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This Issue: Ensuring High-Quality Care | Table of Contents: Fall 2018 | Download this issue

From the Editor

Helping Veterans live life to its fullest

One of VA's most important research priorities is helping translate its research into real-world treatments and care for Veterans, so that their quality of life is the best that it can be. There are many instances where VA research has led to new treatments and improvements in care not only for Veterans, but also for patients in the private sector.

One example is the nationwide implementation of a safety initiative to reduce catheter-related bladder infections. The bladder bundle is a set of protocols that grew out of a Michigan-based patient safety initiative to reduce the incidence of catheter-associated urinary tract infections. CAUTIs are one of the most-common hospital-acquired infections. They frequently affect patients who live in nursing homes, as well.

VA Ann Arbor Healthcare System researchers Drs. Sarah Krein and Sanjay Saint worked together with colleagues to identify the barriers in hospitals and nursing homes to adopting safe practices to reduce CAUTIs. Through a partnership with the Agency for Healthcare Research and Quality, Krein and Saint implemented the bladder bundle in more than 1,000 hospital units throughout the U.S. Through this effort, CAUTI infection rates fell by 22 percent. Saint and Krein's work on promoting the safe use of urinary catheters has significantly changed practice across VA and in the private sector.   

As we work hard to unravel the science behind debilitating conditions that affect our Veterans, it is also important to continue examining the best ways to deliver care, and to help ensure that VA care is the best that it can be. In this issue, we highlight several innovative research projects that aim to do just that.

Dr. Ted Skolarus is a urologist and research scientist at the VA Ann Arbor Healthcare System in Michigan. He is using his VA Career Development Award to examine the quality of prostate cancer survivorship care provided to Veterans across the VA health care system. Each year, 12,000 Veterans are treated in the VA for prostate cancer. Nearly 100 percent of those men who are treated for localized prostate cancer will survive at least five years. That means quality survivorship care is vitally important to these men and their families. Skolarus' research has identified ways to improve the delivery of VA survivorship care, and to facilitate better communication between cancer specialists and the primary care doctors who will provide follow-up care to these Veterans.

We also interviewed Dr. Hal Wortzel, who is co-director of the Suicide Risk Management Consultation Program at the VA Rocky Mountain Mental Illness Research and Education Clinical Center in Denver. The staff of the consultation program are available to any clinician who is working with Veterans who may be at risk of dying by suicide. He says their mantra is: Never worry alone. "If clinicians are particularly concerned about an individual or Veteran that they are seeing," says Wortzel, "we are out there to help develop ideas that could afford some benefit for that individual's care."

Dr. Wortzel's research is focused on suicide prevention in the Veteran population, especially as it relates to Veterans who experience posttraumatic stress disorder or traumatic brain injury. He says that Veterans must manage not only the everyday stressors that people experience, but also those that are unique to military service, such as exposure to combat or chronic pain caused by injury during military service.

In this issue of VARQU, we talk about many more quality-of-care issues that affect Veterans—the types of services that homeless Veterans use most; coaching healthy behaviors in Veterans with heart disease; and monitoring blood pressure at home. We hope you will find this information useful whether you are a Veteran, the family member of one, a researcher, or a clinician.

Erica J. Sprey

Managing Editor, VA Research Quarterly Update

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