Barriers and Facilitators to Cross-Institutional Referrals: System Configuration Analysis of VA Staff Experiences

Kizer KW, Perlin JB, Guice K, Granger E, Friesen D, Gelb Safran D. The urgent need to address VHA community care spending and access strategies. 2024; Available from: https://veteranspolicy.org/wpcontent/uploads/2024/05/Red-Team-Executive-Roundtable-Report.pdf

VA Office of Inspector General. Review of alleged patient deaths, patient wait times, and scheduling practices at the Phoenix VA Health Care System Veterans Health Administration, 2014 August 26 2014. Report No.: 14–02603–267. https://www.vaoig.gov/sites/default/files/reports/2014-08/VAOIG-14-02603-267.pdf

Veterans Access, Choice, and Accountability Act of 2014, House, 113th Congress Sess. 2014. https://www.congress.gov/bill/113th-congress/house-bill/3230

The VA MISSION Act of 2018, Senate, 115th Congress Sess. 2018. https://www.congress.gov/bill/115th-congress/senate-bill/2372

Mattocks KM, Cunningham KJ, Greenstone C, Atkins D, Rosen AK, Upton M. Innovations in community care programs, policies, and research. Med Care. 2021;59(3):S229-s31. https://doi.org/10.1097/mlr.0000000000001550

Statement of Miguel Lapuz, M.D., Acting Deputy Under Secretary for Health, Veterans Health Administration (VHA), Department of Veterans Affairs (VA), before the House Committee on Veterans’ Affairs Subcommittee on Health Hearing before the House Committee on Veterans Affairs, Subcommittee on Health (July 14, 2022). https://docs.house.gov/meetings/VR/VR03/20220714/114988/HHRG-117-VR03-Wstate-LaPuzM-20220714-U1.pdf

FY2023 President's Budget Request. Department of Veterans Affairs. 2022. https://www.va.gov/budget/docs/summary/fy2023-va-budget-rollout-briefing.pdf

Garvin LA, Pugatch M, Gurewich D, Pendergast JN, Miller CJ. Interorganizational care coordination of rural Veterans by Veterans Affairs and community care programs: a systematic review. Med Care. 2021;59(3):S259-s69. https://doi.org/10.1097/mlr.0000000000001542

Greenstone CL, Peppiatt J, Cunningham K, et al. Standardizing care coordination within the Department of Veterans Affairs. J Gen Intern Med. 2019;34(1):4-6. https://doi.org/10.1007/s11606-019-04997-6

LaCoursiere Zucchero T, McDannold S, McInnes DK. “Walking in a maze”: community providers’ difficulties coordinating health care for homeless patients. BMC Health Serv Res. 2016;16(1):480. https://doi.org/10.1186/s12913-016-1722-x

Patzel M, Barnes C, Ramalingam N, et al. Jumping through hoops: Community care clinician and staff experiences providing primary care to rural Veterans. J Gen Intern Med. 2023;38(3):821-8. https://doi.org/10.1007/s11606-023-08126-2

Mattocks KM, Kroll-Desrosiers A, Kinney R, Elwy AR, Cunningham KJ, Mengeling MA. Understanding VA's use of and relationships with community care providers under the MISSION Act. Med Care. 2021;59(3):S252-s8. https://doi.org/10.1097/mlr.0000000000001545

Veterans Health Administration. Referral Coordination Initiative implementation guidebook. 2021. Available from: https://www.va.gov/files/2022-04/Referral-Coordination-Initiative-Guidebook-2.pdf. Accessed 25 Feb 2025.

Cusick A, Gronek J, Gorman M, Hausman MS, Schildhouse RJ. Michigan Market Referral Coordination Initiative: a regional market approach to VA specialty care. J Gen Intern Med. 2023;38(3):871-7. https://doi.org/10.1007/s11606-023-08112-8

Donovan LM, Palen BN, Fernandes LA, et al. The Referral Coordination Team: A redesign of specialty care to enhance service delivery and value in sleep medicine. NEJM Catal. 2021;2(2). https://doi.org/10.1056/CAT.20.0403

Donovan LM, Palen BN, Syed A, et al. Nurse-led triage of new sleep referrals is associated with lower risk of potentially contraindicated sleep testing: a retrospective cohort study. BMJ Qual Saf. 2021;30(7):599-607. https://doi.org/10.1136/bmjqs-2020-011817

Asfaw DA, Price ME, Carvalho KM, Pizer SD, Garrido MM. The effects of the Veterans Health Administration's Referral Coordination Initiative on referral patterns and waiting times for specialty care. Health Serv Res. 2024;59(3):e14303. https://doi.org/10.1111/1475-6773.14303

United States Government Accountability Office. Veterans Community Care Program: VA took action on Veterans' access to care, but COVID-19 highlighted continued scheduling challenges. U.S. Government Accountability Office, 2021 June 28 2021. Report No.: 21–476. https://www.gao.gov/products/gao-21-476

