Updates from the VA Health Care System

Updates from the VA Health Care System

Peter Duane, MD (April 2017)

Faculty at the Minneapolis VAHCS continue to strive for academic excellence and scholarly accomplishment. Recent achievements include:

  • In 2016, 127 Minneapolis VAHCS investigators published 401 articles in peer-reviewed journals.
  • Dr. Erin Krebs, Director of the MVAHCS Women's Clinic and a member of the Medicine Service, was awarded a five-year grant from the Patient-Centered Outcomes Research Institute entitled: Comparative Effectiveness of Patient-Centered Strategies to Improve Pain Management and Opioid Safety for Veterans.
  • Dr. Orly Vardeny, PharmD, MS from the University of WI School of Pharmacy has agreed to take a position at the Minneapolis VAHCS Medicine Service. Dr. Orly's interest is in influenza vaccination and its impact on heart disease. Her current study is a 5-year NIH study entitled: Influenza Vaccine to Effectively Stop Cardio Thoracic Events and Decompensated heart failure (INVESTED).

The VA has several important and innovative educational projects underway. They include:

  • VALUE (VA Longitudinal Integrated Clerkship): This is a 10-month longitudinal integrated clerkship where ten medical students from University of Minnesota complete Medicine, Psychiatry, Surgery, Neurology, Primary Care selective and a VALUE elective. Students have a panel of patients they follow across different care venues. The second cohort of students is currently enrolled in the program. VALUE increased its capacity to 12 students in the 2017-2018 academic year.
  • New Point-of-care ultrasound elective: This is new hands-on intensive point-of-care ultrasound (POCUS) elective was created and recently piloted in February. The POCUS resident, under the supervision of a POCUS super-user attending, is available on a consulting basis for inpatient medical services to support point-of-care ultrasound in clinical decision making as well as bedside procedures.
  • The interprofessional Academic Patient Aligned Care Team (iAPACT): Forty-two internal medicine residents have been integrated into the at the Minneapolis VA as the site of their continuity learning experience in primary care, where they each follow a panel of patients for three years. In this interprofessional, team-based learning environment, trainees are immersed in authentic experiences of care delivery with trainees from mental health and pharmacy using the framework of the patient-centered medical home model. Some specific skills residents obtain, in addition to core medical topics, includes running an effective interprofessional huddle, complex case conferences, motivational interviewing, managing patients who push emotional "buttons", panel management, managing complex pain patients with multidisciplinary clinic, quality improvement projects, and fundamentals of teamwork and managing conflict on teams.

Clinical operations

  • Dr. Adam Bock, Director of Informatics for the Medicine Service, has implemented a process whereby laboratory results are automatically reported to patients by mail without the ordering provider having to take action. This reduces physician workload and meets the VA's mandate to report all laboratory results to patients.
  • Dr. Eric Nitz, Chief Resident for Quality and Safety, implemented a hospital-wide project examining appropriate utilization of routine cardiac monitoring of inpatients. This is the fourth year of the Chief Resident for Quality and Safety program in which the chief's focus is on projects and training of quality improvement and safety during their chief residency year.