Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Acad Emerg Med. 2023 Apr;30(4):240-251. doi: 10.1111/acem.14679. Epub 2023 Mar 1.
To better understand and prioritize research on emergency care for Veterans, the Department of Veteran Affairs (VA) Health Services Research and Development convened the 16th State of the Art Conference on VA Emergency Medicine (SAVE) in Winter 2022 with emergency clinicians, researchers, operational leaders, and additional stakeholders in attendance. Three specific areas of focus were identified including older Veterans, Veterans with mental health needs, and emergency care in the community (non-VA) settings. Among older Veterans, identified priorities included examination of variation in care and its impact on patient outcomes, utilization, and costs; quality of emergency department (ED) care transitions and strategies to improve them; impact of geriatric ED care improvement initiatives; and use of geriatric assessment tools in the ED. For Veterans with mental health needs, priorities included enhancing the reach of effective, multicomponent suicide prevention interventions; development and evaluation of interventions to manage substance use disorders; and identifying and examining safety and effective acute psychosis practices. Community (non-VA) emergency care priorities included examining changes in patterns of use and costs in VA and the community care settings as a result of recent policy and coverage changes (with an emphasis on modifiable factors); understanding quality, safety, and Veteran experience differences between VA and community settings; and better understanding follow-up needs among Veterans who received emergency care (or urgent care) and how well those needs are being coordinated, communicated, and met. Beyond these three groups, cross-cutting themes included the use of telehealth and implementation science to refine multicomponent interventions, care coordination, and data needs from both VA and non-VA sources. Findings from this conference will be disseminated through multiple mechanisms and contribute to future funding applications focused on improving Veteran health.
为了更好地了解和优先考虑退伍军人紧急护理的研究，退伍军人事务部（VA）卫生服务研究与发展部门于 2022 年冬季召集了第 16 届退伍军人事务部急诊医学最新进展会议（SAVE），参会者包括急诊临床医生、研究人员、运营领导人和其他利益相关者。确定了三个重点关注领域，包括老年退伍军人、有心理健康需求的退伍军人以及社区（非 VA）环境中的紧急护理。在老年退伍军人中，确定的优先事项包括检查护理的差异及其对患者结果、利用和成本的影响；急诊部（ED）护理过渡的质量和改善这些过渡的策略；老年 ED 护理改善计划的影响；以及在 ED 中使用老年评估工具。对于有心理健康需求的退伍军人，优先事项包括扩大有效的多组分自杀预防干预措施的覆盖面；制定和评估干预措施以管理物质使用障碍；以及确定和检查急性精神病的安全有效治疗方法。社区（非 VA）紧急护理的优先事项包括检查由于最近的政策和覆盖范围变化，VA 和社区护理环境中使用模式和成本的变化（重点关注可改变的因素）；了解 VA 和社区环境之间的质量、安全性和退伍军人体验差异；以及更好地了解接受紧急护理（或紧急护理）的退伍军人的后续护理需求以及这些需求的协调、沟通和满足情况。除了这三个群体之外，跨领域主题还包括使用远程医疗和实施科学来完善多组分干预措施、护理协调以及 VA 和非 VA 来源的数据需求。本次会议的结果将通过多种机制传播，并为未来的资金申请提供信息，这些申请的重点是改善退伍军人的健康。
