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Reducing Financial Toxicity Associated With Cancer Treatment New Mexico VAHCS Fisher House at its Finest!
PURPOSE
Reduce financial toxicity of housing costs associated with cancer treatment for rural Veterans.
BACKGROUND
Veterans diagnosed with cancer experience financial burdens associated with treatments: financial toxicities (FT). New Mexico (NM) an underserved and socioeconomically challenged state has one VA facility. Veterans commonly experience increased FT in the form of financial burdens related to travel distance, housing, and time off from work for caregivers as required to seek specialized care and cancer treatments. Travel pay and the Mission Act does little to alleviate this burden, and many still experience financial hardships.
METHODS
NMVAHCS Fisher House is reserved for families seeking housing accommodations during their loved one’s hospitalization. Surgical Service coordinated an additional plan to provide services for rural Veterans requiring 4-6 weeks of daily radiation therapy. Special accommodations were granted. Each case is reviewed via consult. Veteran requires an accompanying caregiver. Prior available Veteran discounted hotel rates averaged $96 per night. A 6-week course of shelter during radiation therapy could be $4,032.00, before taxes. No discounts or vouchers were available for meals, or other expenses.
RESULTS
Since FY23, 38 families seeking oncology care were welcomed into the Fisher House, reflecting a potential Veteran cost savings of $153,216.00 related to housing alone. Veterans also experienced cost saving related to food, as most meals were provided through community donations. Veteran satisfaction was improved, evidenced by Fisher House journal for families. Entries were heartwarming, with an outpouring of gratitude to the staff and VA for providing care and hospitality in a difficult time. Several Veterans stated they would not have been able to complete treatment without the Fisher House.
IMPLICATIONS
Although most Veterans have manageable associated out of pocket expenses with cancer treatments, many have associated extensive financial burdens related to receiving treatments. Even with the Mission Act, many live 4-6 hours from the closest oncology center providing radiation therapy, making a round trip for daily treatment up to 12 hours. Consideration in the reduction of travel time and housing expenses, can mean the difference of Veterans accepting treatments resulting in improved overall quality of life and survival outcomes.
PURPOSE
Reduce financial toxicity of housing costs associated with cancer treatment for rural Veterans.
BACKGROUND
Veterans diagnosed with cancer experience financial burdens associated with treatments: financial toxicities (FT). New Mexico (NM) an underserved and socioeconomically challenged state has one VA facility. Veterans commonly experience increased FT in the form of financial burdens related to travel distance, housing, and time off from work for caregivers as required to seek specialized care and cancer treatments. Travel pay and the Mission Act does little to alleviate this burden, and many still experience financial hardships.
METHODS
NMVAHCS Fisher House is reserved for families seeking housing accommodations during their loved one’s hospitalization. Surgical Service coordinated an additional plan to provide services for rural Veterans requiring 4-6 weeks of daily radiation therapy. Special accommodations were granted. Each case is reviewed via consult. Veteran requires an accompanying caregiver. Prior available Veteran discounted hotel rates averaged $96 per night. A 6-week course of shelter during radiation therapy could be $4,032.00, before taxes. No discounts or vouchers were available for meals, or other expenses.
RESULTS
Since FY23, 38 families seeking oncology care were welcomed into the Fisher House, reflecting a potential Veteran cost savings of $153,216.00 related to housing alone. Veterans also experienced cost saving related to food, as most meals were provided through community donations. Veteran satisfaction was improved, evidenced by Fisher House journal for families. Entries were heartwarming, with an outpouring of gratitude to the staff and VA for providing care and hospitality in a difficult time. Several Veterans stated they would not have been able to complete treatment without the Fisher House.
IMPLICATIONS
Although most Veterans have manageable associated out of pocket expenses with cancer treatments, many have associated extensive financial burdens related to receiving treatments. Even with the Mission Act, many live 4-6 hours from the closest oncology center providing radiation therapy, making a round trip for daily treatment up to 12 hours. Consideration in the reduction of travel time and housing expenses, can mean the difference of Veterans accepting treatments resulting in improved overall quality of life and survival outcomes.
