Patient Aligned Care Teams
All patients are individuals who deserve humanistic care and concern. Team-Based care allows each Veteran to be treated as an individual. A holistic spectrum of care is provided to patients when using a team based method.
the Veterans Health Administration is leading the medical care community when providing team based care for Veterans. Team based care is essential in successfully managing patients whom are living longer, with increasingly difficult multiple diagnoses and poly-pharmacy’s. The team based care concept has been adopted by the Northern Arizona VA Health Care System’s implementation of the Patient Aligned Care Team Model (PACT). This team of multiple disciplines: nurse, social worker, dietician, nurse practitioner, psychologist and rehabilitation therapist all work in a cohesive manner. Each discipline focuses on brining their expertise and medical advice to the plan of care for each patient. This team concept promotes interaction and collaboration amongst multi-disciplinary professionals, while advocating for the Veteran patient. Team based care is utilized in the inpatient hospital setting as well as the outpatient clinics.
All patients are individuals who deserve humanistic care and concern. Team-Based care allows each Veteran to be treated as an individual. A holistic spectrum of care is provided to patients when using a team based method.
Let’s say a Veteran makes a simple request for their primary care provider to order a sleep aid to assist with improved sleep. The team as a whole may have invaluable information that changes the direction of care. Instead of the provider ordering the medication from one discipline perspective, the nurse may remind the PCP that a new medication was just ordered at night, hence the latest issue with insomnia. The simple fix is to change the time of day the mediation is administered rather than add an additional medication to the patient’s medication regimen.
The social worker may have input that identifies the patient has considerable stress due to marital or family relationships. In this case implementation of counseling, coping mechanisms, meditation or relaxation techniques may be the best answer. The psychologist may identify that the patient has had an increase in nightmares and post traumatic stress disorder symptoms. This would prevent the wrong drug from being ordered and would allow the provider to implement or increase the proper medication to assist with relieving the PTSD symptoms. All disciplines may have plan of care altering information that allows the patient to receive the appropriate treatment in a timely manner.
In the above scenario, the Veteran benefited from individualized team based care. The team care approach improves the quality of patient care provided by the VA. Team care saves the patient money and time while improving quality. It also allows an increased number of Veterans to receive the quality care the VA provides.
It's just one of the many ways the Northern Arizona VA Health Care System is providing "Personalized, Proactive, Patient-Driven Care."
