06/01/08

Augusta Blind Rehabilitation Center

Information Outcomes Management

Annual Report

June 2007

This report highlights achievements accomplished by this BRC due to the utilization of collected data and information sharing from our stakeholders.

1. VISN 7, BR Education Forum, May 2006 – this BRC worked collectively with the Birmingham BRC to develop the first hub-concept education forum. This event gave all VIST, BROS and BRC staff an opportunity to participate in a education forum and strategic planning process. The Augusta BRC staff participated in GPS training at the Birmingham BRC during the event. The other notable highlight was the utilization of V-TEL technology so that presenters were able to be broadcasted to all locations.

2. VISN 7, BR/VIST Sub Council  - In 2006 the Chief, BRC’s, Birmingham/Augusta and VIST in Augusta were appointed to Co-Chair this Sub Council. This actually gave the field of blind rehabilitation representation at the VISN level. This group made numerous recommendations to the VISN for future consideration as we fully develop the visual impairment continuum of care in our VISN.

3. Augusta Bed Occupancy Rate/Waiting times – the BRC has finished 1 or 2 in occupancy rate for the past 5 years. In addition, this BRC worked with all the referring VIST to reduce waiting times that once were 350 days to maintain under the mandated 120 days for the past 12 months.

4. Access to Care – the BRC submitted a strategic plan to increase capacities to the VISN for funding consideration. Although this proposal was not adopted in full, this document has been utilized by numerous other blind rehabilitation field staff to assist in there future plans to address the visual impairment continuum of care. This BRC has the only BROS in the VISN which was initiated September 2003. Since the inception of this program, the data has demonstrated that veterans receiving this type of service are vastly requiring living skills and low vision services. This has prompted the program to increase stock levels of prosthetic devices in these areas to address capacities. Recently the BRC met with Prosthetics department to develop strategies on increasing stock levels and CO/BRS has provided supplemental funding to assist the BROS/BRC in improving stock and state of the art technologies. In addition, the BRC worked with PolyTrauma Network Site to fund a Polytrauma BROS. This position was filled as of April 2007. We are currently working collectively with the Polytrauma team to develop a vision therapy program that is tailored at specifically TBI patients. The emphasis of the program is to address visual perception deficits. This is totally different therapy that you would see in the BRC.

5. Student Interns – In the past year the BRC has successfully provided internship training for 4 student interns. In addition, one student has recently been hired to fill a vacancy that was created by the hiring of an exiting BRC staff member into the Polytrauma BROS position. The BRC has also had several optometry students interns in the past 18 months and one graduate is providing optometry services in the Macon, Georgia area.

6. GPS Trekker Training – this VAMC provided funding for the BRC to receive training on a global positioning system (Trekker). This device has been preferred by other BRC’s and stakeholders. We promptly provided this training to a veteran within weeks of completing this training and the veteran commended the staff.

7. BR 5.0 – Todd Turansky, Augusta VIST has worked with CO/BRS to successfully implement the first web based database across VHA for Blind Rehabilitation Services. This BRC was involved in all aspects of testing this system and was the first BRC to fully implement BR 5.0. In addition, he assisted the BRC in establishing the Inter-Facility Consult (IFC) system prior to BR 5.0 so that the application process would be fully electronic. The implementation of this system made this BRC the first to be fully electronic relating to the applications process. This system is still in place and the referring VIST support its utilization in conjunction with BR 5.0. This system provides quicker communications about each veteran’s status.

8. Staff Competencies/Qualifications – Lee Stoughton, Vicki Stoughton and Ron Worley became certified in vision rehabilitation therapy. Laurie Hallman, Polytrauma BROS is one of only a few BR Specialist in VHA that possesses three certifications. Several other staff members are pursuing additional certifications.