PURPOSE
Reduce financial toxicity of housing costs associated with cancer treatment for rural Veterans.
BACKGROUND
Veterans diagnosed with cancer experience financial burdens associated with treatments: financial toxicities (FT). New Mexico (NM) an underserved and socioeconomically challenged state has one VA facility. Veterans commonly experience increased FT in the form of financial burdens related to travel distance, housing, and time off from work for caregivers as required to seek specialized care and cancer treatments. Travel pay and the Mission Act does little to alleviate this burden, and many still experience financial hardships.
METHODS
NMVAHCS Fisher House is reserved for families seeking housing accommodations during their loved one’s hospitalization. Surgical Service coordinated an additional plan to provide services for rural Veterans requiring 4-6 weeks of daily radiation therapy. Special accommodations were granted. Each case is reviewed via consult. Veteran requires an accompanying caregiver. Prior available Veteran discounted hotel rates averaged $96 per night. A 6-week course of shelter during radiation therapy could be $4,032.00, before taxes. No discounts or vouchers were available for meals, or other expenses.
RESULTS
Since FY23, 38 families seeking oncology care were welcomed into the Fisher House, reflecting a potential Veteran cost savings of $153,216.00 related to housing alone. Veterans also experienced cost saving related to food, as most meals were provided through community donations. Veteran satisfaction was improved, evidenced by Fisher House journal for families. Entries were heartwarming, with an outpouring of gratitude to the staff and VA for providing care and hospitality in a difficult time. Several Veterans stated they would not have been able to complete treatment without the Fisher House.
IMPLICATIONS
Although most Veterans have manageable associated out of pocket expenses with cancer treatments, many have associated extensive financial burdens related to receiving treatments. Even with the Mission Act, many live 4-6 hours from the closest oncology center providing radiation therapy, making a round trip for daily treatment up to 12 hours. Consideration in the reduction of travel time and housing expenses, can mean the difference of Veterans accepting treatments resulting in improved overall quality of life and survival outcomes.
Optimizing Health Literacy to Improve Veteran Satisfaction and Overall Surgical Outcomes
PURPOSE
To improve veteran surgical literacy, satisfaction, and overall outcomes.
BACKGROUND
For years, discharge education at the New Mexico VAHCS consisted of a fill-in templated non-specific and limited facility wide CPRS note written above an 8th grade reading level. Specific surgical instructions were not provided regarding drain/catheter/ostomy/wound care, activity and bathing instructions, and signs and symptoms to notify the provider. This resulted in post-discharge anxiety, provider calls, and avoidable re-admissions.
METHODS
Nurse Navigator/Patient Educator position was created and filled with intent to create discharge education database specific to diagnosis and procedure, 1:1 patient centered education, and direct access to subject matter expert. The Navigators collaborated with surgeons to develop concise post-operative, evidence- based education, which included easy to read diagrams, 8th grade reading level, and 14 font. Packets were approved through the VHEC/I committee for distribution and stored on the VA Intranet for afterhours ward access to ensure consistency.
RESULTS
28 educational packets were created for the most common surgeries completed to customize education to fit individual needs of the Veteran. Each packet contains basic information regarding the procedure and wound care, but is customizable to include specific drain, catheter, or ostomy teaching. The Navigators meet with the Veteran prior to surgery to develop trusting relationships and begin the education process. After surgery, they visit daily to reinforce education with teach back demonstrations and encourage self-care. Family members are included in education sessions and are provided time for questions. The Navigators ensure veterans do not leave the hospital without necessary equipment and medications. As a result, the NMVAHCS has experienced improvements in the Survey of Healthcare Experiences of Patients (SHEP) scores. Prior to improvements in the educational process, SHEP scores related to discharge education identified areas of concern. After hiring Nurse Navigators, SHEP scores for discharge information increased to 90.3%. General Surgery 14-day readmission rate improved (2.9% in FY 21 to 1.7% FY 22); and 30-day readmission rate improved (12.8% FY21 to 8.7% FY 22), despite increased operative volume.
IMPLICATIONS
Providing Veteran Centered Care with comprehensive education improves selfcare, patient satisfaction, and decreases avoidable readmissions.
