Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, CA, USA.
Division of Health Services Management and Policy, The Ohio State University College of Public Health, Columbus, OH, USA.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221112585. doi: 10.1177/21501319221112585.
The U.S. Department of Veterans Affairs (VA) provides essential care through transitional housing and healthcare for Veterans experiencing homelessness through the Grant and Per Diem (GPD) program and the Homeless Patient Aligned Care Team (HPACT), respectively. At the onset of the SARS-CoV-2 pandemic, GPD organizations and HPACT clinics faced the challenge of being essential providers tasked with ensuring the well-being of Veterans under their care. Through semi-structured interviews with 13 providers (6 HPACT health care providers representing 2 HPACT programs, and 7 GPD staff members) across the U.S., this study explored their experiences navigating the tasks of keeping Veterans safe and providing ongoing care from the start of the pandemic up to the 2021 interview dates. Both GPD and HPACT providers reported amplified safety concerns about COVID-19 infection among staff at the start of the pandemic, which diminished to a lower, stable level after a few months as adaptations made for safety became embedded in their routines. However, ongoing challenges included isolation and mental health challenges among Veterans, inherent limitations of telehealth as a care delivery avenue, provider frustration and burnout due to increased workload and frequent change, and the logistics of administering testing for Veterans to enter GPD housing. Enhanced pandemic preparedness planning for GPD organizations, funding for personal protective equipment (PPE) and providing technology to facilitate Veterans' telehealth access, and strategies for preventing provider burnout are critical to both sustaining homeless providers' capabilities during this pandemic and enhancing readiness to respond to the next public health emergency.
美国退伍军人事务部（VA）通过过渡性住房和医疗保健，分别通过赠款和日薪（GPD）计划和无家可归患者协调护理团队（HPACT），为无家可归的退伍军人提供基本护理。在 SARS-CoV-2 大流行开始时，GPD 组织和 HPACT 诊所面临着作为基本提供者的挑战，他们的任务是确保受其照顾的退伍军人的健康。通过对美国各地的 13 名提供者（6 名代表 2 个 HPACT 计划的 HPACT 医疗保健提供者和 7 名 GPD 工作人员）进行半结构化访谈，本研究探讨了他们在大流行开始时保护退伍军人安全并提供持续护理的经验，直至 2021 年采访日期。GPD 和 HPACT 的提供者都报告说，在大流行开始时，他们对工作人员感染 COVID-19 的安全问题感到担忧加剧，几个月后，由于为安全而做出的适应措施已经融入了他们的日常工作，这种担忧降到了较低且稳定的水平。然而，持续存在的挑战包括退伍军人的隔离和心理健康问题、远程医疗作为一种护理提供途径的固有局限性、由于工作量增加和频繁变化导致的提供者的沮丧和倦怠，以及为退伍军人进行测试以进入 GPD 住房的后勤工作。增强 GPD 组织的大流行防范计划、为个人防护设备（PPE）提供资金以及提供技术以促进退伍军人的远程医疗访问，以及防止提供者倦怠的策略，对于在这场大流行中维持无家可归的提供者的能力以及增强应对下一次公共卫生紧急情况的准备都是至关重要的。
