Three projects submitted by Gulf Coast Veterans Healthcare System (GCVHCS) employees to the Veterans Health Administration (VHA) Innovators Network program were selected for investment Oct. 8.
The projects include a prototype for consolidated appointments for Veterans with chronic kidney disease; a pilot program which could use gamified therapy and/or virtual reality as a technological therapy in the community living center; and a potential solution to potential issues of waste and employee exposure to operating room hazards.
Each were accepted into the VHA Innovators Network’s (iNET) Spark-Seed-Spread Innovation Investment Program, an initiative designed to employ a diverse range of practices using innovation to deliver a better experience for Veterans, their families and VA employees.
Each of the projects, funded for fiscal year (FY) 2020, were developed by GCVHCS employees, something GCVHCS Director Bryan C. Matthews said is representative of the level of knowledge and expertise available throughout the organization.
“We have some of the best medical professionals working tirelessly to provide continuing support to the thousands of Veterans and their families who rely on us for their healthcare needs,” he said.
Cynthia Atwell, a registered nurse at the Biloxi VA Medical Center in Biloxi, Miss., designed a proposal through the ‘Spark” program which centers around combining numerous appointments of like diagnoses. For example, Veterans suffering from chronic kidney disease can be placed into a single 2.5-hour appointment to address up to 12 Veterans at the same time.
Atwell, whose proposal is entitled “Group Medical Visits for Chronic Kidney Disease,” said that labs, medications and diets will be discussed during the group appointments, but the dynamic of the ‘group appointment’ could have another benefit.
“This group environment could also allow Veterans the opportunity to talk with other Veterans who share their same experiences,” she said. “And a ‘group’ medical visit could consolidate like needs into a teaching environment and possibly free up appointment times which could ultimately create access for new patients and those with more intricate needs.”
Atwell said she will form a team and create a prototype and implementation plan for her project during the iNET investment cycle to determine the plan’s feasibility.
GCVHCS Community Living Center (CLC) physician Dr. Leslie Carnahan’s proposal, entitled “Technology to Enhance Veteran Engagement, Socialization, and Physical Activity to Improve Pain & Functioning in the CLC,” was also accepted for the iNET ‘Spark’ initiative. Carnahan will be working to examine the potential of using technology to enhance Veteran engagement, socialization and physical activity to improve pain and functioning for residents at the GCVHCS CLC.
Carnahan said there are currently very limited options for Veteran-initiated, Veteran-directed therapy techniques at the GCVHCS CLC, stating that current options for Veteran-initiated activities include puzzles and model building while staff-led activities include bingo, individual physical therapy, kinesiotherapy and occupational therapy.
“Pain therapies are generally geared toward pharmaceutical treatments,” she said. “This proposal will use various technological options to bridge pain therapy, exercise, socialization and cognitive behavioral approaches to enhance Veteran engagement, socialization, physical activity, and ultimately improve pain and functioning in the CLC patients.”
Carnahan will work to create a prototype for various ‘gamified’ therapy and virtual reality scenarios into her year-long project, forming a team and plan for potential technological therapies at the GCVHCS’ CLC.
Also selected during the iNET FY20 Spark-Seed-Spread program is an initiative which GCVHCS registered nurses Kristina Mate and Sheena Strong submitted under the ‘Seed’ category, ultimately receiving an opportunity to implement a project which could directly impact VA facilities.
After attending a workshop in February, Mate and Strong worked through the problem, discover, and design phase of their project, entitled “Greening the Operating Room: One Wrapper at a Time,” to focus on finding a solution to waste and employee exposure in the operating room to hazardous materials, such as surgical smoke and bodily fluids.
The project has evolved into a major mindset, cultural and practice change throughout the GCVHCS. Mate and Strong assembled a team and created a three-tiered approach for implementing their project: the recycling of paper and plastic in the operating room; the expansion of the utilization of bodily fluid management systems; and the initiation of smoke evacuator systems.
According to Mate and Strong, there are only two operating rooms with bodily fluid management systems which discharge directly into a sanitary sewer. Operating rooms without these systems collect bodily fluids in single-use disposable plastic suction canisters with chemical solidifiers before being sent to bio-hazard waste disposal. Currently, this creates numerous opportunities for accidental employee exposure, according to Mate and Strong.
“Prior to the launch of this project, there was no separation or recycling of recyclable materials such as paper or plastic in the operating room, resulting in these materials being disposed of in the regular trash,” said Mate. “Surgical smoke is created during surgical procedures in which electrocautery or the use of ultrasonic scalpels are used. This creates a gaseous byproduct which can pose a significant health risk as a pulmonary irritant, carcinogen and vector for transmitting infectious particles. No operating room at GCVHCS utilizes smoke evacuation systems,” said Strong.
According to Mate and Strong, implementation of the recycling portion of their proposal has the potential to save the facility $60,000 in unnecessary waste expenses annually; it could also eliminate the use of suction canisters for bodily fluid disposal; and establishing the use of surgical smoke evacuation systems could significantly decrease the risks of employee exposures associated with bodily fluids and surgical smoke.
Mate and Strong launched Phase 1 of their project (the recycling of paper and plastic in the operating room) in August, with Phase 2 (installing body fluid management systems and smoke evacuators in operating rooms) pending contracting. Mate or Strong added that more than 580 pounds of paper and plastic has been recycled since the first part of their project was initiated.
GCVHCS’ Innovation Specialist Elizabeth Williams will work with Atwell, Carnahan, Mate and Strong during the FY20 investment cycle to further develop their projects and encouraged other GCVHCS employees to continue developing their ideas.
“Every employee at the GCVHCS is in a position to strengthen the VA’s innovation efforts and redefine the Veteran and employee experience here,” she said. “Be creative and think big. Failure is only a missed opportunity from a potential lesson learned, and the ideas our employees generate can help us continue to ensure we provide the best possible care we can to the Veterans we serve.”
The Biloxi VA Medical Center and the Mobile, Pensacola, Eglin and Panama City VA Clinics are all part of the Gulf Coast Veterans Healthcare System (GCVHCS) which is headquartered in Biloxi, Mississippi, and provide a variety of medical outpatient services to more than 70,000 Veterans.
Bruce Cummins is a public affairs specialist at the Gulf Coast Veterans Healthcare System (GCVHCS)