Summary: VHA:IE is an official podcast from the Department of Veterans Affairs that features frontline VA employees who are actively engaged in moving the agency forward by developing, implementing, scaling, and spreading innovative approaches and practices that evolve the health care system and improve the way VA serves Veterans. Each episode features a discussion with the employees behind several innovative programs out of the Veterans Health Administration, and sometimes a private-sector guest.
Welcome to the VHA Innovation Ecosystem podcast! Today’s episode focuses on women Veterans, who comprise nearly 15% of all active duty military and 18% of all National Guard and Reserves. There are about 2.2 million women Veterans who make up nearly 7% of all VA health care users. Women are the fastest growing group within the Veteran population, and VA expects the number of women Veterans using VA care to increase dramatically as more women serve in the armed services. During this episode, we offer three segments that introduce programs that help women Veterans take charge of their reproductive rights, creatively tell their service stories, and connect as a community. Our first segment is with Dr. Lori Gawron at the VA Salt Lake City Health Care System. Dr. Gawron’s practice trains primary care providers in the One Key Question algorithm, which starts with a simple question: “Would you like to become pregnant in the next year?” Patient responses facilitate further conversation, and this assessment provides critical information for care, ranging from neonatal vitamins to hormonal contraceptives. Next, we speak with Carey Russ of the White River Junction VA Medical Center. In 2015, the White River Junction VAMC and the Center for Cartoon Studies came together to create the comic anthology “When I Returned,” which captures the experiences of Veterans coming home from war. However, no women Veterans were interviewed or featured in the anthology. In response to this lack of representation, Carey made it a priority and mission to collaborate on a second comic anthology with the purpose of capturing the experiences of women Veterans. Our final segment is with Deborah Harmon-Pugh and Barbara Pittman, the National Campaign Chair and the DC Metro/Capitol Region State President, respectively, of Women Veterans ROCK! A coalition of organizations supporting women Veterans and military families, Women Veterans ROCK! provides resources for housing, employment, education, financial stability, and health and wellness to enable women Veterans to excel in their post-military lives. In this segment, Deborah and Barbara explain the goals of Women Veterans ROCK! and how they fit into the organization and its community. Episode Resources: US Department of Veteran Affairs VA Salt Lake City Healthcare System The Center for Cartoon Studies White River Junction VA Medical Center Women Veterans Rock Women Veterans Civic Leadership Institute Women Veterans Rock 2020 Delegation to Capitol Hill Key Episode Quotes: "When you're at the VA and regularly care for women, you might need extra training on the importance of these topics to feel comfortable with the response that the woman may give." -- Dr. Lori Gawron, VA Salt Lake City Healthcare System "People have been, I think, really just awed, and surprised, and impressed about the women's willingness and ability to share, but also the art. It is really beautiful." -- Carey Russ, White River Junction VA Medical Center "At Women Veterans Rock, we are dedicated to engaging and empowering women Veterans primarily through post military civic engagement." -- Deborah Harmon-Pugh, National Campaign Chair of Women Veterans Rock
Welcome to VHA Innovation Ecosystem podcast! On this episode, we cover advanced care planning and programs that help Veterans have difficult conversations with their care providers and families. Dr. Kimberly Garner and Laura Taylor speak to Advanced Care Planning via Group Visits (ACP-GV). ACP-GV uses interactive, patient-centered group sessions led by health care professionals to engage Veterans in thinking about and planning for future medical decisions. Participation in the group discussions often leads to better management of chronic disease and increased access to primary care, along with enhanced communication, decision-making, and satisfaction. The second practice featured in today’s episode is the Life Sustaining Treatment Veteran Education Video. This practice aims to create a video explaining life-sustaining treatments for Veterans who are visual learners to optimize their decision-making. The video is under development by Elizabeth Williams, an Innovation Specialist and a Clinical Nurse Leader at the Gulf Coast Veterans Health Care System. In the final segment, Dr. Marvin Swartz, the co-director of the National Resource Center on Psychiatric Advance Directives (NRC-PAD) discusses psychiatric advance directives, or PADs. PADs are legal documents that record a person’s preferences for future mental health treatment. NRC-PAD serves as a place for consumers to access the timeliest PAD documentation for their jurisdiction. NRC-PAD also advocates for the implementation of laws that support patient-centered mental health care. Episode Resources: VHA Innovators Network Diffusion of Excellence Initiative U.S. Department of Veterans Affairs Gulf Coast Veterans Health Care System Little Rock Geriatric Research, Education, and Clinical Center National Resource Center on Psychiatric Advance Directives Key Episode Quotes: "A Veteran told me, ‘Thank you for caring enough about us to share this with us or to tell us about this.’ I hear fairly frequently from Veterans that they appreciate being told proactively about things and not having to hunt that information down themselves.” – Dr. Kimberly Garner, Associate Director of VISN 16, Little Rock Geriatric Research, Education and Clinical Center “We just celebrated serving 10,000 Veterans through the program, and our long-term plan is really for Advanced Care Planning via Group Visits to be offered in every VA facility, nationwide.” – Laura Taylor, National Director of Social Work Care Management and Social Work "He said if he knew that this was what the provider were talking about, he would have said no on the front end…There was a learning gap between conversations about these important things and what Veterans understood or took from that.” – Elizabeth Williams, Innovation Specialist and Clinical Nurse Leader in Acute Care at Gulf Coast Veterans Healthcare System "When a person can't consent to treatment, then treatment has to be administered involuntarily, and that can have consequences that's distressing to a person with severe mental illness…these mechanisms are out there, these legal tools are out there, but not that many people know about them. We'd like more widespread knowledge and tools to use them to be available." – Dr. Marvin Swartz, Co-Director of the National Resource Center on Psychiatric Advance Directives
Today’s episode of the VHA Innovation Ecosystem podcast will focus on the recent VHE Aungrial talks that took place on August 29th and 30th of 2018. Over 70 VA employees attended this event and shared their struggles and successes within their respective VA programs. 13 of these professionals gave presentations about their work. Among the presenters was Dr. Ellina Seckel, Associate Chief, Ambulatory and Specialty Care - Pharmacy Service at William S. Middleton Memorial Veterans Hospital in Madison Wisconsin. Dr. Seckel is in charge of implementing the Increasing Access to Primary Care Through Clinical Pharmacy Specialists program. The doctor will explain why the facility felt the need to create a new pharmaceutical position for their primary care teams and the overwhelmingly positive effects it has done for both physician and patient satisfaction. During this special mini-episode you will learn about: What makes a Clinical Pharmacy Specialist different from a traditional pharmacist? How hiring a pharmacist specialist help care access for veterans? How Dr. Seckel implemented the program and achieved such impressive results! The culture shock that had to be overcome before the program could really work. A Clinical Pharmacy Specialist’s role within a primary care team. The feedback from providers and patients. How Dr. Seckel and her team measure the success rate of the program. Dr. Seckel’s hopes for the next five years. Dr. Seckel’s final thoughts. RESOURCES & MENTIONS William S. Middleton Memorial Veterans Hospital The VHA Innovation Experience VA Innovators Network Diffusion of Excellence U.S. Department of Veterans Affairs VHA: IE Podcast Quotes from today’s episode: "Imagine every veteran having same-day access to care. Imagine every veteran being on only the medications they need, and their chronic conditions well controlled, and imagine every veteran feeling well and whole." -- Dr. Seckel "How the pharmacist provider or clinical pharmacy specialist works within the team, we do have weekly team meetings, for example on my team, once a week, I sit down with our primary care provider, our RN, the LPN, and our scheduler and we talk about the patients that might be facing so unique challenges and we strategize together on how each of us can be most supportive to that patient." -- Dr. Seckel "So pharmacist providers in Madison in 2015, recognized that we had an access issue. Wait times were greater than 30 days in primary care and we wanted to do something about it." -- Dr. Seckel "VA pharmacists providers have been able to hold scopes of practices federally since 1995, and in fact, today there are over 4000 pharmacists practicing under scopes of practices allow them these privileges today." -- Dr. Seckel Thank you for joining us for the VHA Innovation Ecosystem podcast. If you know a veteran who may need a little help or you are that veteran, please call the VA’s crisis line at 1-800-273-8255 and press 1.
