of patient contact time. The cost of an intervention similar to the one evaluated in the current study would be in the range of $17-30 per patient ...

The IAM is calling on top Veterans Affairs officials to ensure that employees and veterans at VA facilities are adequately protected from COVID-19.. IAM International President Robert Martinez Jr. says the agency must provide all workers with personal protective equipment, clean and sanitize workplaces in a timely manner and follow all CDC guidelines.. When it comes to the critical work our members do every day, serving and protecting our nation, the Veterans Administration must ensure that the men and women who do the work are protected from COVID-19, wrote Martinez.. The IAM and the National Federation of Federal Employees Federal District 1 (NFFE-IAM) have sounded the alarm over several VA facilities with a lack of PPE and rising COVID-19 cases. Stories have emerged of inadequate basic safety supplies, such as masks, soap and hand sanitizer.. We will be monitoring the Veterans Administration to ensure that workers are protected and that they are never forced to choose between their job and ...

Our collaborative care intervention resulted in more-rapid improvement in depression symptomatology and a more-rapid and sustained improvement in mental health status compared to a consult-liaison model that resembled the primary care-mental health relationship that exists in many primary care settings. Although there was some variability between the 2 groups in the amount of change in the SCL, SF-36 MCS, and Sheehan scales 3 and 9 months after enrollment, all significant differences favored collaborative care. Analyses adjusting for patient baseline characteristics remained significant with one exception.. To help put our findings into context, we can compare our results with the findings from a study also using the SF-36 MCS as a study outcome.45 This study of a general primary care population aged 18 to 64 compared the effectiveness of nortriptyline or 20 sessions of interpersonal psychotherapy with usual care. They found a mean change of 15 points on the SF-36 MCS in the treatment group and ...

The underlying principle of PCMH is that primary care should strive to be patient-centered-that is, focused on each patients individual needs and characteristics, rather than compelling patients to adapt to the constraints posed by the health system. VA adoption of PCMH reinforces the mission of patient-centered primary care by integrating psychosocial and environmental determinants of health. Implementation was accomplished with enhancements to staff support through new FTEE, but also by optimizing staff productivity through improved team function and interpersonal care. The expansion of primary care efforts to include care coordination and patient and family education included the expectation that a broader range of patient needs would be thereby addressed.. Nationally, GeriPACT was developed in response to the existence of a small but complex subset of patients whose primary care needs were not able to be addressed adequately in the original primary care structure (eg, within the standard ...

Evaluation of mental health services provided by the VA for veterans with selected mental diagnoses and recommendations for improving capacity and quality monitoring.

Thank you for being a user of Guideline Central!. As part of our continued efforts towards protecting your privacy and personal information, weve made recent updates to our privacy policy.. By updating our privacy policy with clearer language, our goal is to help you better understand what data we collect and how we use that information. When we collect your data through site visits and account creation, we agree to never sell that information to third-parties ...

VA has a six-week online interactive workshop that offers training in how to provide better care. It also helps caregivers learn how to manage their own emotions, stress and physical health.

The National Center for Biomedical Ontology was founded as one of the National Centers for Biomedical Computing, supported by the NHGRI, the NHLBI, and the NIH Common Fund under grant U54-HG004028 ...