VA Polytrauma Rehabilitation Centers Help Veterans Get Back to Living

“World class system…has no equal”

When soldiers started coming home from Iraq and Afghanistan with complex injury patterns, VA responded with the Polytrauma System of Care.

VA’s role in rehabilitation is to motivate and push, to provide tools, skills and equipment to face and overcome challenges.

According to Dr. Lucille Beck, VA’s Chief Consultant for Rehabilitation Services, “We quickly realized we would need to establish a new system and new models of care to treat the most severely wounded and injured soldiers from the ongoing conflicts in the Middle East.”

Polytrauma is used by VA to describe the complex, multiple injuries to multiple body parts and organs, one of which is life threatening, and which occur as a result of a single event. This event can be blast-related injuries (seen from Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF)), or the result of a motor vehicle accident, falls, or other such incidents. Four Polytrauma Rehabilitation Centers are located in Richmond, Va., Palo Alto, Calif., Tampa, Fla., and Minneapolis, Minn., with a fifth opening in San Antonio, Texas in October.

Polytrauma is defined as two or more injuries to physical regions or organ systems, one of which may be life threatening, resulting in physical, cognitive, psychological, or psychosocial impairments and functional disability. Traumatic Brain Injury (TBI) frequently occurs in polytrauma in combination with other disabling conditions such as amputation, auditory and visual impairments, spinal cord injury, post-traumatic stress disorder, and other medical problems.

Due to the severity and complexity of their injuries, Veterans with polytrauma require an extraordinary level of coordination and integration of clinical and other support services.

As Dr. Beck notes, “The recovery process to achieve a new level of ‘normal’ requires a determined patient, who is backed by a strong support network and a committed team of highly skilled rehabilitation specialists. The recovery of every patient has its advancements and setbacks, joys and challenges, and this journey can be long. Yet, our experience with every patient advances medical knowledge, producing improvements in the care delivery and rehabilitation for all who are recovering from Polytrauma.”

The VA Polytrauma System of Care currently provides specialty rehabilitation care across 108 VA Medical Centers with services available at the four regional Polytrauma/TBI Rehabilitation Centers, 22 Polytrauma Network Sites and 86 Polytrauma Support Clinic Teams.

Polytrauma Rehabilitation Centers provide the most intensive specialized care and comprehensive rehabilitation care for Veterans with complex and severe polytrauma. They maintain a full staff of dedicated rehabilitation professionals and consultants from other specialties to support these patients.

Polytrauma Network Sites provide specialized, post-acute rehabilitation, both inpatient and outpatient, in consultation with the Rehabilitation Centers in a setting appropriate to the needs of Veterans and their families. These Network Sites provide proactive case management for existing and emerging conditions and identify local resources for VA and non-VA care.

Polytrauma Support Clinic Teams are located at 86 medical centers with dedicated outpatient, teams of rehabilitation specialists across multiple disciplines. They provide specialty rehabilitation care close to home and can evaluate and develop individualized treatment plans. They also provide interdisciplinary rehabilitation care and long-term management of patients with ongoing or changing rehabilitation needs.

At 41 medical centers without specialized rehabilitation teams, there are Polytrauma Points of Contact, designated VA primary care staff member knowledgeable in the Polytrauma System of Care. They coordinate case management and referral within the system of care and also make referrals to rehabilitation services provided within local community.

“VA’s Polytrauma System of Care strongly advocates family involvement throughout the rehabilitation process,” according to Dr. Beck. “VA strives to ensure that patients and their families receive all necessary support services to enhance the rehabilitation process while minimizing the inherent stress associated with recovery from TBI and Polytrauma.”

VA offers multiple levels of clinical, psychosocial and logistical support to ensure a smooth transition and continuous care for patients and their families. VA assigns a dedicated case manager to each patient and family at a rehabilitation center. Families can access this case manager for assistance 24 hours a day, 7 days a week.

Dr. Shane McNamee believes that, “VA’s highly coordinated, effective system is unparalleled in this nation’s medical system for those who have suffered a traumatic brain injury.” Dr. McNamee is the Chief of the Physical Medicine & Rehabilitation Service at the Richmond, Va. VAMC.

He adds, “Our integrated transition plan of care, from military treatment facilities, to our Polytrauma Rehabilitation Centers, and into the community, is paramount to the success of our Wounded Heroes and their families. The system set up throughout VA is world class and has no equal for those suffering from TBI.”

Between 2005 and 2011, over 2,000 severely injured inpatients with traumatic brain injury received care at a VA Polytrauma Rehabilitation Center. More than 32,000 Veterans with TBI were treated at Polytrauma Network Site clinics.

There were more than 775 remotely conducted telehealth encounters and more than 535,000 OEF/OIF Veterans screened for possible TBI.

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