Voices of VISN 6 Is Published Monthly by Deanne Seekins // VISN 6 Network Director Fanning Communications VA Mid-Atlantic Health Care Network

Official News From Around Your VISN VOLUME 10 ISSUE 11 OCTOBER 2020

VOICESExcellent Care – Earned OF by Veterans VISN – Delivered Here 6

NEW INVENTION Prioritizes Communication Without Substituting Safety

Inside This Issue By Megan Kon

2 Whole Health Is Integrative The Clear Talker mask is the latest eyes to physically express my greeting.” invention from the Central Virginia VA John Miller, Brian Burkhardt and Medicine: Aromatheraphy Health Care System (CVHCS) in Rich- Seth Hills are rehabilitation engineers New In- 3 Salisbury VA Increases its mond, meant to aid in communication who work with Oliver. Their expertise, Critical Care Capability with between patients and staff. The device, including vacuum forming, injection vention Virtual Technology a product of the hospital’s Assistive molding, laser cutting, electronics, 3D Technology team (AT), could revolution- printing and a whole range of other 4 VISN 6 Opens New CBOC In Prioritizes Communication ize peoples’ everyday lives. When masks valuable skills, helps Veterans return to a Tidewater became a requirement at all federal sense of normalcy. 6 Joins Local Hospitals in COVID health care facilities, AT realized how “[The Clear Talker mask] may not much current surgical masks hindered make the cover of a fashion magazine,” Substituting Safety Outreach Campaign Without communication. said Hills, who has developed several 7 CGVAMC Social Workern “I noticed after wearing a mask all adaptive sports tools, custom mounting Deploys to Lake Charles day that I would come home and my eyes solutions and a novel wheelchair inter- 8 A Time for Innovation were tired,” said Melissa Oliver, occupa- face, while with AT. “The fact that you 10 VEText Mobile Check-in is tional therapist and program coordinator can see each other’s faces and catch those of the AT team. “I had to rely on just my social cues is invaluable.” Convenient, Easy 11 Diabetes Awareness Month TOP PHOTO: Wearing ClearTalker Mask

STORY CONTINUED ON PAGE 5

Excellent Care – Earned by Veterans – Delivered Here | OCTOBER 2020 ///////////////////////////////////////// 1 MESSAGE FROM THE Whole Health Is Integrative Medicine: AROMATHERAPY

