Setting the Stage for a New Strategic Plan for Geriatrics and Extended Care in the Veterans Health Administration: Summary of the 2008 VA State of the Art Conference, "The Changing Faces of Geriatrics and Extended Care: Meeting the Needs of Veterans in the Next Decade"
Setting the Stage for a New Strategic Plan for Geriatrics and Extended Care in the Veterans Health Administration: Summary of the 2008 VA State of the Art Conference, "The Changing Faces of Geriatrics and Extended Care: Meeting the Needs of Veterans in the Next Decade"
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DOI：
10.1111/j.1532-5415.2008.02079.x
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发表时间：
2008-12-01
影响因子：
6.3
通讯作者：
Burris, James F.
中科院分区：
文献类型：
--
作者：
Shay, Kenneth;Burris, James F.
退伍军人事务部（VA）承担了早期的领导作用，专注于照顾老年人。1998年，由退伍军人事务部卫生部副部长任命的退伍军人事务部长期护理未来联邦咨询委员会建议将退伍军人事务部的长期护理计划转向非机构形式。十年后，弗吉尼亚州的老年病和扩展护理办公室（GEC）于2008年3月25日至27日在弗吉尼亚州召集老年病和医疗保健、政策和财务专家，启动了一项战略规划过程，向弗吉尼亚州的临床医生和临床管理人员介绍了弗吉尼亚州GEC的“最新技术”。反复出现的临床主题包括老年退伍军人的数量和复杂性不断增加，最近增加了年轻的退伍军人到VA的扩展护理组合，痴呆症和精神疾病在整个GEC中施加的挑战，以及在多个场所提供护理时需要无缝。正在进行的研究工作，量化的需求和资源，并验证护理模式将仍然是不可或缺的，以满足临床挑战。严重供应不足的临床医生的所有学科与一般或专业的老年医学知识仍然存在。VA的大部分医疗保健工作人员和领导层都接近退休年龄，推动了对新的教育方法，招聘和保留策略以及创新交付系统的需求。对非正式护理人员的依赖日益增加，突出了支持这些合作伙伴的必要性。VA的医疗保健预算分配说明了国家政策如何决定系统，区域和当地的临床决策。最新退伍军人的转业培训正在提高全系统的效率。教育患者和家庭并赋予其权力，可优化卫生资源的利用。
The Department of Veterans Affairs (VA) assumed an early leadership role in focusing on care of elderly adults. In 1998, the Federal Advisory Committee on the Future of VA Long-Term Care, appointed by the VA Undersecretary for Health, recommended redirection of VA's extended care programs toward noninstitutional forms. A decade later, VA's Office of Geriatrics and Extended Care (GEC) initiated a strategic planning process by convening experts in geriatrics and health care, policy, and finance in Virginia on March 25 to 27, 2008, to present to VA clinicians and clinical managers the "State of the Art" of VA GEC.Recurring clinical themes included rising numbers and complexity of aging veterans, recent addition of younger veterans to VA's extended care mix, challenges that dementia and mental illness exert throughout GEC, and need for seamlessness in delivery of care across multiple venues. Ongoing research efforts quantifying demand and resources and validating models of care will remain indispensible for meeting clinical challenges.Serious undersupply of clinicians of all disciplines with general or specialty geriatrics knowledge persists. Much of VA's healthcare workforce and leadership are approaching retirement age, driving the need for new educational approaches, recruitment and retention strategies, and innovative delivery systems. Growing dependence on informal caregivers highlights the need for supporting these partners.VA's healthcare budget allocation illustrates how national policy dictates systemic, regional, and local clinical decisions. Rehabilitation of the newest veterans is resulting in systemwide efficiencies. Educating and empowering patients and families results in optimized utilization of health resources.