Program development and defining characteristics of returning military in a VA Polytrauma Network Site.
The conflicts in Iraq and Afghanistan have resulted in a new generation of combat survivors with complex physical injuries and emotional trauma. This article reports the initial implementation of the Polytrauma Network Site (PNS) clinic, which is a key component of the Department of Veterans Affairs (VA) Polytrauma System of Care and serves military personnel returning from combat. The PNS clinic in Palo Alto, California, is described to demonstrate the VA healthcare system's evolving effort to meet the clinical needs of this population. We summarize the following features of this interdisciplinary program: (1) sequential assessment, from initial traumatic brain injury screening throughout our catchment area to evaluation by the PNS clinic team, and (2) clinical evaluation results for the first 62 clinic patients. In summary, this population shows a high prevalence of postconcussion symptoms, posttraumatic stress, poor cognitive performance, head and back pain, auditory and visual symptoms, and problems with dizziness or balance. An anonymous patient feedback survey, which we used to fine-tune the clinic process, reflected high satisfaction with this new program. We hope that the lessons learned at one site will enhance the identification and treatment of veterans with polytrauma across the country.
Lew
Henry L
HL
Physical Medicine and Rehabilitation Service, Department of Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, B117, Palo Alto, CA 94304, USA. henrylew@stanford.edu
Poole
John H
JH
Vanderploeg
Rodney D
RD
Goodrich
Gregory L
GL
Dekelboum
Sharon
S
Guillory
Sylvia B
SB
Sigford
Barbara
B
Cifu
David X
DX
D000328:Adult; D001416:Back Pain / Q000175:diagnosis / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000453:epidemiology; D034381:Hearing Loss / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008403:Mass Screening; D008889:Military Personnel; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D010346:Patient Care Management / Q000458:organization & administration*; D017060:Patient Satisfaction; D004856:Postural Balance; D016730:Program Development; D012047:Rehabilitation Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D012678:Sensation Disorders / Q000175:diagnosis / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*; D014728:Veterans; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology; D014857:Warfare