By Steve Wilkins | VISN 6 PUBLIC AFFAIRS NETWORK DIRECTOR During a recent email conversa- Veterans have sought unsuccessful- The month of November is tion, Joy Fealy-Kalar, Field Based Im- ly for years, adding, “Mental peace upon us, and we will soon honor plementation Team Consultant with of mind (not common in Veterans) those who defended our nation against all enemies, the Office of Patient Centered Care is good for the health of the whole foreign and domestic, on Veterans Day. Many of & Cultural Transformation declared, body … all this with an aromatherapy you, like me, remember the sacrifices of our family “Whole Health isn’t just CIH [com- inhaler, priced at $1.25 that will last 3-6 members who fought before us. But November 11 plementary and integrative health] months.” we will salute everyone who took part in uniformed approaches, and it isn’t a service line Aromatherapy is thought of as defense of our nation. They deserve it. We have where we send all patients who are an art and a science. Humans have much to thank them for. So, it only makes sense that interested in these approaches, so used it for a very long time. Ancient we honor them every day with the best care, with the collaboration with Nursing, Mental cultures have incorporated aromatics greatest expedience. Our experience this year, pro- Health, Primary and Specialty Care is in resins, balms, and oils. Aromather- viding Veterans the care they need and deserve while going to be key in transforming our VA apy works through the sense of smell keeping them safe from the Coronavirus disease, has healthcare system.” and skin absorption with products been challenging, but we met the need. From the It seems that the concept of like spritzers, diffusers, inhalers and start, we asked ourselves how we can expeditiously Whole Health tends to be a little mis- candles. Practitioners say that its use provide care without compromise. We have been understood by both patients and cli- can help with pain management, stress trying to answer the question since January, and nicians when they are first introduced and anxiety reduction, soothing joints, because we addressed the question quickly, we were to it, but in reality, this approach to and can even alleviate some effects of able to swiftly implement changes as the nation shut care isn’t new. It is often referred to as chemotherapy. down by early March. Many of our staff collaborated holistic care or integrative health. But So, this serves as a great example to invent new practices that helped ease the burden Christine Anne, Nurse Practitioner at of incorporation of Whole Health into of restrictive care. It’s impossible to visit one of our the Fayetteville VA gets it, and agreed a patient-centered plan of care. It is not facilities without noticing many of the changes with Fealy-Kalar, stating, “Yes, Whole a stand-alone regimen. But Fealy-Kalar we’ve made to protect each other, staff and Veterans Health has programs and services, but wants to remind us that inclusion of alike. Moving forward, for the foreseeable future, it is NOT a program or service line.” these practices can have significant im- as our facilities cautiously transition back to full In fact, she went on, offering that pact on Veteran health and wellbeing, service, we are offering Veterans Virtual Care First. Whole Health is a health care model not to mention the reduction in the That means we are advocating video and telephone to address the needs of the Whole overall cost of providing care in this appointments whenever and wherever we can, based Person. She’s right — Whole Health model. She says that, “We also know on the medical need, condition and practicality. As provides varied clinical and comple- from the 18 (VA Whole Health) Flag- we expanded our capability and availability this mentary services to meet the multi-lev- ship sites that Veterans have a three- year, Veterans discovered that they like the service, el needs of body, mind, spirit, and fold reduction in opioids with this and appreciate the opportunity for personal contact social support for each individual. approach of developing shared goals, without compromising their personal safety, or To illustrate, Anne laid out a connecting the Veteran with what taking unnecessary health risks. As Veterans engage recent scenario involving aromather- really matters to them, and teaching us to make appointments, we will triage according to apy. According to Emily Cronkelton, them self-care techniques and pro- urgency and their need for personal contact. I think writing in Healthline, an online blog, viding CIH services.” With that, Anne what I am most proud of this year is that we have “Aromatherapy is a holistic healing concluded, “This creates and supports been able to accommodate the need in numbers treatment that uses natural plant ex- Optimal Health and WELLBEING at approaching those before the pandemic hit. We were tracts to promote health and well-be- every level of care.” able to do it only because our virtual capability and ing.” Veterans’ acceptance of it enabled us to pivot rapidly. Anne related, “Aromatherapy It is our honor for every Veteran that drove our pre- was provided last week for a Veteran paredness, and continues to drive our commitment with multiple mental/ health issues.” to be there for them in the weeks, months and years She said that on the next day during to come. the follow up call by the RN Aroma- therapist, the Veteran stated, “After using this aromatherapy inhaler, I felt – DeAnne M. Seekins strange, like peaceful, not a care in the VISN 6 Network Director world.” Anne is convinced that Aroma- therapy helped the Veteran achieve a Aromatherapy has been integrated as part of the Whole Health regimen of pa- state of relaxation that they hadn’t felt tient-centered care at Fayetteville VA, with in a long time, and that many other demonstrably positive results.

