Last updated
Virtual Rehab Experiential Care
Share PrintThe use of Virtual Reality (VR) in the rehabilitation and therapy setting not only allows us to open doors but also to engage our population in a much more immersive way. Each Veteran experiences a unique and individual connection in the VR environment. This enhances the providers ability to integrate complimentary approaches into traditional care.
Origin:
July 2020, Richard L. Roudebush Veterans' Administration Medical Center (Indianapolis, Indiana)
Adoptions:
1 successful
Partners:
XR Network
Recent Updates
Overview
Problem
The COVID-19 Pandemic sparked a renewed global focus on mental health, especially with Veteran healthcare. Pandemic-related barriers to recreation and leisure were contributing factors during this mental health crisis. Inpatient Veterans were experiencing higher levels of isolation due to contamination precautions and the inability to interact with peers, fa
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The COVID-19 Pandemic sparked a renewed global focus on mental health, especially with Veteran healthcare. Pandemic-related barriers to recreation and leisure were contributing factors during this mental health crisis. Inpatient Veterans were experiencing higher levels of isolation due to contamination precautions and the inability to interact with peers, family, and the community. But VA pushed service delivery adaptations and innovations for Veterans nationwide for continued support despite new and changing barriers. The Indianapolis VA Recreational Therapy (RT) team identified an opportunity to serve Veterans using fully immersive VR environments for recreation and leisure participation supporting therapeutic goals. VR creates intervention approaches that are beneficial for Veteran mental health while maintaining pandemic safety precautions. Inpatient Veterans were able to experience the benefits of recreation and leisure within safe environments, that are both cost effective and sustainable.
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Solution
The Indianapolis VA RT Team leveraged the innovative capabilities of VR with a Whole Health perspective to create virtual therapeutic environments. This approach also needed to be cost-effective to promote sustainability with potential for expansion. By putting the Veteran into VR, the Recreational Therapist engages the Veteran in whatever capacity and space
...
The Indianapolis VA RT Team leveraged the innovative capabilities of VR with a Whole Health perspective to create virtual therapeutic environments. This approach also needed to be cost-effective to promote sustainability with potential for expansion. By putting the Veteran into VR, the Recreational Therapist engages the Veteran in whatever capacity and space they are in. This passive device created proactive engagement from Veteran participants while enhancing Veterans’ receptiveness to other VA care.
Virtual Reality engages the user/Veteran/colleague in a more tailored and fully immersive environment. To address Veteran mental health needs we use VR to target the following areas: Stress, Anxiety, and/or Depression. Allowing us to immediately break down barriers of expectation, bias, and resistance to change that hinder participation. By changing the therapeutic environment in an innovative and novel way, participants experience interventions that impact the therapy objectives. Self-reported feedback showed reduction in at least one of the following domains: Stress, Anxiety, and or Depression with a 90% rate. See more
Virtual Reality engages the user/Veteran/colleague in a more tailored and fully immersive environment. To address Veteran mental health needs we use VR to target the following areas: Stress, Anxiety, and/or Depression. Allowing us to immediately break down barriers of expectation, bias, and resistance to change that hinder participation. By changing the therapeutic environment in an innovative and novel way, participants experience interventions that impact the therapy objectives. Self-reported feedback showed reduction in at least one of the following domains: Stress, Anxiety, and or Depression with a 90% rate. See more
Results
Since implementing VR, we have seen adoptions across other areas such as Domiciliary, Nursing, Employee Wellness, Acute Rehab, and Pain Clinic. This has engaged more Veterans in their care and promoted openness to other VA providers, increasing satisfaction and participation. Moving forward we have received continued support to expand through Whole Health an
...
Since implementing VR, we have seen adoptions across other areas such as Domiciliary, Nursing, Employee Wellness, Acute Rehab, and Pain Clinic. This has engaged more Veterans in their care and promoted openness to other VA providers, increasing satisfaction and participation. Moving forward we have received continued support to expand through Whole Health and other funding sources.
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more
Metrics
- To date we have served 250 Veterans and counting with a 100% participant recommended use rate.
- Reduction in at least one of the follow domains: Stress, Anxiety, and/or Depression at 90% rate.
- After initial cost of equipment and app acquisition, depending on system, no annual fee.
- Intervention times can be as little as 15 minutes.
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Implementation
Timeline
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Identify area of need.
Conduct investigative inquiry to identify area of need for service. -
Research appropriate Virtual Reality equipment.
Research which Virtual Reality developer/modality is most appropraite to address identified need. -
Purchase equipment and create protocol
Create protocol for use and purchase equipment. -
Trial equipment and adjust protocol accordingly
Train staff, learn equipment, trial equipment. After trial, reevaluate and adjust protocol accordingly. -
Implement program
Implement use of Virtual Reality in population and target area of need. -
Evaluate efficacy
Ongoing collection of efficacy through patient outcomes and patient feedback to prove this is meeting the area of need.
Departments
- Pain management
- Adaptive sports
- Information technology
- Whole health
- Physical medicine and rehabilitation
- Infection control
- Finance department
- Addiction and substance abuse treatment
- Administration
Core Resources
| Resource type | Resource description |
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PEOPLE |
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TOOLS |
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Optional Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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Support Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
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Risks and mitigations
| Risk | Mitigation |
|---|---|
| Information Technology barriers | Some Virtual Reality systems record data and use cloud storage. Working with the Information Technology department to determine if said system does use this type of storage is important. This will reduce the barrier to use of the equipment. |
| Cleaning procedures and instructions | Cleaning procedures and instructions are a must to obtaining equipment and are readily available from most companies. Obtaining this will be essentual to approval from Infection Control. |
| Contraindications | Prior Physician approval for participation if participants meet certain contraindications such as seizures. Obtain appropriate documentation of refresh rate of headsets to assist with appropriate recommendation. Work with physician to develop plan for approval. |
About
Origin story
The Recreational Therapy team in Indianapolis, just before the COVID-19 pandemic, had identified a potential area for engaging Veterans. The program received an internal assistive technology grant to purchase two Virtual Reality headsets. Immediately after receiving the grant the COVID-19 pandemic restrictions came into place. These initial restrictions seve
...
The Recreational Therapy team in Indianapolis, just before the COVID-19 pandemic, had identified a potential area for engaging Veterans. The program received an internal assistive technology grant to purchase two Virtual Reality headsets. Immediately after receiving the grant the COVID-19 pandemic restrictions came into place. These initial restrictions severely limited the ability to conduct recreational and leisure activities. The initial goal of VR was to address physical outcomes within patients in an acute rehab setting which quickly shifted to a mental health approach to address rising needs. Shortly after shifting, VR was validated by consistent outcomes showing improvements in Stress, Anxiety, and/or Depression in inpatient Veterans. Participant feedback showed enjoyment and began to open doors with Veterans.
Original team
Evan Davis
Recreational Therapist
Dustin Ervin
Recreational Therapist
Comment
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