scholarly journals Addressing Behavioral Symptoms of Dementia Through STAR-VA Implementation: Do Outcomes Vary by Behavior Type?

2020 ◽  
Vol 35 ◽  
pp. 153331752091157
Author(s):  
Jenefer M. Jedele ◽  
Kim Curyto ◽  
Brian M. Ludwin ◽  
Michele J. Karel
Keyword(s):  
Veterans Health Administration ◽  
Behavioral Symptoms ◽  
Veterans Health ◽  
Health Administration ◽  
Target Behavior ◽  
Target Behaviors ◽  
Multicomponent Intervention ◽  
Community Living Centers ◽  
Behavior Frequency ◽  
And Behavior

Objectives: The STAR-VA program in Veterans Health Administration Community Living Centers (CLCs, nursing home settings) trains teams to implement a psychosocial intervention with residents with behavioral symptoms of dementia (BSD). Methods: Across 71 CLCs, 302 residents selected as training cases had target behaviors categorized into one of 5 types: physically aggressive (PA), physically nonaggressive, verbally aggressive, verbally nonaggressive, and behavior deficit (BD). Results: Across all groups, there were significant declines in team-rated behavior frequency (36%) and severity (44%), agitation (10%), distress behaviors (42%), depression (17%), and anxiety (20%). The magnitude of changes varied across behavior category. For example, those with a PA target behavior experienced a greater percentage decline in agitation and distress behavior scores, and those with a BD target behavior experienced a greater percentage decline in depressive and anxiety symptoms. Conclusions: STAR-VA, a multicomponent intervention, is generally effective across various types of behavioral symptoms associated with dementia.

scholarly journals Nursing Home Referral Within the Veterans Health Administration: Practice Variation by Payment Source and Facility Type

2017 ◽  
Vol 40 (7) ◽  
pp. 687-711
Author(s):  
Edward Alan Miller ◽  
Stefanie Gidmark ◽  
Emily Gadbois ◽  
James L. Rudolph ◽  
Orna Intrator
Keyword(s):  
Nursing Home ◽  
Discharge Planning ◽  
Veterans Health Administration ◽  
Practice Variation ◽  
Veterans Health ◽  
Department Of Veterans Affairs ◽  
Health Administration ◽  
Staff Perceptions ◽  
Medical Centers ◽  
Community Living Centers

Veterans enrolled within the Veterans Health Administration (VHA) of the U.S. Department of Veterans Affairs (VA) may receive nursing home (NH) care in VHA-operated Community Living Centers (CLCs), State Veterans Homes (SVHs), or community NHs, which may or may not be under contract with the VHA. This study examined VHA staff perceptions of how Veterans’ eligibility for VA and other payment impacts NH referrals within VA Medical Centers (VAMCs). Thirty-five semistructured interviews were performed with discharge planning and contracting staff from 12 VAMCs from around the country. VA staff highlights the preeminent role that VA priority status played in determining placement in VA-paid NH care. VHA staff reported that Veterans’ placement in a CLC, community NH, or SVH was contingent, in part, on potential payment source (VA, Medicare, Medicaid, and other) and anticipated length of stay. They also reported that variation in Veteran referral to VA-paid NH care across VAMCs derived, in part, from differences in local and regional policies and markets. Implications for NH referral within the VHA are drawn.

scholarly journals Is Variation in Resident-Centered Care and Quality Performance Related to Health System Factors in Veterans Health Administration Nursing Homes?

2018 ◽  
Vol 55 ◽  
pp. 004695801878703 ◽  
Author(s):  
Jennifer L. Sullivan ◽  
Ryann L. Engle ◽  
Denise Tyler ◽  
Melissa K. Afable ◽  
Katelyn Gormley ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Health System ◽  
Veterans Health Administration ◽  
Community Living ◽  
Veterans Health ◽  
Health Administration ◽  
Staff Members ◽  
Centered Care ◽  
Community Living Centers ◽  
System Factors

The purpose of this research was to explore and compare common health system factors for 5 Community Living Centers (ie Veterans Health Administration nursing homes) with high performance on both resident-centered care and clinical quality and for 5 Community Living Centers (CLC) with low performance on both resident-centered care and quality. In particular, we were interested in “how” and “why” some Community Living Centers were able to deliver high levels of resident-centered care and high quality of care, whereas others did not demonstrate this ability. Sites were identified based on their rankings on a composite quality measure calculated from 28 Minimum Data Set version 2.0 quality indicators and a resident-centered care summary score calculated from 6 domains of the Artifacts of Culture Change Tool. Data were from fiscal years 2009-2012. We selected high- and low-performing sites on quality and resident-centered care and conducted 12 in-person site visits in 2014-2015. We used systematic content analysis to code interview transcripts for a priori and emergent health system factor domains. We then assessed variations in these domains across high and low performers using cross-site summaries and matrixes. Our final sample included 108 staff members at 10 Veterans Health Administration CLCs. Staff members included senior leaders, middle managers, and frontline employees. Of the health system factors identified, high and low performers varied in 5 domains, including leadership support, organizational culture, teamwork and communication, resident-centered care recognition and awards, and resident-centered care training. Organizations must recognize that making improvements in the factors identified in this article will require dedicated resources from leaders and support from staff throughout the organization.

An Intervention With Meaning

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 376-383 ◽  
Author(s):  
Brooke A. Levandowski ◽  
Constance M. Cass ◽  
Stephanie N. Miller ◽  
Janet E. Kemp ◽  
Kenneth R. Conner
Keyword(s):  
High Risk ◽  
Qualitative Methodology ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Safety Planning ◽  
Health Administration ◽  
Suicide Method ◽  
Treatment Providers ◽  
Interactive Nature ◽  
Behavioral Health Treatment

Abstract. Background: The Veterans Health Administration (VHA) health-care system utilizes a multilevel suicide prevention intervention that features the use of standardized safety plans with veterans considered to be at high risk for suicide. Aims: Little is known about clinician perceptions on the value of safety planning with veterans at high risk for suicide. Method: Audio-recorded interviews with 29 VHA behavioral health treatment providers in a southeastern city were transcribed and analyzed using qualitative methodology. Results: Clinical providers consider safety planning feasible, acceptable, and valuable to veterans at high risk for suicide owing to the collaborative and interactive nature of the intervention. Providers identified the types of veterans who easily engaged in safety planning and those who may experience more difficulty with the process. Conclusion: Additional research with VHA providers in other locations and with veteran consumers is needed.

Veterans Health Administration Mental Health Program Evaluation Technical Manual

2009 ◽  
Author(s):  
Marcela Horovitz-Lennon ◽  
Katherine E. Watkins ◽  
Harold Alan Pincus ◽  
Lisa R. Shugarman ◽  
Brad Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Program Evaluation ◽  
Health Program ◽  
Mental Health Program ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Technical Manual
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