Evaluation of the Department of Veterans Affairs Mental Health Services (2018) / Chapter Skim
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10 Patient-Centered Care and the Veteran Experience
10 Patient-Centered Care and the Veteran Experience
Pages 221-232
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From page 221... ...
Important features of patient-centered care include increasing the engagement of patients in care and shared decision making between patients and clinicians. Research shows that patient-centered care approaches to health care delivery improve health outcomes, increase patient satisfaction, and enhance health care–seeking behavior and self-management (Rathert et al., 2013)
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From page 222... ...
BHIP teams, which can include psychologists, psychiatrists, psychiatric nurses, social workers, peer support specialists, and administrative staff, hold regular interdisciplinary team meetings to facilitate teamwork and provide the staff with dedicated time to discuss veteran care, establish treatment goals, and review other issues as they arise (Barry et al., 2016)
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From page 223... ...
The VA's recent efforts to improve patient-centered care and increase engagement include the creation of treatment decision aids. The National Center for PTSD launched an online PTSD treatment decision aid in March 2017.1 This decision aid helps patients learn about the benefits and risks of evidence-based treatment options and guides them in clarifying their preferences and treatment goals (VA, 2017a)
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Using data from the committee's survey of veterans and site visit interviews, this section examines perspectives from veterans and VA staff on various aspects of patient-centered care at the VA. The information gathered provides insights into the extent to which veterans are receiving care that is respectful of and responsive to individual patient preferences, needs, and values.
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From page 225... ...
Overall, veterans who use VA mental services reported positive care experiences on a number of questions, but there is substantial room for improvement. As Table 10-1 shows, 63 percent of survey respondents who use VA mental services indicated that their VA mental health provider helped them either some or a lot, and 61 percent were at least somewhat satisfied with the care they received.
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Among OEF/OIF/OND veterans who use VA mental health care, the adjusted odds ratio of responding being very or completely satisfied with mental health care at VA Variable Variable Value Odds Ratio Lower CL Upper CL Race Non-Hispanic black only 2.048* 1.100 3.816 Alcohol dependence score Continuous 0.956*
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From page 227... ...
Other variables that significantly predicted worse outcomes on one of the three outcome measures included some college or bachelor's degree, higher alcohol dependence score, deployment time of 25–36 months, and encouragement from others to get help. Interview data collected on the site visits illustrates some of the challenges that the VA faces in meeting patients' preferences, needs, and values.
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For example, Table 8-4 shows 69 percent reported their mental health provider understands their background and val
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Interactions with Support Staff In response to the committee's inquiry about efforts to provide customer service training and to evaluate the performance of front-line staff (VA, 2017a) , the VA responded that a standardized "soft skills" training (focused on communication skills, stress reduction, and veteran suicide prevention)
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SUMMARY Using information from the committee's survey, site visit, and literature research, this chapter examined and described patient-centered care initiatives in place at the VA. Furthermore, it described patient and provider experiences with patient-centered care.
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From page 231... ...
• Some of the VA's notable recent efforts to improve patient-centered care and increase engagement include the creation of a PTSD treatment decision aid and an expansion of the peer support program. • Findings from the committee's survey research demonstrate that a majority of veterans (69 percent)
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2014. Patient aligned care teams (PACT)
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