Nebraska hospice veteran partnership 2007 annual meeting feb 23 2007
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Nebraska Hospice-Veteran Partnership 2007 Annual Meeting Feb 23, 2007 PowerPoint PPT Presentation


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Nebraska Hospice-Veteran Partnership 2007 Annual Meeting Feb 23, 2007. Content. Hospice-Veteran partnership Program Status of HVP Program National Collaboration NHPCO’s Veterans Advisory Council (VAC) Update State Veterans Home Project State Veterans Homes Data and Demographics

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Nebraska Hospice-Veteran Partnership 2007 Annual Meeting Feb 23, 2007

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Nebraska hospice veteran partnership 2007 annual meeting feb 23 2007

Nebraska Hospice-Veteran Partnership2007 Annual MeetingFeb 23, 2007


Content

Content

  • Hospice-Veteran partnership Program

    • Status of HVP Program

    • National Collaboration

    • NHPCO’s Veterans Advisory Council (VAC) Update

  • State Veterans Home Project

    • State Veterans Homes Data and Demographics

    • Survey, Focus Group and Interviews Findings

    • Next Steps

  • Resources


The hvp map

The HVP Map

  • Established (green) HVPs (33 states)

    • Steering Committee, and

    • Regular meetings and

    • Activities initiated

  • Emerging (orange) HVPs(8 states)

    • Leaders identified , or

    • Interest expressed, or

    • Planning initiated

  • Pre-contemplative (pink)(9 states)

    • Little activity

  • Hawaii: Green

  • Washington, DC: Green

  • Alaska: Pink

There is some HVPactivity in every VISN


Strategies for success

Strategies for Success

  • Acknowledge and respect all interest positions and cultural differences

    • WIIFM factor

    • Language of organization

    • Rules, regulations and SOP

    • Perceptions


Understanding differences

Understanding Differences


National collaboration

National Collaboration

  • VA Field Advisory Council

    • Led by Dr. Scott Shreve

    • Family Satisfaction, Bereavement and State Veterans Homes

  • NHPCO National Veterans Advisory Council

    • Chaired by Kandyce Powell

    • Membership mirrors Hospice-Veteran Partnerships

  • Council of States

    • Led by Donna Bales

    • Promoting Hospice-Veteran Partnerships with state hospice organizations


Veterans advisory council

Veterans Advisory Council

  • Policy and Advocacy Workgroup

    • VA Purchased Hospice Care

    • VA/Medicare Hospice Benefit Interface

    • VA Physician - Community Hospice Interface

    • Hospice - Nursing Home Interface

  • Access and Outreach Workgroup

    • VA 101 Toolkit

    • Veteran Volunteer Training Manual

    • HVP Listserv ([email protected])

  • Data and Outcomes Workgroup

    • Veteran/military status

    • Veteran-specific family satisfaction survey


Va hospice and palliative care veterans home workgroup

VA Hospice and Palliative Care Veterans Home Workgroup

  • National web-based survey (completed)

    • 58 of 119 State Home administrators and managers responded (48%)

  • Focus group (completed)

    • 19 State Home administrators and managers attended

  • Interviews (ongoing)

    • 15 administrators and their staff participated


State veterans homes data and demographics

State Veterans Homes Data and Demographics

  • Veteran deaths

    • > 6,000 veteran deaths in State Veterans Homes each year

    • 20% average mortality rate

  • Length of stay variable

    • Demographics of patient population

    • Eligibility criteria

    • Size of facility and focus of services


Svh web based survey

SVH Web-based Survey

  • Availability of HPC services

    • Few SVH have designated hospice beds

    • Many SVH contract with community hospices

  • What works

    • Pain and symptom management

    • Bereavement support to families

    • Overall quality of hospice care


Svh web based survey1

SVH Web-based Survey

  • What could work better?

    • Support to SVH staff

    • Meeting unique needs of veterans

    • Communication between SVH and hospice

  • What are some of the challenges?

    • SVH staff limited understanding of the Medicare Hospice Benefit

    • Hospice prognosis requirements and treatment limitations


Focus group

Focus Group

  • Availability of HPC services

    • Confirmed that more SVH contract with community hospices than provide care directly

  • What’s working

    • Expertise in pain and symptom management

    • Bereavement for families and SVH staff

  • What could work better

    • Communication and coordination

    • Hospice understanding the unique needs of veterans

    • Physician to physician communication


Focus group1

Focus Group

  • What can hospices do to help SVHs?

    • Provide hospice and palliative care education and training for SVH staff

    • Know about PTSD and other unique care needs of veterans

    • Be able to navigate the systems of care and services for veterans

  • What can VA do to help SVHs?

    • Good question!


Interviews

Interviews

  • Availability of HPC services

    • Provided directly or contracts with community hospices

    • Rate of hospice referrals variable

    • Triggers for hospice referrals variable


Interviews1

Interviews

  • What works with Hospices?

    • Pain and symptom management

    • Immediate access to hospice services

    • Consistent staff and services

    • Patient, family and SVH staff benefit

    • Hospice staff visibility within SVH

    • Hospice is responsive to requests for community resource information


Interviews2

Interviews

  • What could work better?

    • Lack of knowledge about veterans’ issues

    • Medications (receiving, packaging)

    • Communication, interaction with hospice staff

    • Patient and family education


Next steps

Next Steps

  • Encourage VA hospice and palliative care staff to interface with SVH staff

    • Hospice and palliative care education and training

    • Resource for consultation, information and collaboration

  • Encourage community hospices to

    • Learn more about the systems of care and services for veterans

    • Learn more about veterans’ and their unique end-of-life issues

    • Communicate more effectively with SVH staff


Resources

Resources

  • Hospice-Veteran Partnership Toolkit (on NHPCO’s Veterans’ Webpage)

    • www.nhpco.org/veterans

  • Military History Card

    • www.va.gov/oaa

  • Wounded Warriors: Their Last Battle

    • email [email protected]

  • VA Hospice and Palliative Care

    • www.va.gov/GeriatricsSHG/page.cfm?pg=65

  • National Association of State Veterans Homes

    • www.nasvh.org

  • List of SVH Websites

    • www.va.gov/statedva.htm


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