The fifth episode of the VHA Innovation Ecosystem podcast, VHA:IE, focuses on how VA is helping Veterans reflect on and share their stories with their health providers, loved ones, and the community at large. On this episode, you will hear from the team behind a program that personalizes the healthcare experience by including a Veteran’s life story in their medical file, along with a project that aims to address how Veterans may confront death. You’ll also hear from a non-profit dance group that is helping restore Veterans' physical, mental, and emotional strength through workshops and public performances. The first program, My Life, My Story, is building a network of employees and volunteers who sit down with Veterans and then craft written life stories for inclusion in Veterans’ medical records. This allows Veterans to feel seen and heard and enables doctors to better understand the lives of those they care for. The program originated at the William S. Middleton Memorial Veterans Hospital in Madison, Wisconsin, and is being spread across VA as it gains popularity with both Veterans and caregivers. Dr. Ryan Vega, Director of the Diffusion of Excellence Initiative, speaks with Thor Ringler about My Life, My Story, including the challenges with sustaining the program and his future vision for it. Before I Die, the second program featured in the episode, is a worldwide community art project that is being implemented at the Tomah VA Medical Center. The facility will erect an eco-friendly recycled paper wall that will allow patients and visitors to write their answer to the question, “Before I die, I want to…” The project is meant to help patients and their loved ones begin an important discussion about death. John D’Adamo, Acting Director of the VHA Innovators Network, talks with Amanda Meinke about the wall’s ability to connect Veterans with their community and loved ones. The final segment features an interview with Jacques Heim and Chris Loverro from the non-profit dance troupe DIAVOLO. Through the Veterans Project: A Long Journey Home, DIAVOLO helps Veterans reconnect with their bodies and mental and emotional strengths. John D’Adamo sits down to discuss the program with Heim, who is DIAVOLO’s founder and artistic director, and Loverro, who is a performer and Army Veteran. Episode Resources: US Department of Veteran Affairs VHA Innovators Network Diffusion of Excellence Initiative Before I Die DIAVOLO My Life, My Story Key Episode Quotes: "We want you to talk about what's comfortable for you to share with your VA care team. We don't actually have a set of questions that we ask. We have topics that we cover." -- Thor Ringler, William S. Middleton Memorial Veterans Hospital "Some people look at death as a negative, and this way, people can write down their hopes and dreams and aspirations and build our relationship with death and one another by sharing these things." -- Amanda Meinke, Tomah VA Medical Center "I really believe the more we can bring closer the Veterans and the civilians together, for the civilians to really understand who are the Veterans, what they are about, who are they – the better we can help the Veterans." -- Jacques Hines, DIAVOLO founder and artistic director "Don't be intimidated by the dance component. It's not about learning to be a dancer, it's about coming together in a tribe and learning how to move and create." -- Chris Loverro, Army Veteran and DIAVOLO performer
The fourth episode of the VHA Innovation Ecosystem podcast, VHA:IE, focuses on LGBTQ+ Veterans and the unique challenges they face in receiving care. On this episode, you will hear from a team building a community for LGBTQ+ Veterans in the Tuscaloosa and Hampton VA Medical Centers, and learn about a program that provides comprehensive LGBT health care training to VA providers, along with a drag show fundraiser for the White River Junction VA Medical Center (WRJVAMC) LGBTQ+ Health and Equality workgroup. You’ll also hear from a non-profit that advocates for and provides resources and support to LGBTQ+ service members, Veterans, and their families. The first program, Serving All Who Served, is a health education group for LGBT Veterans that aims to improve identity-related stress, well-being, mental health, and healthcare utilization, and aims to act as a support group for LGBT Veterans. The program originated at the Hampton VA Medical Center and is being implemented at the Tuscaloosa VA Medical Center. LGBT