Marc I Rosen1, Steve Martino1, John Sellinger1, Christina M Lazar1, Brenda T Fenton1, Kristin Mattocks1. 1. is the Director of Addictions Firm, is the Chief of Psychology, is the Director of Clinical Health Psychology, is the Associate Director, Methods and Biostatistics Core, PRIME Center; all at VA Connecticut Healthcare System in West Haven. is the Associate Chief of Staff for Research at the VA Central Western Massachusetts Healthcare System in Leeds. Marc Rosen and Steve Martino are Professors of Psychiatry, John Sellinger is an Assistant Professor of Psychiatry, and is a Research Associate, all at Yale University in New Haven, Connecticut. Kristin Mattocks is an Associate Professor of Population and Quantitative Health Sciences at the University of Massachusetts Medical School in Worcester.
Abstract
BACKGROUND: The Compensation and Pension (C&P) determination process is a potential gateway to accessing pain treatment in the Veterans Health Administration (VHA). However, attitudes about C&P as a gateway and about collaboration with C&P clinics among VHA staff are unknown. METHODS: In preparation for an initiative to link veterans seeking compensation for musculoskeletal disorders to treatment, clinical and administrative staff from the 8 VHA medical centers in New England were invited to complete a relational coordination survey that examined how different workgroups collaborate (communication and relationships) to provide pain care to veterans. A subset of those staff also participated in a semistructured interview about pain treatment referral practices within their medical centers. VHA staff were from primary care, administration, pain management, and C&P teams. RESULTS: Eighty-three VHA staff were invited to complete the relational coordination survey; 66 completed the survey and 39 participated in the semistructured interview. Most C&P staff interviewed thought of the compensation examination as a forensic process and that C&P-based efforts to engage veterans might interfere with the examination or were not their responsibility. However, some examiners described their efforts to determine new veterans' eligibility for VHA care and to connect them to specific treatments. VHA staff reported that there was little communication between the C&P team and other teams. The survey results supported this finding. The C&P group's relational coordination composite scores were lower than any other workgroup. CONCLUSION: Outreach to veterans at New England C&P clinics was inconsistent, and C&P teams rated low on a measure of coordination with workgroups involved in pain treatment. Compensation examinations appear to be underused opportunities to help veterans access treatment. C&P-based treatment engagement is feasible; it is being done by some Compensation teams.
BACKGROUND: The Compensation and Pension (C&P) determination process is a potential gateway to accessing pain treatment in the Veterans Health Administration (VHA). However, attitudes about C&P as a gateway and about collaboration with C&P clinics among VHA staff are unknown. METHODS: In preparation for an initiative to link veterans seeking compensation for musculoskeletal disorders to treatment, clinical and administrative staff from the 8 VHA medical centers in New England were invited to complete a relational coordination survey that examined how different workgroups collaborate (communication and relationships) to provide pain care to veterans. A subset of those staff also participated in a semistructured interview about pain treatment referral practices within their medical centers. VHA staff were from primary care, administration, pain management, and C&P teams. RESULTS: Eighty-three VHA staff were invited to complete the relational coordination survey; 66 completed the survey and 39 participated in the semistructured interview. Most C&P staff interviewed thought of the compensation examination as a forensic process and that C&P-based efforts to engage veterans might interfere with the examination or were not their responsibility. However, some examiners described their efforts to determine new veterans' eligibility for VHA care and to connect them to specific treatments. VHA staff reported that there was little communication between the C&P team and other teams. The survey results supported this finding. The C&P group's relational coordination composite scores were lower than any other workgroup. CONCLUSION: Outreach to veterans at New England C&P clinics was inconsistent, and C&P teams rated low on a measure of coordination with workgroups involved in pain treatment. Compensation examinations appear to be underused opportunities to help veterans access treatment. C&P-based treatment engagement is feasible; it is being done by some Compensation teams.
Authors: Marc I Rosen; William C Becker; Anne C Black; Steve Martino; Ellen L Edens; Robert D Kerns Journal: Pain Med Date: 2019-03-01 Impact factor: 3.750
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Authors: Steve Martino; Christina Lazar; John Sellinger; Kathryn Gilstad-Hayden; Brenda Fenton; Paul G Barnett; Brad R Brummett; Diana M Higgins; Paul Holtzheimer; Kristin Mattocks; Tu Ngo; Thomas E Reznik; Alicia M Semiatin; Todd Stapley; Marc I Rosen Journal: Pain Med Date: 2020-12-12 Impact factor: 3.750