2 \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\ OCTOBER 2020 | Excellent Care – Earned by Veterans – Delivered Here (RIGHT PHOTO) Intensive Care Unit (ICU) Veteran Patient Robert Trivette speaks with an ICU nurse in Cincinnati, Ohio, through a monitor via video connection during the rollout of the Tele-Critical Care program in the Salisbury VA HCS ICU. The program enables ICU staff in hub locations to support patient care efforts in local, more remote hospitals. (LEFT PHOTO) Salisbury VA HCS Executive Director Joseph Vaughn establishes a video connection with Michelle Bonham during the rollout of the Tele-Critical Care program in the Salisbury VA HCS Intensive Care Unit (ICU). The program enables ICU staff in hub locations to support patient care efforts in local, more remote hospitals. SALISBURY VA INCREASES ITS CRITICAL CARE CAPABILITY WITH VIRTUAL TECHNOLOGY By VISN 6 Public Affairs immediately. also means being a partner in developing, Critical Care Nurse Manager Daryl At- implementing, and sharing evidence-based Intensive Care medicine at the Salisbury kinson agrees with De Comarmond, adding, best practice examples within our Tele-ICU VA Health Care System (HCS) took a big leap “Tele-ICU not only provides the highest level network. Through collaboration with our forward Oct. 26 when Executive Director of care for our Veterans, it serves as a means of Tele-ICU partners, we can now share, adopt, Joe Vaughn pressed a button connecting the collaboration and backup to our bedside staff. and implement evidence-based protocols — medical center’s Intensive Care Unit to a video This allows our team to remain present with directly affecting patient outcomes. connection at the Cincinnati VA Medical our Veterans during these critical moments, De Comarmond claims the launch of Center. supplementing communication, coordination, the Tele-ICU operations in Salisbury is a Known as Tele-Critical Care, the program and closing the loop with patient care needs significant milestone on the road to becoming responsible for the connection is designed to extending beyond the bedside.” a High-Reliable Organization, an organiza- enhance quality of intensive care situations by After months of preparation to adapt tional aspiration shared at the facility, VISN adding an additional layer of monitoring and and install equipment, and to train staff on and VHA levels. He is proud to add that as the increasing access to intensive care expertise procedures, ensuring proper communica- solution, the Tele-Critical Care program lever- and consultation around the clock. Tele tion protocols and operational practices, ages virtual care technology to provide back- Critical Care services mean Veterans receiving everything was in place Oct. 26 for Salisbury ground and on-demand critical care support ICU care are being watched, even when local leadership to officially establish the connec- 24/7, 365 days/year without the concern for providers are out of the room. tion. Vaughn pressed the button that put him unplanned staff attrition. “Being an organiza- According to Salisbury VAHCS Chief of in direct video contact with Michelle Bonham, tion that is sensitive to operations, we listened Medicine Dr. Charles De Comarmond, “The at the Cincinnati VA Medical Center, home of to our ICU staff. From there, we started the launch of our new Tele-ICU operations in the Tele Critical Care East monitoring center. process to bring on Tele-Critical Care to Salis- Salisbury is a significant milestone in our road Currently, the monitoring center partners bury so that our team could always have the to High-Reliable Organization.” De Comar- with satellite hubs in Cleveland, Ann Arbor, confidence that someone, somewhere, is there mond contends, Tele-ICU not only provides Baltimore, Orlando and Atlanta connecting to to support them.” the highest level of care for our Veterans, it a total 22 medical facilities. Soon, coordinators Now, being part of a national network of serves as a means of collaboration and backup hope to add the Central Virginia Health Care VAs connected virtually, provides immediate to our bedside staff. He related a situation two System in Richmond as an additional hub. resources to our healthcare team — all at the years ago when the facility found itself com- Being a part of VA’s Tele-ICU program push of a button. promised by a staffing shortage and worked hard to find a permanent solution. De Comarmond says hospitals like the Salisbury VAMC cannot cost-effectively support an ICU with 24/7, 365 days/year in- house critical care specialists, thus we rely on hospitalist cross-coverage to support essential coverage during night tours and weekends. He indicated that participation in VA’s national Tele-Critical Care program will optimize their staffing structure. “Now critical care support From left, Salisbury VA HCS Chief of Medicine Dr. Charles de Comarmond is joined by TeleCritical Care Team members, including Salisbury VA Nurse Manager for Critical Care Daryl Atkinson, Philips eICU Sr. and consultation is available for our hospital- Clinical Transformation Manager Paula Keally, APRN TeleCritical Care Lynn Fitzwater, Salisbury VA Executive ists and ICU nurses at the push of a button, Director Joseph Vaughn, Salisbury VA HCS Associate Medical Director for TeleCritical Care Dr. Jeneen Gifford, Salisbury VA HCS Acting Chief of Staff Dr. Randall Gehle, and Dr. Rubin Cohen, Medical Director for Salisbury which means that rapid decision making can Critical Care during the rollout of the Tele-Critical Care program in the Salisbury VA HCS ICU. The program start without delays when help is needed enables ICU staff in hub locations to support patient care efforts in local, more remote hospitals.

Excellent Care – Earned by Veterans – Delivered Here | OCTOBER 2020 ///////////////////////////////////////// 3

By VISN 6 Public Affairs VISN 6 Director DeAnne Seekins (2nd from left) stands VISN 6 OPENS NEW CBOC IN TIDEWATER to cut the ceremonial ribbon on the new Tidewater Community Based Outpatient Clinic with (from right) A new Community Based Outpatient ic. About 40 people will staff the clinic when it Hampton VA Acting Director Dr. Shawn Alexaander, Associate Directors Crystal Lindaman and Dr. Taquisa Clinic (CBOC) opened in Portsmouth, Va., on is fully operational. Simmons, and Dr. Dennis Walker (left), Hampton Thursday, Oct. 15th. This represents the fourth Most significantly, this will represent the VAMC acting Chief of Staff. The clinic opened Oct. 15. community clinic in the Hampton Roads VA 3rd CBOC in the Tidewater region, an area Healthcare System, joining existing clinics in that has been, and projects to remain, one of Hampton VA medical center. It will enable Virginia Beach and Chesapeake, Va., as well the fastest-growing areas of Veteran demand them to avoid crossing the Hampton Roads as a clinic in Albemarle, N.C. The 14,000-SF for care in the United States. In fact, this bridge tunnel, a significant barrier to timely facility will begin operations at 600 Crawford area has grown so significantly that VA has care, while also allowing the medical center Street, Suites 300 and 400, in Portsmouth, Va. scheduled to open a health care center (HCC), to repurpose some space for more specialized The clinic will open with two Patient-Aligned a much larger facility, in FY23/24, to satisfy the services on the hospital campus. Care Teams (PACT) to service approximately growing demand for services; with another The new clinic is scheduled to open 2,400 Veterans, although it contains capacity HCC in the early planning stages. initially with two PACT Teams as well as 2 to accommodate another 6,000 for a total of Veterans should enjoy shorter drive Behavioral health teams. 8,400 Veterans receiving their care in the clin- times to the clinic than previous trips to the