Champion Education Program, the second VA effort featured in the episode, is based out of the Chalmers P. Wylie VA Ambulatory Care Center in Columbus, Ohio. Spearheaded by LGBTQ+ Veteran Care Coordinator Jessica Homan, the program engages providers and staff in common healthcare scenarios involving LGBT individuals and provides feedback on these hypothetical interactions. After training completion, each facility identifies LGBT Champions to form a network of providers educated in LGBT-affirming care. Our third segment focuses on Queens, Queers, and Camo, a new drag show fundraiser for the WRJVAMC LGBTQ+ Health and Equality workgroup. The first show celebrated the diversity of those who serve in the military and offered a place for LGBTQ+ Veterans to connect and enjoy a fun and relaxing evening, all while raising money for a good cause. The final segment features an interview with Jennifer Dane, the Diversity and Inclusion Policy Analyst for the American Military Partner Association (AMPA). AMPA is a non-profit that advocates for the families of LGBTQ military members and Veterans and provides a network and support system for these military families. Episode Resources US Department of Veteran Affairs VA Innovators Network Serving All Who Served LGBT Champion Education Program Queens, Queers, and Camo White River Junction VA Medical Center Hampton VA Medical Center Tuscaloosa VA Medical Center LGBT Champions Program Manchester VA Medical Center The American Military Partner Association Key Episode Quotes: "Affirmative care for our LGBT Veterans is an approach where we're acknowledging the obstacles to healthcare. So an understanding that there are certain healthcare disparities, difficulties with access, higher risk for certain healthcare concerns and suicidal ideation and, at the same time, we're embracing and celebrating a part of who they are: because it may not be all of who a person is, but LGBT identity is an important part of a person.” -- Dr. Tiffany Lange-Altman, LGBTQ Veteran Care Coordinator at Hampton VA Medical Center "Historically, LGBT veterans have not had a great experience within the military or within VA facilities. So, we want to make sure that we are giving them the best healthcare possible." -- Jessica Homan, LGBT Veteran Care Coordinator at Chalmers P. Wylie VA Ambulatory Care Center "What I noticed at the show was lots of people meeting each other for the first time who may have lived in that area of Vermont and New Hampshire for decades but never knew there were other people out there who were like them." -- Calvin Smith, Social Worker at the Manchester VA Medical Center "The biggest thing we can contribute is that, although we are a large organization, we also are collaborative and work together in other organizations, so it's all one vision." -- Jennifer Dane, Diversity and Inclusion Policy Analyst for the American Military Partner Association
The third episode of the VHA Innovation Ecosystem podcast, VHA:IE, focuses on 3D printing and its uses within the medical community. On this episode, you will hear from a team using 3D printing for art therapy and another team using 3D printing for pre-surgical planning, as well as the plan for a 3D printing training network. You’ll also hear from the creator of a 3D printing community creating free prosthetics. The first program, 3D Printing as Art Therapy, seeks to make 3D printing an integral part of recreational therapy. The program is based out of White River Junction VA Medical Center, where Recreational Therapist Brooke Robertson-Drew and VA Innovation Specialist Brynn Cole have found that 3D printing is allowing Veterans to express themselves in unique and unexpected ways and form positive relationships while learning a new skill. The second VA effort highlighted is 3D Printing for Pre-Surgical Planning, which focuses on using 3D printing to enhance Veteran care by improving understanding of complex patient anatomy. Medical imaging coupled with 3D printing can allow physicians to see and interact with patient anatomy before the patient goes to the operating room. The program is headed by Dr. Beth Ripley, an Innovation Specialist and Staff Radiologist at the VA Puget Sound Health Care System. Our third segment comes from the Chillicothe VA Medical Center, where Innovation Specialist Scott Bryant heads the 3D Printing Program. Through this program, Scott and his team train staff from other medical centers on the use of 3D