VA Emergency Clinic: Case Study

The Orlando VA Medical Center, established in October 2006 serves over 105,000 veterans around Central Florida, including a Community Living Center, two Mental Health Rehabilitation Treatment Programs/Domiciliary in two different locations, along with three large multi-specialty Satellite Outpatient Clinics and four Community-Based Outpatient Clinics.

The Hampton VA Medical Center Primary Care Service recognizes _________________ for their outstanding service. Mr./Ms.____________ performed beyond expectations to ensure that our staff and veterans needs were addressed. For their efforts, I am pleased to recommend a contribution award of $2500.

This week’s case looks at the critical situation occurring at Riverview Regional Medical Center located in Etowah County, Alabama. The medical center, located near a strong competitor, is run by a veteran in the hospital management market, Mr Matt Hayes. Hayes is actively in the process of developing new ideas and revolutionary steps in an attempt to remain competitive in the market and regain profitability. The overall performance of Riverview Regional Medical Center appears to have decreased throughout multiple departments except outpatient surgical procedures, outpatient CT imagining, MRI imagining and inpatient MRI scans.

The reporting party (RP) arrived at the facility on 6/9/16 at 7:40AM in response to male resident Douglass Gass DOB: 7/3/42 "911" call. The resident had fallen at approximately 11:00PM the night before. Consequently the resident was non-ambulatory and sustained minor injuries. The resident was treated and transported to the VA Hospital in Westwood. The RP disclosed that the resident was the "911" caller who stated he had been on the floor the entire night and no caregiver responded to his aid. During the conclusion of the call a caregiver appeared and was of the ongoing incident. The RP state several concerning conditions were observed. The facility was in violation of several Fire Code items. The resident and his roommate had no operable signal system.

Any patient brought into the Emergency Department, is first signed in at ED receptionist desk and triaged by a triage nurse, prioritized and brought to patient room by a charged nurse either by wheelchair or stretcher or walking by the patient depending on patient’s illness. A nurse is assigned to the patient. Emergency Doctor comes in and if the patient illness is life threatening it is stabilized and the Doctor orders test such as blood work and x-ray if necessary to be conducted. Based on the test result the patient is either discharged or admitted. Certain times the emergency department is filled with a lot of patient that there is no place to sit and patients keep coming in and creating

A practice change in a non-VA primary care practice led by a Nurse Practitioner (NP) that includes identifying eligible veterans and utilizing the referral process guidelines to peer support services. In the Veterans Choice Program, 2015 the authorization for all non-VA medical care for veterans who resides more than 40 miles from a VA health care clinic or is not able to obtain a medical appointment within 30 days is eligible to receive care from a non-VA entity. The consignment of all medical care appointments are over sought by Health Net, which authorizes all non-service, secured care. PCPs are highly fortified to communicate with veterans with a courtesy memorandum for their medical appointment. PCPs must adhere to the subsequent standards

The drugs protected by the law are safe yet still harmful. War veterans feeling the worst of the pain, after being honorably discharged for injuries sustained in action. While going through treatment for the injuries the veterans found themselves addicted to the pain medication. The veterans needing help through their addictions, PTSD, and injuries found themselves sedated for most of their treatment at the VA hospital. Waggoner; a patient at the VA hospital was addicted to pain medication and expected help from the medical staff. However instead of getting the help he needed he was given more drugs than necessary according to Cironline “The VA hospital in Roseburg kept him so doped up that he could barely stay awake. Then, inexplicably, the

Primary Care is a large service, thus in order to meet the medical needs of each veteran it is imperative to have the ability to make adjustments in “real-time”. To achieve these goals it is essential that the Primary Care Service expand and adapt the Group Practice Manager (GPM) approach. Furthermore, this approach is specifically designed for the Primary Care Service to maximize veteran care while meeting the standards of the Hampton VA Medical Center.

The urgent care clinic nurse is treating a client who is experiencing abdominal pain. The client states, “I think I ate tainted food last night.” What should the nurse do after the client states that the food was tainted?

The number of urgent care clinics in the United States has exploded in the past five years. In fact, the American Academy of Urgent Care Medicine says there are currently as many as 9,300 clinics in the country. It’s very clear that this care model is growing.

In 1636 U.S. veteran administration hospitals were made to help and take care of the war veterans that come in injured or ill. Also, the bills for this should be taken care of so there are no worries for the most part, but none of this is happening the way it should be or how the system was created to be. Veterans are turned away and avoided by the U.S. veterans hospitals, they have a big thirst for money that has not been quenched and because of this, the veterans that come in are not being treated properly and this effect is turning out very negative.

• benefits for them. You getting a higher education and improving your skills means you can do more at your current job.

When focusing on the Centers for Medicare and Medicaid Systems strategies for improvement with unnecessary emergency room visits, a major key area is accessibility to health care at the appropriate health care setting. For many years, there has been the perception that the emergency department is the only place for someone who is uninsured or underinsured can go to receive the needed and appropriate health care, and in some situations that may be the case. (Rhodes et al, 2013, p.394) Due to the decreases in reimbursements for the publicly funded, more and more physicians are opting out to treating these patients, thus leading to an increase in emergency department utilization. According to a study conducted by Rhodes, Bisgaier, Lawson, Soglen, Krug, and Haitsma, this is becoming a greater concern for the

Management and administrations play a vital role in the success of the workplace and VA system on the whole. With all that has happened, I think that it is safe to say that effective leadership is lacking in more than half of the areas within the VA. It is also my belief that to truly see a significant turnover for the best results, all upper management should either be replaced or undergo some evaluation to find alternative solutions. The above-implemented change mentioned goes hand in hand with new staff hiring. With all the corruption that has happened, I do not believe in moving executives around into different positions will be beneficial. If an executive exhibits misconduct and poor performance in one department, what exactly would be

Thursday morning was one more day that I experienced nursing in a different setting as a LPN. I was extremely excited to get to the VA with everything in place this time. I knew I would get to do something new! I was picked to go work with DR. Frank Gyimesi and his nurse, Helen, who is a LPN. It has been 4 years since I have worked in women’s health. After going under Helen’s wing and getting educated on the VA, who is eligible, and getting an education on the use of their eligibility, is unbelievable. Women veterans health care is a growing program for today’s health care system due to the number of women that enter the military compared to many years ago. Military sexual trauma is something that