Improving Care Coordination Between Veterans Health Administration Primary Care Teams and Community Home Health Aide Providers: A Qualitative Study

Author:

Franzosa Emily12ORCID,Judon Kimberly M.1,Gottesman Eve M.1,Koufacos Nicholas S.1,Runels Tessa3,Augustine Matthew14,Van Houtven Courtney H.5678,Boockvar Kenneth S.12

Affiliation:

1. Geriatric Research, Education and Clinical Center (GRECC), James J. Peters VA Medical Center, Bronx, NY, USA

2. Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

3. Pain, Research, Informatics, Medical Comorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA

4. Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

5. Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health System HSR&D, Durham, NC, USA

6. Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA

7. Duke-Margolis Center for Health Policy, Durham, NC, USA

8. Duke Center for the Study of Aging and Human Development, Durham, NC, USA

Abstract

Effective coordination between medical and long-term services is essential to high-quality primary care for older adults, but can be challenging. Our study assessed coordination and communication through semi-structured interviews with Veterans Health Administration (VHA) primary care clinicians ( n = 9); VHA-contracted home health agencies ( n = 6); and home health aides ( n = 8) caring for veterans at an urban VHA medical center. Participants reported (1) establishing home health services is complex, requiring collaboration between many individuals and systems; (2) communication between medical teams and agencies is often reactive; (3) formal communication channels between medical teams and agencies are lacking; (4) aides are an important source of patient information; and (5) aides report important information, but rarely receive it. Removing structural communication barriers; incentivizing reporting channels and information sharing between aides, agencies, and primary care teams; and integrating aides into interdisciplinary teams may improve coordination of medical and long-term care.

Funder

VA Primary Care Analytics Team, VA Office of Primary Care

Publisher

SAGE Publications

Subject

Geriatrics and Gerontology,Gerontology

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