Journal article
Implementation of the Geriatric Patient-Aligned Care Team Model in the Veterans Health Administration (VA)
Journal of the American Board of Family Medicine, Vol.31(3), pp.456-465
05/2018
DOI: 10.3122/jabfm.2018.03.170272
PMID: 29743228
Abstract
Here, we describe the implementation of a specialty primary care medical home (PCMH) model called Geriatric Patient-Aligned Care Teams (GeriPACT) in the Veterans' Health Administration (VA) that is focused on serving older complex patients. In particular, our aims in this article are to describe how the GeriPACT model was developed and implemented in VA sites, provide a closer look at how GeriPACT functions by presenting a case study, and highlight data showing national variation in the implementation of GeriPACT staffing models and PCMH practices.
Stakeholder feedback regarding the GeriPACT model was obtained from a GeriPACT team and the director of GeriPACT in VA. Here, we present national data regarding variations in GeriPACT staffing and PCMH practices.
Following the adoption and implementation of the GeriPACT model and release of the GeriPACT handbook, sites were able to adopt the model's principles. The VA's adoption of PCMH reinforced the mission of patient-centered primary care by integrating psychosocial and environmental determinants of health. This was accomplished with enhancements to staff support through new full-time employment equivalents, but also by optimizing staff productivity through improved team function and interpersonal care. The GeriPACT model was implemented in a bottom-up fashion that has led to variation in how GeriPACTs are structured and staffed, as well as how they conform to various PCMH principles.
GeriPACT is one approach for bringing an interdisciplinary, patient-centric perspective to primary care in a manner that can likely support the higher staffing costs with economies realized from diminished reliance on institutional placement and highly technologic health care. It is a model which can provide training for the next generation of providers and clinicians.
Details
- Title: Subtitle
- Implementation of the Geriatric Patient-Aligned Care Team Model in the Veterans Health Administration (VA)
- Creators
- Jennifer L Sullivan - From Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System (JLS); Boston University School of Public Health, Boston, MA (JLS); Atlanta Veterans Affairs Medical Center, Atlanta, GA (RE, TP); Section of Geriatric Medicine and Gerontology, Emory University School of Medicine, Atlanta (RE, TP); Center for Comprehensive Access & Delivery Research & Evaluation Center and the VISN 23 Patient Aligned Care Team PACT Demonstration Laboratory, Iowa City VA Health Care System, Iowa City, IA (SS); Department of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (SS); US Department of Veterans Affairs, Geriatrics and Extended Care Services, Washington, D.C. (KS). jennifer.sullivan@va.govRina Eisenstein - From Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System (JLS); Boston University School of Public Health, Boston, MA (JLS); Atlanta Veterans Affairs Medical Center, Atlanta, GA (RE, TP); Section of Geriatric Medicine and Gerontology, Emory University School of Medicine, Atlanta (RE, TP); Center for Comprehensive Access & Delivery Research & Evaluation Center and the VISN 23 Patient Aligned Care Team PACT Demonstration Laboratory, Iowa City VA Health Care System, Iowa City, IA (SS); Department of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (SS); US Department of Veterans Affairs, Geriatrics and Extended Care Services, Washington, D.C. (KS)Thomas Price - From Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System (JLS); Boston University School of Public Health, Boston, MA (JLS); Atlanta Veterans Affairs Medical Center, Atlanta, GA (RE, TP); Section of Geriatric Medicine and Gerontology, Emory University School of Medicine, Atlanta (RE, TP); Center for Comprehensive Access & Delivery Research & Evaluation Center and the VISN 23 Patient Aligned Care Team PACT Demonstration Laboratory, Iowa City VA Health Care System, Iowa City, IA (SS); Department of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (SS); US Department of Veterans Affairs, Geriatrics and Extended Care Services, Washington, D.C. (KS)Samantha Solimeo - From Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System (JLS); Boston University School of Public Health, Boston, MA (JLS); Atlanta Veterans Affairs Medical Center, Atlanta, GA (RE, TP); Section of Geriatric Medicine and Gerontology, Emory University School of Medicine, Atlanta (RE, TP); Center for Comprehensive Access & Delivery Research & Evaluation Center and the VISN 23 Patient Aligned Care Team PACT Demonstration Laboratory, Iowa City VA Health Care System, Iowa City, IA (SS); Department of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (SS); US Department of Veterans Affairs, Geriatrics and Extended Care Services, Washington, D.C. (KS)Kenneth Shay - From Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System (JLS); Boston University School of Public Health, Boston, MA (JLS); Atlanta Veterans Affairs Medical Center, Atlanta, GA (RE, TP); Section of Geriatric Medicine and Gerontology, Emory University School of Medicine, Atlanta (RE, TP); Center for Comprehensive Access & Delivery Research & Evaluation Center and the VISN 23 Patient Aligned Care Team PACT Demonstration Laboratory, Iowa City VA Health Care System, Iowa City, IA (SS); Department of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (SS); US Department of Veterans Affairs, Geriatrics and Extended Care Services, Washington, D.C. (KS)
- Resource Type
- Journal article
- Publication Details
- Journal of the American Board of Family Medicine, Vol.31(3), pp.456-465
- DOI
- 10.3122/jabfm.2018.03.170272
- PMID
- 29743228
- ISSN
- 1557-2625
- eISSN
- 1558-7118
- Language
- English
- Date published
- 05/2018
- Academic Unit
- General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094525602771
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