National Center for Healthcare Advancement and Partnerships
American College of Emergency Physicians (ACEP)
VHA’s partnership with American College of Emergency Physicians leads to benefits for Veterans requiring emergency care
The Veterans Health Administration (VHA), as the largest integrated health care system in the United States, offers many services and programs to Veterans with specific needs. Veterans who utilize the VHA health care system are more likely than the general population to report poor physical and mental health and to have chronic health conditions, such as traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), or anxiety or depression. VHA provides Veterans with the best care to serve their specific needs, including when Veterans visit VHA emergency departments (EDs). Those Veterans who visit non-VHA EDs need to receive the best care, too.
If a Veteran visits a non-VHA ED because he or she has sustained a wound, for example, these community-based, non-VHA ED providers must have awareness of, and education around, how to care for that person given his or her Veteran-specific health conditions. To achieve this, VHA partnered with the American College of Emergency Physicians (ACEP) in August 2018 to educate community ED providers about Veteran-specific needs, services, and care, as well as to enhance recruitment efforts to bring more ED professionals to work in VHA medical facilities. VHA and ACEP have already delivered on three identified partnership goals while working together.
The goals of the partnership include: to educate non-VHA community ED providers on Veteran benefits and VHA resources (such as the Veterans Crisis Line) so that they can speak to Veterans about available options; to provide non-VHA medical professionals with education around Veteran-centered and Veteran-specific care; and to place more qualified emergency medicine professionals in VHA. This VHA-ACEP partnership will disseminate ED best practices by applying the knowledge of both organizations to services that serve Veterans’ health.
This partnership, managed by VHA’s Office of Specialty Care Services and facilitated by VHA’s Office of Community Engagement (OCE), has increased ED providers’ ability to offer Veteran-centered emergency care. Emergency care refers to hospital services that must be provided immediately to prevent the death or serious impairment to the health of the patient.
Dr. Chad Kessler, national program director for emergency care at VA, who manages this partnership through Specialty Care Services, pointed out that this partnership has been successful in myriad ways:
- Now, more resources are available (such as canes and walkers for geriatric patients) in EDs;
- VHA has been able to learn about and implement technology made available by ACEP, such as its Clinical Emergency Department Registry, its Emergency Department Information Exchange, and its Emergency Department Information System;
- Veterans’ access to VHA’s tele-urgent care program will continue to expand. Through that program, Veterans can go to outpatient care centers to speak through an iPad to ED providers about low-level acute needs, such as flu symptoms.
Josh Geiger, executive officer for emergency care at the Department of Veterans Affairs (VA) and a United States Marine Corps Veteran, called the tele-urgent care program “game-changing in the world of emergency medicine.” Thanks to this collaboration, VHA’s EDs are able to achieve the “benchmark” standard and level of quality set in the industry by ACEP, Dr. Kessler said.
ACEP, a nonprofit corporation, was founded in 1968 and its mission is founded on the idea that quality emergency care is a fundamental individual right. The organization is dedicated to providing education to Veterans and the health care professionals who treat Veterans. Dr. Kessler described ACEP as a leader in emergency medicine, saying that ACEP helped define the field.
“ACEP has been integral to growing emergency department care within VHA,” said Dr. Kessler.
VHA EDs are already on the front lines of providing exceptional care to Veteran populations, as demonstrated by the Louis Stokes Cleveland VA Medical Center ED’s recent Level 1 Geriatric ED accreditation from ACEP for its Geriatric Emergency Room Innovations for Veterans (GERI-VET) program.
The Louis Stokes Cleveland VA Medical Center ED is a standout example of the kind of high-quality ED this partnership can help support and produce. It achieved ACEP’s highest level of accreditation (Level 1) for its GERI-VET program for geriatric Veterans. The Cleveland facility is the first VA ED to receive such recognition, according to Dr. Jill Huded, acute care geriatrician at the facility. The GERI-VET program focuses on a targeted population of Veterans: geriatric (ages 65 and older) patients, who may have additional physical, psychological, and social needs when they visit an ED, such as heart disease, arthritis, or cancer. At the Cleveland ED, intermediate care technicians (ICTs) help provide care to these Veterans. ICTs are military-trained medics and corpsman who are Veterans themselves and are able to offer a level of connection with Veteran patients that enhances the patient-provider experience.
“The Cleveland ED offers a global, whole-health approach to care that is geriatric-friendly,” said Dr. Kessler. “It allows for excellent care and outcomes for geriatric Veterans.”
Now, ICTs from the Cleveland VA are training and educating providers at other facilities about this high-quality, specific care for older Veterans. This kind of training and education is mirrored in the goals and outcomes of the VHA-ACEP partnership.
VHA ED providers offer high-quality care to Veteran patients and this partnership offers non-VHA, community providers the chance to learn from VHA and ACEP together; when VHA and nongovernmental partners come together in this way, their resources combine to bring Veterans even better service.
“The care coordination offered by VHA EDs is second-to-none,” said Mr. Geiger. “There’s a sense of camaraderie in VHA EDs; I can say something to other Veterans in the VHA waiting room and feel understood.”Dr. Tracy Weistreich, acting director of OCE, said that community ED providers and Veterans alike will continue to experience positive outcomes from this partnership.
“When a Veteran comes to a VHA emergency room, they can rest assured that providers there will bear in mind their coexisting health-related needs in addition to emergency care,” she said. “Now, through this partnership, VHA can spread that knowledge to other emergency departments and we know that Veterans, no matter where they receive care, will benefit.”
To learn more about OCE and how it brings effective partnerships to life throughout VHA, visit: https://www.va.gov/healthpartnerships.
To learn more about ACEP’s work, visit: https://www.acep.org.
Posted December 2, 2019