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Published on: April 23, 2014
Early lessons learned in implementing a women's health educational and virtual consultation program in VA
Kristina M Cordasco1, Jessica L Zuchowski, Alison B Hamilton
1*VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, North Hills †VA Greater Los Angeles Healthcare System Departments of ‡Medicine §Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA ∥VHA Specialty Care Services, Office of Patient Care Services, Veterans Health Administration, Washington, DC ¶Louis Stokes Cleveland VA Medical Center #Case Western Reserve University, Cleveland, OH **VHA Women's Health Services, Office of Patient Care Services, Veterans Health Administration, Washington, DC ††Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.
Background:
Many Veterans Health Administration primary care providers (PCPs) have small female patient caseloads, making it challenging for them to build and maintain their women's health (WH) knowledge and skills. To address this issue, we implemented a longitudinal WH-focused educational and virtual consultation program using televideo conferencing.
Objective:
To perform a formative evaluation of the program's development and implementation.
Research Design:
We used mixed methods including participant surveys, semi-structured interviews, stakeholder meeting field notes, and participation logs. We conducted qualitative content analysis for interviews and field notes, and quantitative tabulation for surveys and logs.
Subjects:
Veterans Health Administration WH PCPs.
Results:
In 53 postsession surveys received, 47(89%) agreed with the statement, "The information provided in the session would influence my patient care." Among 18 interviewees, all reported finding the program useful for building and maintaining WH knowledge. All interviewees also reported that sessions being conducted during their lunch hour limited consistent participation. Logs showed that PCPs participated more consistently in the 1 health care system that provided time specifically allocated for this program. Key stakeholder discussions revealed that rotating specialists and topics across the breadth of WH limited submission of cases.
Conclusions:
Our WH education and virtual consultation program is a promising modality for building and maintaining PCP knowledge of WH, and influencing patient care. However, allocated time for PCPs to participate is essential for robust and consistent participation. Narrowing the modality's focus to gynecology, rather than covering the breadth WH topics, may facilitate PCPs having active cased-based questions for sessions.
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