Research and policy recommendations from the SOTA XVI: State of the Art Conference on VA Emergency Medicine

Michael J Ward; Ula Hwang; S Nicole Hastings; Christine Timko; Jason I Chen; Anita A Vashi; Kristin Mattocks; Erica A Abel; Dawn M Bravata

doi:10.1111/acem.14679

Research and policy recommendations from the SOTA XVI: State of the Art Conference on VA Emergency Medicine

Acad Emerg Med. 2023 Apr;30(4):240-251. doi: 10.1111/acem.14679. Epub 2023 Mar 1.

Authors

Michael J Ward^{1

2

3}, Ula Hwang^{4

5}, S Nicole Hastings^{6

7}, Christine Timko^{8

9}, Jason I Chen^{10

11}, Anita A Vashi^{8

12

13}, Kristin Mattocks^{14

15}, Erica A Abel^{16

17}, Dawn M Bravata^{18

19

20}

Affiliations

¹ Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
² Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
³ Geriatric Research Education and Clinical Center (GRECC), VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
⁴ Geriatric Research Education and Clinical Center (GRECC), James J. Peters VA Medical Center, Bronx, New York, USA.
⁵ Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
⁶ HSR&D Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
⁷ Department of Medicine, Division of Geriatrics, Duke University School of Medicine, Durham, North Carolina, USA.
⁸ HSR&D Center for Innovation to Implementation, Center for Innovation to Implementation, VHA Palo Alto Health Care System, Menlo Park, California, USA.
⁹ Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Stanford, California, USA.
¹⁰ HSR&D Center to Improve Veteran Involvement in Care, Portland VA Medical Center, Portland, Oregon, USA.
¹¹ Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland, Oregon, USA.
¹² Department of Emergency Medicine, University of California, San Francisco, California, USA.
¹³ Department of Emergency Medicine (Affiliated), Stanford University, Stanford, California, USA.
¹⁴ VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, USA.
¹⁵ Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
¹⁶ HSR&D Pain Research, Informatics, Multi-morbidities, and Education Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA.
¹⁷ Yale Center for Medical Informatics, Yale School of Medicine, New Haven, Connecticut, USA.
¹⁸ VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.
¹⁹ Departments of Medicine and Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
²⁰ Regenstrief Institute, Indianapolis, Indiana, USA.

PMID: 36775279
DOI: 10.1111/acem.14679

Abstract

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.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Aged
Health Services Research
Humans
Patient Transfer
Policy
United States
United States Department of Veterans Affairs
Veterans* / psychology