A Quality Improvement Initiative Designed to Increase Veteran Choice and Consult Retention.

IF 1.3 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal for Healthcare Quality Pub Date : 2025-08-28 DOI:10.1097/JHQ.0000000000000494

Marina E Robson Chase, Madeline J Anderson, Wesley A Stephens, Andrew M Harris, Melissa R Newcomb

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引用次数: 0

Abstract

Introduction: To improve access to care, the Veterans Administration (VA) offers eligible veterans the choice to receive Community Care (CC). Local changes to CC scheduling coincided with a decrease in expected surgical volumes. This project aimed to increase the retention of CC eligible veterans from 66% to 76% by September 2024, while prioritizing veteran autonomy.

Methods: The quality improvement team learned CC eligible veterans were not offered a choice between community and VA care during scheduling. A decentralized and individualized scheduling process was developed to ensure veteran choice was respected and to increase consult retention. Consult retention rates were measured as the intervention was progressively scaled across surgical disciplines.

Results: With the new scheduling process, retention rate increased from 66.1% to 69.3% and veteran choice was respected for over 5,500 veterans.

Conclusions: As both private and VA networks explore strategies to retain patients within their health systems, a decentralized scheduling approach may not significantly affect retention rates. However, this project highlights how easily complex health care processes can lose sight of patient-centered care, which must remain the ultimate goal.

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质量改进计划旨在增加退伍军人的选择和咨询保留。

简介：为了改善获得护理的机会，退伍军人管理局（VA）为符合条件的退伍军人提供接受社区护理（CC）的选择。局部CC计划的改变与预期手术量的减少相一致。该项目旨在到2024年9月将符合CC条件的退伍军人的保留率从66%提高到76%，同时优先考虑退伍军人的自主权。方法：质量改进小组了解到符合CC条件的退伍军人在安排时没有提供社区和退伍军人护理之间的选择。制定了分散和个性化的日程安排流程，以确保老兵的选择得到尊重，并增加咨询留用率。随着干预在外科学科中的逐步扩大，咨询保留率被测量。结果：在新的调度流程下，保留率从66.1%提高到69.3%，5500多名退伍军人的选择得到了尊重。结论：随着私人和VA网络都在探索将患者保留在其卫生系统内的策略，分散的调度方法可能不会显著影响保留率。然而，这个项目强调了复杂的医疗保健过程是多么容易忽视以患者为中心的护理，这必须仍然是最终目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal for Healthcare Quality HEALTH CARE SCIENCES & SERVICES-

CiteScore

2.10

自引率

0.00%

发文量

期刊介绍： The Journal for Healthcare Quality (JHQ), a peer-reviewed journal, is an official publication of the National Association for Healthcare Quality. JHQ is a professional forum that continuously advances healthcare quality practice in diverse and changing environments, and is the first choice for creative and scientific solutions in the pursuit of healthcare quality. It has been selected for coverage in Thomson Reuter’s Science Citation Index Expanded, Social Sciences Citation Index®, and Current Contents®. The Journal publishes scholarly articles that are targeted to leaders of all healthcare settings, leveraging applied research and producing practical, timely and impactful evidence in healthcare system transformation. The journal covers topics such as: Quality Improvement • Patient Safety • Performance Measurement • Best Practices in Clinical and Operational Processes • Innovation • Leadership • Information Technology • Spreading Improvement • Sustaining Improvement • Cost Reduction • Payment Reform