printing to improve healthcare through classroom learning and hands-on creation. The program then provides 3D printing kits for the trainers to train other employees at their medical centers who are engaged in patient care. To end the episode, Jennifer Owen, the founder of Enabling the Future, speaks about the global network of volunteers who use their 3D printers to create free, 3D-printed hands and arms for those in need of an upper limb assistive device. The network of e-NABLE volunteers collaborate on ways to improve open source 3D-printable designs for hands and arms for those who were born missing fingers or who have lost them due to war, disease, or natural disaster. Episode Resources: The U.S. Department of Veterans Affairs The Diffusion of Excellence Initiative VA Innovators Network 3D Printing as Art Therapy 3D Printing for Pre-Surgical Planning e-NABLE Key Episode Quotes: “It's really incredible to get a group of Veterans together to embark on this new journey of learning a specific skill set, and it's not focused around trauma. It's not a group mental health session. It really is a shared experience.” – Brynn Cole, Innovation Specialist at the White River Junction VA Medical Center “The fact that we can now give surgeons a chance to train or practice and kind of get a practice run, looking at their patients' anatomy before they go into the operating room, is huge.” – Dr. Beth Ripley, Innovation Specialist and staff radiologist at the Seattle Division of the VA Puget Sound Health Care System “One of our Veterans is in a wheelchair, and he’s involved in the wheelchair games. He said one of the major issues they have at the games is, “Where do I put my helmet?” They have to put it on their lap, the helmet falls off, and he really wanted to make some kind of a holder for that. He was able to do that on the 3D printer.” – Scott Bryant, Innovation Specialist at the Chillicothe VA Medical Center “Because there's such a diverse amount of experiences throughout the community, you can have a design where somebody's trying really, really hard to figure out how to work a tensioner so that the fingers all work properly and the engineers are overthinking it and then, suddenly, the guy who plays guitar goes, ‘Well, why don't you just make a tensioner box like you would be able to tune a guitar?’ and they're like, ‘Why didn't we think of that?’.” – Jennifer Owen, Founder of enablingthefuture.org
The second episode of the VHA Innovation Ecosystem podcast, VHA:IE, features three programs focused on addressing opioid abuse. During this episode, you will meet the pain management team at the Tomah VA Medical Center, the team behind VA’s Opioid Overdose Education and Naloxone Distribution (OEND) Program, and the leadership of non-profit Project Lazarus. The first program, Pain University, is a comprehensive pain treatment program for Veterans that uses pain management materials and instruction to educate Veterans about alternatives to opioids and empower them to self-manage their pain without medications. Through the program, which originated at the Tomah VA, Veterans can take courses that range from basic physical pain management to electives like yoga, which are adaptable based on the needs of Veterans and availability at the facility. Dr. Kris Eneberg-Boldon, Physical Medicine and Rehabilitation Services (PMRS) Manager, and Dr. Wes Kurszewski, a physical therapist and course instructor, discuss Pain University’s coursework and how it improves quality of life for Veterans struggling with chronic pain. The second VA effort highlighted, the Opioid Education and Naloxone Distribution (OEND) Program, aims to reduce harm and risk of life-threatening opioid-related overdose and deaths among Veterans. Key components of the OEND program include education and training for Veterans and their families regarding opioid overdose prevention, recognition of opioid overdose, opioid overdose rescue response, and issuing naloxone kits. VA Boston Health Care System Patient Safety Manager Pamela Bellino, Dr. Elizabeth Oliva, OEND Program Coordinator, and Dr. Jennifer Burden, Deputy Director of Mental Health Residential Rehabilitation Treatment Programs in VA’s Office of Mental Health and Suicide Prevention, explain the motivation to scale OEND, barriers to making naloxone more widely available, and the program’s impact. Lastly, Fred Wells Brason II, Founder and CEO of Project Lazarus, and Darrell Stone, a Certified Peer