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A medical companion program assigned caregiver is standing next to a Veteran in a US Navy Hat who is about to undergo a same day surgical procedure.

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Medical Companion Program

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The Medical Companion Program seeks to provide caregiver services in lieu of hospitalization to those Veterans who do not have a responsible adult available. By doing so, it provides increased access to care by addressing a psychosocial barrier while at the same time, demonstrating a significant cost savings to the government.

This innovation is replicating across multiple facilities as its impact continues to be validated. See more replicating innovations.

Origin:

June 2019, Edward Hines Junior Hospital

Adoptions:

1 in-progress, 1 unsuccessful

Partners:

Care Management and Social Work Services, Community Engagement, Hospital Medicine

Contact Team

Overview

Problem

Per VA regulations, all Veterans who undergo outpatient or ambulatory procedures using sedation and/or anesthesia are required to have a responsible adult accompany them to the procedure in order to facilitate their recovery and transition from a VA medical facility to their desired destination post care. For those Veterans who do not have a responsible adu ... See more

Solution

In FY 2019, a piloted Medical Companion Program was launched utilizing an investment from the VHA Innovators Network. As a result of the pilot's success, a local Medical Companion Program was launched in February 2020.

Results

FY 2021 was the first full fiscal year that our facility had an operational medical companion program. As a result, 150 Veterans were successfully able to complete their procedures in the outpatient setting. Comparatively, only 14 Veterans required admission into an observation unit to facilitate their outpatient procedures.

Metrics

  • Number of Veterans who utilized MCP services to facilitate their outpatient procedures (FY 21)-150
  • Cost savings to the government (FY 21): $395,000.00
  • Average reduction in average Veteran cost (FY 21): 88%
  • Number of Veterans who utilized MCP services to facilitate their outpatient procedures (FY 22 Quarters 1&2): 102
  • Cost savings to the government (FY 22 Quarters 1&2): $265,000.00
  • Average reduction in average Veteran cost ( FY 22 Quarters 1&2): 86%
  • Program cost (FY 21): $55,227.00
  • Program costs (FY 22 Quarters 1&2): $$41,322.00

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

There are no successful adoptions for this innovation.

Implementation

Timeline

  • 2 weeks
    Identification of a funding source and allocating funds accordingly (disclaimer--this step would be necessary absent any national directive allocating a funding source)
  • 2 weeks
    Identify team members that will work together to implement the practice (to include, but not limited to: Social work, Utilization Management, Fiscal Service (if necessary), Office of Community Care (if necessary), Contracting representative (if necessary), Medicine Service, Surgery Service)
  • 1-3 months
    Identify/onboard a MCP Coordinator (recommend a .5 FTE)
  • 1 month
    Administrative tasks--develop a referral mechanism, tracking mechanism, data collection tool, SOP (absent national directive that supersedes the need), Fact Sheet, etc..
  • 2 weeks
    Staff education--educate staff and personnel about the Medical Companion Program, who might be eligible for the program, how to submit a referral, etc..

Departments

  • Social work
  • Gastroenterology
  • Administration
  • Internal medicine
  • Outpatient surgery

Core Resources

Resource type Resource description
PEOPLE
  • A Medical Companion Program Coordinator .5 FTE
  • Clinical Application Coordinator 2-4 hours/week for 1-2 weeks
  • Office of Community Care representative 2 hours week/ongoing
  • Fiscal Office representative 2 hours/week for 3-4 weeks
PROCESSES
  • Preparation of a Powerpoint Presentation providing education regarding the Medical Companion Program that can be reviewed with staff
TOOLS
  • Computer equipment---laptop, monitors
  • Telephone (landline vs VA issued cell phone as determined by the MCP Coordinator)

Support Resources

Resource type Resource description
PEOPLE
  • Hines VA Medical Companion Program Coordinator is available for consultation and support in a mechanism determined between sites that is most suitable
  • Hines VA Office of Community Care is available for consultation and support in a mechanism determined between sites that is most suitable

Risks and mitigations

Risk Mitigation
Unknown national support for the Medical Companion Program Implementing a team approach and soliciting support on the local level to operate a Medical Companion Program while at the same time, elevating the program through national initiatives when the opportunity is present.

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

VA User (GEC, RN) posted

New Mexico has successfully implemented this program within our facility beginning in FY 21

1
VA User (Registered Nurse (RN)/3S) Innovation owner edited

As a GI nurse navigator our team helped roll out this innovation ate our facility. (Jennifer Moreno Department of Veterans Affairs Medical Center 3350 La Jolla Village Drive San Diego, CA 92161)

We have been utilizing the medical companion program for about 2-3 years now.

Please add us to the Successful adoptions list !

VA User (PHYSICIAN ASSISTANT- GI) posted

Starting to think about how we can implement at the Washington, DC VA

Email

Email with questions about this innovation.

About

Origin story

In the spirit of VA's mission focused mindset, in FY 2018, Hines VA had to pursue unwarranted admission under an inpatient observation status for 149 Veterans so that they could have their outpatient procedures performed. An overnight observation stay cost the facility a minimum of $3000.00 per night (not including auxiliary expenses) therefore the facility ... In the spirit of VA's mission focused mindset, in FY 2018, Hines VA had to pursue unwarranted admission under an inpatient observation status for 149 Veterans so that they could have their outpatient procedures performed. An overnight observation stay cost the facility a minimum of $3000.00 per night (not including auxiliary expenses) therefore the facility had spent well over $447,000.00 in unwarranted admissions in FY 2018. This was simply not a sustainable solution for our facility and therefore, staff began reviewing alternative options where it was then discovered that community home health agencies can and do offer companionship services for same day surgical procedures as part of their everyday business operations.

Original team

Stephanie Sawin

Social Worker and Medical Companion Program Coordinator

Jeanne Obrochta

Social Work Clinical Manager

Joseph Ader

Social Work Executive

Brad Hagen

Accounting Officer

Deborah Daniels

Utilization Management

Jualia Sims

Office of Community Care

Dr Sandy Reynertson

Acting Chief of Medicine