Supplement Features VA Research on Emergency
Emergency care visits in both VA and non-VA (community) settings have nearly doubled from the 1980’s to more than 3 million visits in FY 2022. As of FY2022, 139 VA facilities provided emergency and urgent care for Veterans. To better understand strengths and gaps in the existing literature and to identify strategic priorities for research, HSR&D convened a state-of-the-art (SOTA) conference on VA Emergency Medicine (SAVE) in 2022. SAVE included 51 experts from within and outside VA in the field of emergency medicine, including clinicians, researchers, and operational leaders. SOTA conference attendees focused on three priority areas: emergency care of older Veterans, Veterans with mental health needs in the emergency setting, and emergency care in non-VA community settings. In addition, cross-cutting themes included the use of telehealth, implementation science to refine evidence-based interventions, care coordination, and data needs. Attendees presented recommendations to guide research and funding efforts, as well as clinical and policy recommendations. This special issue of Academic Emergency Medicine is one outcome of the SOTA conference and is dedicated to diverse topics relevant to VA emergency medicine.
Articles in this supplement include, but are not limited to:
- Carlson and colleagues’ findings suggest that ED episodes of treatment for Veterans’ nonfatal firearm injuries, regardless of injury intent, are important opportunities for suicide prevention efforts for VA users, especially among older Veterans and those living in rural areas.
- Cordasco and colleagues found that among Veterans with chronic ambulatory care sensitive conditions (i.e., asthma, angina, heart failure) and an ED visit documenting follow-up care needs, some Veterans reported getting needed care, but many did not. A common facilitator to receiving care was nurses or providers reaching out to Veterans.
- Hwang and colleagues evaluated VA ED visits for Veterans >65 years to assess geriatric emergency department (GED) screening and found progressive increases, reflecting VA’s commitment to integrating geriatric emergency care across VA.
- Patel and Kessler discuss why working in VA emergency medicine is “The Hidden Jewel of Emergency Medicine Careers,” noting that VA empowers its frontline clinical staff to be at the center of creating solutions to improve care.
- Seidenfeld and colleagues found that among 260,625 Veterans with a diagnosis of dementia, 35% made at least one ED visit during the two-year study period compared to 20% with no dementia diagnosis.
- This special issue includes 23 manuscripts and addresses key research and operational priorities identified during the SOTA conference. SOTA findings also have been presented as an HSR&D cyberseminar – and have helped HSR&D in adding Emergency Medicine as a priority to guide the Scientific Merit Review Board when reviewing grant applications.
Guest Editors for this supplement were Michael Ward, MD, PhD, MBA, emergency medicine staff physician at VA Tennessee Valley Healthcare, and Dawn Bravata, MD, core investigator with HSR&D’s Center for Health Information and Communication (CHIC). An additional editorial was authored by Drs. Chad Kessler and Neil Patel, who co-lead VA’s Office of Emergency Medicine.
Special Issue on Veteran Emergency Care. Academic Emergency Medicine. April 25, 2023;30(4):225-436.
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