Support Specialist, share how the non-profit provides training and technical assistance to communities and clinicians addressing prescription medication issues. Project Lazarus leverages experience, data, and compassion to empower communities and individuals to prevent overdoses and opioid poisonings, establish effective addiction treatment and support, and meet the needs of those living with pain. Episode Resources: US Department of Veterans Affairs Diffusion of Excellence VA Innovators Network Pain University Opioid Overdose Education and Naloxone Distribution (OEND) Program Project Lazarus VA Crisis Line (1-800-273-8255, press 1) Key Episode Quotes: "One of our goals is to help supplement the opiate safety initiative to reduce opiates, but at the same time to prevent opiate-use from ever starting." -- Dr. Kristin Eneberg-Boldon, Physical Medicine Rehabilitation Service Manager at the Tomah VA Medical Center "No two lower back pains are the same, there are some commonalities, but everybody has their own factors involved in their pain." -- Dr. Wes Kurszewski, Physical Therapist at the Tomah VA Medical Center "The problem is [that] naloxone is not readily available in many hospital settings where someone might experience an opioid overdose." -- Pam Bellino, Patient Safety Manager at VA Boston Healthcare System "[Naloxone] is an amazing medication because it is inert unless opioids are present. That means it won't have any effect unless there are opioids in the system." -- Dr. Elizabeth Oliva, Opioid Overdose Education and Naloxone Distribution (OEND) Program "I was also called upon to intervene in soldiers who had developed substance use issues at Fort Bragg to help them change what needed to be changed in order for them not to be dishonorably discharged and lose their Veteran benefits." -- Fred Wells Brason II, Project Lazarus
The inaugural episode of VHA:IE features three innovative suicide prevention programs – two from the VA health care system and one from the private sector. The first VA program, Preventing Veteran Suicide by Partnering with Faith-Based Organizations, engages faith-based leaders and community members to identify and refer Veterans and Service members who may be at risk for suicide. Dr. Joseph Hunter, the suicide prevention coordinator at the Albany Stratton VA Medical Center in Albany, New York , discusses the approach his team took to outreach with organizations, the obstacles Joe and his team ran into as they have built the program, the positive effect within the community, and methods to measure success. The second VA program highlighted, REACH VET, uses Veteran health records to identify individuals at risk for suicide and provides targeted interventions. Aaron Eagan, National Program Manager for REACH VET, and Dr. Jodie Trafton, Director of Program Evaluation and Resource Center at the VA Office of Mental Health and Suicide Prevention, discuss the initial idea that sparked REACH VET and how the program identifies at-risk Veterans, plus they share some of the technical and communication barriers their team faced when getting the program off the ground. Lastly, Antigone Davis, Global Head of Safety at Facebook, describes Facebook’s push to make its users aware of their power to help someone with suicidal ideations leveraging artificial intelligence and pattern recognition to flag posts and comments with phrases that identify at-risk members. She delves further into the software’s power and the overwhelming support the program has received from the Facebook user community. Episode Resources: • The U.S. Department of Veterans Affairs • VA Innovators Network • Albany Stratton VA Medical Center • Atlanta VA Health Care System • Preventing Veteran Suicide by Partnering with Faith-Based Organizations • REACH VET • VA Crisis Line (1-800-273-8255, press 1) Key Episode Quotes: "There are about fourteen Veterans dying by suicide on a daily basis. We needed a strategy to try to reach out to that population." -- Joseph Hunter, Suicide Prevention Coordinator "REACH VET is really an opportunity to use our rich data and our electronic medical records and what is really some complicated math to say that this veteran might be at risk." -- Aaron Eagan, National Program Manager for REACH VET "It is quite amazing to see how people will respond with offers of help or offers of comfort or support when someone indicated they may be in distress." -- Antigone Davis, Global Head of Safety, Facebook