RAVEE: Reaching All Veterans @ Every Encounter
Last updated
Share PrintVHA should be utilizing this model of care, where everyone can RAVEE. To RAVEE is to Reach All Veterans @ Every Encounter and connect Veterans with the services they need. Every Veteran suicide prevented is something that VHA should rave about. There is no wrong door for identification of suicide risk; it is everyone's business.
Origin:
January 2023, Bath VA Medical Center, Canandaigua VA Medical Center, Elmira VA Clinic, Rochester Calkins VA Clinic, Rochester Clinton Crossings VA Clinic, Wellsboro VA Clinic, Wellsville VA Clinic
Adoptions:
1 successful
Awards and Recognition:
National HeRO Award
Partners:
Audiology and Speech, Clinical Services, Mental Health and Suicide Prevention, Office of Health Informatics, Office of Primary Care, Optometry, Physical Medicine and Rehabilitation, Systems Redesign and Improvement
Recent Updates
Overview
The problem
Images
Above:
The above pareto chart indicates the number of missed screens (Y-axis) in each service (X-axis). It was identified that in FY22, Primary Care, Medicine and Specialty Care, Optometry and Audiology represented 54.6% of missed screens. This proved that we needed to target every encounter.
The solution
When a Veteran screens positive, appropriate avenues have been developed for follow-up and connection to needed services including a warm hand-off to Primary Care Mental Health Integration (PCMHI). Suicide prevention should be approached as an entire health care system, breaking the stigma that suicide prevention is a mental health responsibility. At VHA, there is no wrong door for suicide prevention. See more
Videos
Above:
Dr. Weyand, Chief of Optometry explains the why and how of RAVEE
The results
Metrics
- Suicide screening for Veterans increased an additional 9,000 encounters annually. An estimated 0.6% of veterans will screen positive, requiring additional follow up care. Utilizing RAVEE and partnerships with PCMHI, facilities can reach more veterans that would have otherwise walked out the doors.
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Images
Above:
VA Finger Lakes Healthcare System and Audiology Clinic ROI with RAVEE
Implementation
Timeline
-
Two to Four Weeks
Identify implementation team members and develop RAVEE implementation plan -
One Month
Communicate the implementation plan and expectations to clinical chiefs and employees utilizing Safety Forums, Process Improvement Forums, Leadership Rounding, Team Huddles, and Service Level Meetings. -
One Month
Provide training on Suicide Screening for all clinical staff and peer to peer mentoring. Implement standard work in all clinics including a resource sheet with contacts for completing a warm hand off when indicated. -
One Month
Monitor and share real-time data back to clinical teams.
Departments
- Cardiology
- Audiology and speech
- Dental/oral surgery
- Dermatology
- Emergency care
- Geriatrics
- Hospital medicine
- Internal medicine
- Mental health care
- Nursing services
- Neurology
- Optometry
- Orthopedics
- Pain management
- Pharmacy
- Primary care
- Social work
- Pulmonary medicine
- Physical medicine and rehabilitation
- Suicide prevention
- Urgent care
- Urology
- Women Veteran care
- Wound care and ostomy
- Cardiology
- Military sexual trauma
- Whole health
- Nutrition, food, and dietary
- Adaptive sports
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
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TOOLS |
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Optional Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
Risks and mitigations
| Risk | Mitigation |
|---|---|
| Concern about cost | Leveraged current staffing by utilizing subject matter experts in suicide prevention to conduct trainings and peer to peer mentoring sessions (no cost). |
| Provider Discomfort | Peer to peer mentoring, sharing of best practices, role playing, scripting, and sharing success stories empowered providers to conduct screening. |
| Lack of Sustainment | Daily clinical huddles are held to monitor the outcome of this innovation. Suicide prevention screening metrics are presented daily on the enterprise wide visual dashboard and executive leadership meetings, following the pillars of a High Reliability Organization (HRO). Sustainment efforts are implemented when identified through these means. |
Contact
Comment
Comments and replies are disabled for retired innovations and non-VA users.
Email megan.winderl@va.gov with questions about this innovation.
I believe another useful resource is the clinical laboratory. When a Veteran presents for a blood draw, we spend 5-10 minutes with each Veteran face-to-face and in a private setting. Often the Veterans tell us their stories, including how they have been struggling. In such an intimate setting, my coworkers and I have been the first person that the Veteran felt comfortable enough to speak to, and we've often contacted Veteran Teams to intervene when a Veteran admits they were thinking of suicide.