Evaluating Service Delivery and Support Mechanisms to Improve the Quality of Life for Service Members and Veterans with Spinal Cord Injuries
Abstract
Rationale and Objective for the Proposed Work: A study of combat casualties in Iraq and Afghanistan between 2005 and 2009 found that the incidence of spine trauma among Service members exceeded reported rates from previous conflicts, approximately 11.1% of combat wounded. According to the Office of Research, the Department of Veterans Affairs (VA) delivers care to more than 27,000 of an estimated 42,000 Veterans with spinal cord injuries and related disorders (SCI/D) eligible for VA care through its care delivery system each year. Previous studies reveal that key barriers to care for Service members and Veterans derive from a spectrum of delivery system weaknesses: lack of trust in the system, stigma and safety concerns, wariness of care efficacy, etc. Research suggests that to support outcomes of consequence, health service providers, regardless of setting, must deliver care that addresses the biological, psychological, and social components of health. The fragmentation of health care and social services in the United States, even among federal systems, makes this task challenging at best, particularly for those with multiple health problems and limited access to care, each of which contributes to poor health outcomes. To support the best possible outcomes among the federal health systems SCI/D populations, this research seeks to assess through a qualitative analysis to clarify: Which health system services and supports contribute to improved quality of life for SCI/D Service members and Veterans from the point of injury through reintegration within the community? Types of Individuals the Project Will Help and How It Will Help Them: This project will help key players involved in the SCI/D healthcare delivery and support services: Military Health System (MHS) and Veterans Health Administration (VHA) clinical providers and staff, community-based organizations, as well as SCI/D patients and their caregivers. The research team and its partners will have a better understanding of the care delivery structure and its supports. It will also point to aspects of the health care delivery system that work well for SCI/D Service members and Veterans and caregivers as well as those that need improvement. The project will further help MHS and VHA care delivery teams better understand barriers associated with the provision of health care and ways to manage their clinical relationship with SCI/D patients and their caregivers. Potential Applications, Benefits, and Risks: This research team will pursue a multi-staged study to obtain inputs that will allow us to: (1) map the MHS-VHA SCI/D services delivery and supports continuum; (2) assess key players perspectives of strengths and weaknesses in care delivery and supports from point of injury through reintegration within the local community; and (3) develop system recommendations that can be implemented and sustained. The project will add to our understanding of the challenges faced by two large federal health systems, MHS and VHA, undertaking a care coordination effort for SCI/D patients. It analyzes inputs from stakeholders interviews that explain best practices and gaps in aligning MHA-VHA service delivery components from point of injury through reintegration within the community. A risk is that the project findings may not be able to solve all of the problems associated with the provision of SCI/D health care; hence, the research team will seek additional funding to explore strengths and weaknesses across other centers. Projected Timeline for Achieving the Desired Outcomes: This study should take 2 years, to include the mapping, evaluation, and practice recommendations phases. Likely Contributions of the Proposed Research Project to Advancing the Field of SCI Research: This collaborative project is designed to include clinic-based leadership and staff from the MHS, VHA, and community-based agencies to ensure that a breadth of perspectives guides the work. An addi
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910354
Entities
People
- Suzanne Wood
Organizations
- United States Army
- University of Washington