title: A Quality Improvement Initiative for Designing and Implementing a Military Service Screening Tool for a Community Emergency Department.
abstract: OBJECTIVE
  Veterans eligible for health care in the Veterans Administration (VA) health system often receive care in community emergency Departments. In line with initiatives from Joining Forces and the American Academy of Nursing, emergency departments have an opportunity to screen for veterans during routine ED visits and provide resource information regarding various VA services.
  
  
  METHODS
  Our aims were to design and implement a screening process to identify veterans during an ED visit, notify ED providers of veteran status, and develop a Veteran Resource Guide to be distributed at the time of discharge. We embedded the mandatory question, "Have you ever served in the military?" in the electronic medical record (EMR). This question was asked of all patients 18 years and older.
  
  
  RESULTS
  During an 80-day period, we screened 9364 patients and identified 415 veterans who would not be known to the providers using standard methods. We were able to deliver the Veteran Resource Guide to 77 of the 277 veterans discharged home.
  
  
  CONCLUSIONS
  The addition of the mandatory question about military service to the EMR during the primary care assessment successfully identified veterans who presented for care in a community emergency department. Future initiatives should include automated processes to ensure that the Veteran Resource Guide is provided and to foster collaboration between community emergency departments and the VA.
authors.affiliation: Durham, NC; Arlington, VA; Washington, DC. Electronic address: MMerkl@virginiahospitalcenter.com.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Merkl
authors.affiliation: Durham, NC; Arlington, VA; Washington, DC.
authors.forename: Paula
authors.initials: P
authors.lastname: Tanabe
authors.affiliation: Durham, NC; Arlington, VA; Washington, DC.
authors.forename: John P
authors.initials: JP
authors.lastname: Sverha
authors.affiliation: Durham, NC; Arlington, VA; Washington, DC.
authors.forename: Barbara
authors.initials: B
authors.lastname: Turner
mesh_terms: D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006764:Hospitals, Community; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D058996:Quality Improvement; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*
keywords: Electronic medical record; Emergency departments; Patient-centered care; Process improvement; Veterans