Abstract:
Introduction/Background: This study aimed to improve the referral process for Veterans
with mental health who are seeking long-term care support through the VA with a
needs and gaps analysis. Hackman and Oldham’s theoretical framework served as a lens
to gain insight into stakeholders of the process and explore the need for stakeholders to
know the whole process to yield the most effective outcome.
Methods: Survey, 9 structured interviews, Mental Health admission data collection
Results: More than 45% of all clinical staff at Manchester Veterans Affairs Medical
Center reported not feeling confident or only slightly confident on their knowledge of the
Long-Term Care Referral Process while 71% reported not feeling confident or slightly
confident on their knowledge of the PASRR as part of the referral process. Data
Collection from Geriatric programs found all four programs had 35% or more Veterans e
nrolled with a Mental Health diagnosis. There were five central themes found from
interviews in data analysis; a lack of knowledge of the referral process, an increase in
aging mental health Veterans, needed resources, COVID Impact and a need for more
training.
Discussion: A discovered lack of knowledge of the whole referral process amongst
stakeholders is negatively impacting nursing home placements with an inconsistency in
completing the PASRR which supports existing literature on a need for a standardization
of the PASRR and an Interdisciplinary approach. This study introduced an approach to
standardize the PASRR implementation and improve the effectiveness of the LTC
referral process through Oldham & Hackman’s theoretical framework. While this was
applied to the LTC referral process this approach can be generalized to other areas
working to breakdown the compartmentalization of workflows. Manchester is one VA of
171 facilities. This study was limited to VA stakeholders and future research would
benefit from community stakeholder insight.
