VA Home Based Primary Care improves quality of care for Veterans

VA Home Based Primary Care improves quality of care for Veterans

Veteran Kenneth Tutt, age 79, starts his weekdays with an 8:00 a.m. telephone call to his Home Based Primary Care provider of four years, Nurse Practitioner Rhonda Weinhold. Together they review his weight, blood pressure and sugar levels. Nurse Practitioner Rhonda Weinhold on a recent Home Based Primary Care visit with Veteran Kenneth Tutt. Like most HBPC patients, Tutt takes a high number of medications to treat multiple health conditions. Weinhold’s 80 HBPC patients average 14 daily medications. Some more than thirty. HBPC teams set-up 30-day medication boxes for patients. “Instead of having to take their medicines out of 10 or 15 bottles, we put them in a medication organizer for them,” Weinhold said. “We love doing it, but more and more we noticed our patients were on so many medications. We just stopped and thought, are there medications we could potentially get rid of that actually might be doing more harm or that are not needed?” VA Geriatric Scholars Program Weinhold recently participated in the VA Geriatric Scholars Program , a workforce development program to integrate geriatrics into primary care practices. One cornerstone of this training is understanding appropriate and potentially inappropriate prescribing practices for older patients. With this in mind, she developed a local quality improvement project to improve medication management, including reducing the average number of medications taken by patients in her panel. She teamed up with HBPC team member Jena Willis, Doctor of Pharmacy. They decided to consolidate the pharmacist’s medication de-escalation recommendations into a plain-language addendum to the patient’s shared electronic health record—the digital version of a patient’s medical file. “These are the meds we think could possibly be taken off the patient’s medication list,” Weinhold explained. “I would go into the home and review it face-to-face,” she said. In-person outreach allowed her to […]

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