PURPOSE
To improve veteran surgical literacy, satisfaction, and overall outcomes.
BACKGROUND
For years, discharge education at the New Mexico VAHCS consisted of a fill-in templated non-specific and limited facility wide CPRS note written above an 8th grade reading level. Specific surgical instructions were not provided regarding drain/catheter/ostomy/wound care, activity and bathing instructions, and signs and symptoms to notify the provider. This resulted in post-discharge anxiety, provider calls, and avoidable re-admissions.
METHODS
Nurse Navigator/Patient Educator position was created and filled with intent to create discharge education database specific to diagnosis and procedure, 1:1 patient centered education, and direct access to subject matter expert. The Navigators collaborated with surgeons to develop concise post-operative, evidence- based education, which included easy to read diagrams, 8th grade reading level, and 14 font. Packets were approved through the VHEC/I committee for distribution and stored on the VA Intranet for afterhours ward access to ensure consistency.
RESULTS
28 educational packets were created for the most common surgeries completed to customize education to fit individual needs of the Veteran. Each packet contains basic information regarding the procedure and wound care, but is customizable to include specific drain, catheter, or ostomy teaching. The Navigators meet with the Veteran prior to surgery to develop trusting relationships and begin the education process. After surgery, they visit daily to reinforce education with teach back demonstrations and encourage self-care. Family members are included in education sessions and are provided time for questions. The Navigators ensure veterans do not leave the hospital without necessary equipment and medications. As a result, the NMVAHCS has experienced improvements in the Survey of Healthcare Experiences of Patients (SHEP) scores. Prior to improvements in the educational process, SHEP scores related to discharge education identified areas of concern. After hiring Nurse Navigators, SHEP scores for discharge information increased to 90.3%. General Surgery 14-day readmission rate improved (2.9% in FY 21 to 1.7% FY 22); and 30-day readmission rate improved (12.8% FY21 to 8.7% FY 22), despite increased operative volume.
IMPLICATIONS
Providing Veteran Centered Care with comprehensive education improves selfcare, patient satisfaction, and decreases avoidable readmissions.
PURPOSE
To improve veteran surgical literacy, satisfaction, and overall outcomes.
BACKGROUND
For years, discharge education at the New Mexico VAHCS consisted of a fill-in templated non-specific and limited facility wide CPRS note written above an 8th grade reading level. Specific surgical instructions were not provided regarding drain/catheter/ostomy/wound care, activity and bathing instructions, and signs and symptoms to notify the provider. This resulted in post-discharge anxiety, provider calls, and avoidable re-admissions.
METHODS
Nurse Navigator/Patient Educator position was created and filled with intent to create discharge education database specific to diagnosis and procedure, 1:1 patient centered education, and direct access to subject matter expert. The Navigators collaborated with surgeons to develop concise post-operative, evidence- based education, which included easy to read diagrams, 8th grade reading level, and 14 font. Packets were approved through the VHEC/I committee for distribution and stored on the VA Intranet for afterhours ward access to ensure consistency.
RESULTS
28 educational packets were created for the most common surgeries completed to customize education to fit individual needs of the Veteran. Each packet contains basic information regarding the procedure and wound care, but is customizable to include specific drain, catheter, or ostomy teaching. The Navigators meet with the Veteran prior to surgery to develop trusting relationships and begin the education process. After surgery, they visit daily to reinforce education with teach back demonstrations and encourage self-care. Family members are included in education sessions and are provided time for questions. The Navigators ensure veterans do not leave the hospital without necessary equipment and medications. As a result, the NMVAHCS has experienced improvements in the Survey of Healthcare Experiences of Patients (SHEP) scores. Prior to improvements in the educational process, SHEP scores related to discharge education identified areas of concern. After hiring Nurse Navigators, SHEP scores for discharge information increased to 90.3%. General Surgery 14-day readmission rate improved (2.9% in FY 21 to 1.7% FY 22); and 30-day readmission rate improved (12.8% FY21 to 8.7% FY 22), despite increased operative volume.
IMPLICATIONS
Providing Veteran Centered Care with comprehensive education improves selfcare, patient satisfaction, and decreases avoidable readmissions.