VHA Polytrauma System of Care: Current Developments

1
VHA Polytrauma System of Care Current
Developments

• Micaela Cornis-Pop, Ph.D.
• VA SLP National Conference
• Dallas, 2006

2
A New Generation of Veterans I am 26 years old,
back from the war in Iraq, and live in the VA
Nursing home in Washington DC
I am married to Jason and we have a daughter
3
LtCol Maxwell Tim USMC
Nine months ago, Marine Lt. Col. Tim Maxwell
could barely speak. His right side didn't work -
none of it from his vision down to his foot.
Thoughts got jumbled in his brain. His left arm
was almost useless.
But Maxwell isn't the kind of guy who gives up
easily.
It's probably why Maxwell, 40, is where he is
today - a Marine still on active duty looking for
ways to improve himself and the Marine Corps.
Devil Dog Marines Blog, March 2006
4
New Patient Population

• Complex injuries with resulting long term
  disabilities
• Require access to a broad spectrum of services
• Providers should have specialized training and
  experience in polytrauma
• Mild injuries can produce functional impairments
  with delayed onset

5
High Expectations

• Patients and families
• State of the art care
• Advanced rehabilitation opportunities
• Extended inpatient rehabilitation
• VA Leadership
• External stakeholders

6
Polytrauma System of Care

• Polytrauma Rehabilitation Centers
• Regional, acute rehab, training, research
• Polytrauma Network Sites
• VISN, post acute rehab, community re-entry
• Polytrauma Facility Team
• Local, follow up per expertise
• Polytrauma Case Management
• Local, case management

7
Designated Polytrauma Sites

• Richmond

• Boston (1)
• Syracuse (2)
• Bronx (3)
• Philadelphia (4)
• Washington D.C (5)
• Richmond (6)

8
Designated Polytrauma Sites

• Tampa

• Augusta (7)
• Tampa (8)
• Nashville (9)
• Houston (16)
• Dallas (17)

9
Designated Polytrauma Sites

• Minneapolis

• Cleveland (10)
• Indianapolis (11)
• Hines (12)
• St. Louis (15)
• Minneapolis (23)

10
Designated Polytrauma Sites

• Palo Alto

• Tucson (18)
• Denver (19)
• Seattle (20)
• Palo Alto (21)
• West LA (22)

11
Implementation of PNSs

• Current efforts
• Interdisciplinary teams and processes
• Setting up programs, space, and equipment
• Outreach to patients and services within facility
  and the VISN
• Communication with other programs
• Education and training

12
Polytrauma Rehabilitation Care
A SLP Program
Brain Injury Program
Polytrauma Rehabilitation Center
Hearing Loss
Head Injuries
Spinal Cord Injury Program
Cord injury
Pain Management
Pain
Amputations
Soft Tissue Trauma
Emotional Shock
Vision Loss
Amputee Program
PTSD Program
Rehabilitation And Orthopedic Programs
Blind Rehabilitation Program
13
Rehabilitation Care for the New Generation Of
Veterans

• Coordinated multidisciplinary rehabilitation
• Challenging goals
• Age appropriate materials and procedures
• Participation in life activities
• Computer savvy
• Strong family and community support

14
Education and Training

• Polytrauma Acute Clinical Care Issues, 7/05
• Polytrauma Rehabilitation Processes and
  Challenges, 8/05
• Health Promotion and Reintegration after Injury
  during Deployment, 8/05
• Traumatic Brain Injury, 1/04, VHI
• Polytrauma Symposium, Las Vegas, Aug 1-3

15
Telehealth

• Links PRCs PNSs
• Videoconferencing
• Coordination of care
• Consultations
• Clinical services
• Education