9. Prosthetics Issues – the BRC has worked collectively with the Prosthetics Department to improve stock levels so we can provide timely services. The Prosthetic Department assign one primary staff member to work with the BRC and this has improved services. The waiver process for certain items that were not considered on contract created major delays in services. After numerous meetings this process was waved and discontinued except for a few new technologies. This VAMC is in the process of locating space for the Prosthetic’s Department to move into at the Uptown Division, which will further enhance services.

10. Public Relations – the BRC has been featured in several newspaper articles in the past 18 months covering work with active duty injured visually impaired soldiers and veterans alike. Each of these articles highlighted the quality of services provided to these individuals and the soldier/veteran’s pleasure with their outcomes from the training.

11. National Involvement – the BRC has numerous staff members who have served on National BRS Committees that are working on best practices, future strategic plans, Polytrauma/Seamless Transition and development of a new functional outcomes tool to be utilized. The Chief, BRC has been asked to work with CARF (Paul Andrews) to develop new Vision Rehabilitation Standards that will foster all levels of VHA vision rehabilitation and the visual impairment continuum of care.

12. Nursing – the Nursing staff continues to provide training on numerous types of visual impairment medical monitoring devices. They have been providing training on the mandated Audible Medication Device (Script-Talk). This BRC has a high prevalence of diabetes and this staff continues to be diligent in addressing these types of veterans. Customer Service Interviews conducted reveal veterans complete trust and satisfaction in the services.

13. Customer Satisfaction – Customer Satisfaction is one of the top performance measures at this VAMC and for the BRC. Performance in these areas are monitored through numerous methods such as Blind Veterans Advisory Board (BVAB), Blind Rehabilitation Advisory Committee (BRAC), Inpatient and Outpatient Customer Satisfaction Interviews and the All Employee Survey. The results of these interviews demonstrate the veteran’s satisfaction with the program. In addition, the BRC tracks and trends complaints. In the past several months the biggest concerns expressed from staff is the lack of space and the veterans and stakeholders have expressed concerns about private rooms and implementation of VHA Visual Impairment Continuum of Care. These issues have been discussed with top management and are being considered in future strategic planning.

14.  Staff Education – The BRC Staff created an Education Committee several years ago and have received VAMC funding in support of bringing special guest presenters to provide education on topics to enhance their skills and abilities. Due in part to this Committee’s efforts CO/BRS decided to establish a BRS Education Committee to address future education needs. The BRC had Laurie Hallman, Polytrauma BROS serve on this National Committee.

15.  Eye Care Consultation – in the spring of 2007, Dr. Patti Fuhr, Director Optometry Service, Birmingham VAMC, conducted a consultative site visit by our request to assist this VAMC in addressing current eye care and future challenges to meet the visual impairment continuum of care. Many of the recommendations made during this consultative visit have been implemented. Recommendations related to increasing staffing levels have not been approved at this point.

16.  Staff Cross-Training – as a part of succession planning and providing coverage during times that staff are on leave the BRC continues to encourage and support cross-training of staff in all areas.

17.  Functional Outcomes – recently CO/BRS informed the BRC’s that the grant for the RR&D Functional Outcomes Study has been discontinued. CO/BRS is exploring creating funding to start utilization of a new functional outcomes tool. The Chief, BRC served on a National Committee that made recommendations to utilize a tool that is being utilized in the private sector.

18.  Future Projects – the BRC has plans to utilize the new Fisher House being built in the next couple of years. The Fisher House is a home away from home for patients and family members receiving medical care. This will assist our BROS in providing services for veterans that need outpatient clinic interventions who are traveling from great distances. The Chief, BRC has been in communications with Director, Occupational Therapy, Medical College of Georgia (MCG) to develop strategies on developing a research project that would utilize OT’s who have received training in low vision. The future goal is for this VAMC to be able to utilize these OT’s to improve access to care for visually impaired veterans as we move forward in developing a full visual impairment continuum of care.

19.  BRC Brochure – due to recent program changes and increases in access to care, the BRC has begun to develop a new brochure that will contain more program details and an insert with program outcomes. Our stakeholders have provided us with some suggestions to making this more meaningful for veterans that have been included.