Ramalingam NS, Barnes C, Patzel M, Kenzie ES, Ono SS, Davis MM. “It’s like finding your way through the labyrinth”: a qualitative study of Veterans’ experiences accessing healthcare. J Gen Intern Med. 2024;39(4):596-602. https://doi.org/10.1007/s11606-023-08442-7

Vanneman ME, Wagner TH, Shwartz M, et al. Veterans’ experiences with outpatient care: comparing the Veterans Affairs system with community-based care. Health Aff. 2020;39(8):1368-76. https://doi.org/10.1377/hlthaff.2019.01375

Golden SE, Lafferty M, Tyzik A, et al. A qualitative study of VA entrants’ experiences discussing community care with Veterans. Sage Open. 2023;13(4):21582440231204666. https://doi.org/10.1177/21582440231204666

Nevedal AL, Wagner TH, Ellerbe LS, Asch SM, Koenig CJ. A qualitative study of primary care providers’ experiences with the Veterans Choice Program. J Gene Intern Med. 2019;34(4):598-603. https://doi.org/10.1007/s11606-018-4810-2

United States Government Accountability Office. Veterans Community Care Program: Improvements needed to help ensure timely access to care. United States Government Accountability Office, 2020 20–643. https://www.gao.gov/assets/gao-20-643.pdf

Savoy A, Khazvand S, Mathew A, et al. Consultants’ and referrers’ perceived barriers to closing the cross-institutional referral loop, and perceived impact on clinical care. Int J Med Inform. 2023;180:105265. https://doi.org/10.1016/j.ijmedinf.2023.105265

McCormack C, Savoy A, Mathew A, et al. Characterizing barriers to closing cross-institutional referral loops: workflow and information flow analysis. Appl Ergon. 2024;115:104177. https://doi.org/10.1016/j.apergo.2023.104177

Unertl KM, Weinger MB, Johnson KB, Lorenzi NM. Describing and modeling workflow and information flow in chronic disease care. J Am Med Inform Assoc. 2009;16(6):826-36. https://doi.org/10.1197/jamia.M3000

Holden RJ, Carayon P, Gurses AP, et al. SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics. 2013;56(11):1669-86. https://doi.org/10.1080/00140139.2013.838643

Carayon P, Wetterneck TB, Rivera-Rodriguez AJ, et al. Human factors systems approach to healthcare quality and patient safety. Appl Ergon. 2014;45(1):14-25. https://doi.org/10.1016/j.apergo.2013.04.023

Werner NE, Rutkowski R, Graske A, et al. Exploring SEIPS 2.0 as a model for analyzing care transitions across work systems. Appl Ergon. 2020;88:103141. https://doi.org/10.1016/j.apergo.2020.103141

Tarver WL, Savoy A, Patel H, Weiner M, Holden RJ. Inefficient processes and associated factors in primary care nursing: system configuration analysis. JMIR Hum Factors. 2024;11:e49691. https://doi.org/10.2196/49691

Watkins DC. Rapid and rigorous qualitative data analysis: The “RADaR” technique for applied research. Int J Qual Methods. 2017;16(1):1609406917712131. https://doi.org/10.1177/1609406917712131

Holden RJ, Carayon P. SEIPS 101 and seven simple SEIPS tools. BMJ Qual Saf. 2021;30(11):901-10. https://doi.org/10.1136/bmjqs-2020-012538

Department of Veterans Affairs. Consult processes and procedures. Washington, DC, US 2022. https://www.va.gov/vhapublications/publications.cfm?pub=1

Kenzie ES, Patzel M, Nelson E, Lovejoy T, Ono S, Davis MM. Long drives and red tape: mapping rural veteran access to primary care using causal-loop diagramming. BMC Health Serv Res. 2022;22(1):1075. https://doi.org/10.1186/s12913-022-08318-2

Sittig DF, Singh H. A new sociotechnical model for studying health information technology in complex adaptive healthcare systems. Qual Saf Health Care. 2010;19(Suppl 3):i68-74. https://doi.org/10.1136/qshc.2010.042085

O’Connor GE, Cook LA. Reducing referral leakage: an analysis of health-care referrals in a service ecosystem. J Serv Mark. 2020;34(4):513-28. https://doi.org/10.1108/JSM-03-2019-0140

Campa AJ. Kaiser agrees to $200 million in fines, fixes after failing to provide timely mental health care. Los Angeles Times; 2023. Available from: https://www.latimes.com/california/story/2023-10-13/kaiserpermanente-200-million-settlement-mental-health-care

Yoon J, Gujral K, Dismuke-Greer C, Scott JY, Jiang H. Growth of community outpatient care in the Veterans Affairs system after the MISSION Act. J Gen Intern Med. 2024;39(12):2233-40. https://doi.org/10.1007/s11606-024-08787-7

Comments (0)

No login
gif