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Article
Barriers and strategies for coordinating care among veterans with traumatic brain injury: a mixed methods study of VA polytrauma care team members
Population and Quantitative Health Sciences Publications
  • Bridget M. Smith, Edward Hines Jr. VA Hospital, Chicago
  • Rachael N. Martinez, Edward Hines Jr. VA Hospital, Chicago
  • Charlesnika T. Evans, Northwestern University Feinberg School of Medicine
  • Karen L. Saban, Loyola University Chicago
  • Salva Balbale, Northwestern University Feinberg School of Medicine
  • Eric J. Proescher, Jesse Brown VA Medical Center, Chicago
  • Kevin Stroupe, Loyola University Chicago
  • Timothy P. Hogan, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences, Division of Health Informatics and Implementation Science
Publication Date
2018-3-14
Document Type
Article
Abstract

BACKGROUND: Veterans who experience traumatic brain injury (TBI) may have long-term needs placing a premium on well-coordinated care. This study aimed to (1) identify barriers to care coordination for Veterans with TBI; and (2) describe strategies used by VA polytrauma care team members to coordinate care for Veterans with TBI.

METHODS: We utilised a mixed method design, including an online survey of VA polytrauma care team members (N = 236) and subsequent semi-structured interviews (N = 25). Analysis of the survey data was descriptive; interview data was analysed using constant comparative techniques.

RESULTS: The most common system-related barriers 25 for access to military records (64%) and insufficient time (58%). The most common patient-related barriers were missed appointments/no shows (87%) and the mental health issues (74%). Strategies reported on the survey to promote coordination reflected the centrality of teamwork and communication, and included promoting multidisciplinary team collaboration (32%) and holding 30 regular meetings (23%). Interview findings were consistent, emphasising the effective functioning of multidisciplinary clinics.

CONCLUSION: Polytrauma care team members encounter barriers to care coordination for Veterans with TBI, and have developed strategies in response. Information sharing, provider workload, communication, and patient engagement will be critical to address in future efforts to enhance care coordination in this context.

Keywords
  • Traumatic brain injury,
  • Veterans,
  • coordination
DOI of Published Version
10.1080/02699052.2018.1444205
Source

Brain Inj. 2018 Mar 14:1-8. doi: 10.1080/02699052.2018.1444205. Link to article on publisher's site

PubMed ID
29537883
Related Resources

Link to Article in PubMed

Citation Information
Bridget M. Smith, Rachael N. Martinez, Charlesnika T. Evans, Karen L. Saban, et al.. "Barriers and strategies for coordinating care among veterans with traumatic brain injury: a mixed methods study of VA polytrauma care team members" (2018) ISSN: 0269-9052 (Linking)
Available at: http://works.bepress.com/karen-saban/25/