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 VeteransI 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. Richmond Boston (1) Syracuse (2) Bronx (3) Philadelphia (4) Washington D.C (5) Richmond (6) Designated Polytrauma Sites

8. Tampa Augusta (7) Tampa (8) Nashville (9) Houston (16) Dallas (17) Designated Polytrauma Sites

9. Minneapolis Cleveland (10) Indianapolis (11) Hines (12) St. Louis (15) Minneapolis (23) Designated Polytrauma Sites

10. Palo Alto Tucson (18) Denver (19) Seattle (20) Palo Alto (21) West LA (22) Designated Polytrauma Sites

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 HearingLoss Polytrauma Rehabilitation Center Head Injuries Spinal Cord Injury Program Cord injury Pain Management Pain Amputations Soft Tissue Trauma Emotional Shock Vision Loss Amputee Program Rehabilitation And Orthopedic Programs PTSD Program 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