Veterans Emergency Management Evaluation Center, North Hills, CA, USA; Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.
VA Eastern Colorado Health Care System Denver-Seattle Center of Innovation, Aurora, CO, USA.
J Am Med Dir Assoc. 2022 Jun;23(6):917-922. doi: 10.1016/j.jamda.2022.03.014. Epub 2022 Apr 4.
Describe how Department of Veterans Affairs (VA) Home Based Primary Care (HBPC) team members discussed the COVID-19 vaccine with Veteran patients and their caregivers; describe HBPC team members' experiences providing care during the pandemic; identify facilitators and barriers to vaccinating HBPC Veterans during the COVID-19 pandemic.
Online survey that included 3 open-ended COVID-19 vaccine-related questions.
HBPC Program Directors from 145 VA Medical Centers were invited to participate and share the survey invitation with team members. The survey was open from March to May 2021. We collected N = 573 surveys from 73 sites.
We analyzed demographic data using descriptive frequencies and open-ended questions using thematic analysis.
Respondents from all HBPC roles were included in the study: Registered Nurses, Psychologists, Advanced Registered Nurse Practitioners, Social Workers, Dieticians, Occupational Therapists, Pharmacists, Physical Therapists, HBPC Program Directors, HBPC Medical Directors, MDs, Physician Assistants, Other. Qualitative thematic analysis revealed 3 themes describing VA HBPC team members' experiences discussing and administering the COVID-19 vaccine: communication and education, advocating for prioritization of HBPC Veterans to receive the vaccine, and logistics of delivering and administering the vaccine.
Our study findings highlight the multifaceted experiences of VA HBPC team members discussing and administering initial doses of the COVID-19 vaccine to primarily homebound Veterans. Although the VA's HBPC program offers an example of a singular health care system, insights from more than 70 sites from across the United States reveal key lessons around the internal and external structures required to successfully support programs and their staff in providing these key activities. These lessons include proactively addressing the needs of homebound populations in national vaccine rollouts and developing vaccine education and training programs for HBPC team members specifically aligned to HBPC program needs. These lessons can extend to non-VA organizations who care for similar homebound populations.
描述退伍军人事务部（VA）家庭为基础的初级保健（HBPC）团队成员如何与退伍军人患者及其护理人员讨论 COVID-19 疫苗；描述 HBPC 团队成员在大流行期间提供护理的经验；确定在 COVID-19 大流行期间为 HBPC 退伍军人接种疫苗的促进因素和障碍。
包括 3 个与 COVID-19 疫苗相关的开放性问题的在线调查。
从 145 个 VA 医疗中心邀请 HBPC 项目主任参加，并与团队成员分享调查邀请。该调查于 2021 年 3 月至 5 月开放。我们从 73 个地点共收集了 573 份调查。
我们使用描述性频率分析人口统计学数据，并使用主题分析对开放性问题进行分析。
研究包括来自所有 HBPC 角色的受访者：注册护士、心理学家、高级注册护士从业者、社会工作者、营养师、职业治疗师、药剂师、物理治疗师、HBPC 项目主任、HBPC 医疗主任、MD、医师助理、其他。定性主题分析揭示了描述 VA HBPC 团队成员讨论和管理 COVID-19 疫苗接种经验的 3 个主题：沟通和教育、倡导将 HBPC 退伍军人列为优先接种疫苗的对象，以及提供和管理疫苗的后勤工作。
我们的研究结果突出了 VA HBPC 团队成员讨论和管理最初剂量的 COVID-19 疫苗给主要居家的退伍军人的多方面经验。尽管 VA 的 HBPC 计划提供了一个单一医疗保健系统的范例，但来自美国各地 70 多个地点的见解揭示了在成功支持计划及其工作人员提供这些关键活动方面所需的内部和外部结构的关键经验教训。这些经验教训包括在国家疫苗推出中主动解决居家人群的需求，并为 HBPC 团队成员专门制定与 HBPC 计划需求相一致的疫苗教育和培训计划。这些经验教训可以扩展到照顾类似居家人群的非 VA 组织。