CONTINUED FROM PAGE 4 Durham Researchers Collect Career Development Grants

Durham VA HCS has announced the most recent recipients of Career Development Award grants. VA’s Career Development Program was established to provide mentoring for junior researchers so that they can learn from renowned, experienced VA researchers. Awardees from this program have become national and international leaders in their research fields. Awards are provided in all areas of VA’s research enterprise, and support researchers at three levels. The distinctions separate entry-level work in Rehabilitation Research and Development Service, project stages lasting from 3-5 years, and a senior skill enhancement opportunity that could include a year-long sabbatical. Candidates must be nominated by a VA facility and must identify an appropriate VA mentor. CONTINUED ON PAGE 5 Dan V. Blalock, PhD

4 \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\ OCTOBER 2020 | Excellent Care – Earned by Veterans – Delivered Here STORY CONTINUED FROM COVER 5 New Invention Prioritizes Communication Without Substituting Safety

(LEFT PHOTO) The Clear Talker mask is composed of a thermoplastic polyester commonly known as PETG, that provides significant chemical resistance, durability and excellent formability for manufactur- ing. The mask sizes are universal, based on The National Institute for Occupational Safety and Health.

The Clear Talker meets FDA these masks on, I almost felt like a weight requirements for surgical masks under came off of my shoulders,” said Bur- the emergency use authorization for khardt. “I felt lighter knowing the burden single-use surgical masks during the of understanding was diminished with COVID-19 pandemic, says Burkhardt. the ease of seeing the whole face.” When the pandemic is over, the Clear The clear masks on the market today Talker will be submitted for approval to have filters located directly in front of the become the new surgical mask standard. mouth, which obstruct visibility of the mouth. THE INSPIRATION BEHIND THE MASK “The idea behind the Clear Talker Born with progressive hearing loss was to create a product with the fewest in both ears, AT member John Miller was manufactured parts, while still being able the inspiration behind the Clear Talker to read lips,” Burkhardt added. mask. AT held focus groups to test the de- “As a person with hearing loss, I do sign to ensure it helped people read body have hearing aids that allow me to hear language, facial expressions and improve sound,” Miller said. “But I also rely on the overall connection lip reading to fill in the blanks that I miss Oliver said she hopes to have all with my hearing. After the pandemic testing completed within a few weeks to started, I was grateful everyone was wear- begin distributing the masks to staff at ing masks, but it made my day-to-day life the hospital. harder.” To learn more about this highly Miller’s personal experience inspired specialized team, visit (Hyperlink) https:// him to pursue an engineering degree that www.richmond.va.gov/services/Assis- would allow him to directly help people tive_Technology_at_McGuire_VA_Medi- with disabilities cal_Center.asp

The collage of mask prototypes shows the evolution of THE DESIGN development. “The first time the three of us had

CONTINUED FROM PAGE 4

Dan V. Blalock, PhD is a licensed clinical psychologist and health services researcher at the Durham VA Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) who studies self-management of health behaviors. Through a newly bestowed 5-year VA HSR&D Career Development Award, he will extend this work to focus on Telehealth Treat- ment of Veterans with Alcohol Misuse at Risk for Cardiovascular Disease. J. Antonio Gutierrez, MD, MHS is an interventional cardiologist at the Durham VA Health Care System who specializes in vascular medicine and who conducts research on peripheral artery disease and poly-vascular disease. His newly received 5-year VA HSR&D Career Development Award will focus on Telehealth to Improve Functional Status and Quality of Life in Veterans with Peripheral Artery Disease (PAD). VA’s Career Development Program was established to provide mentoring for junior researchers so that they can learn from renowned, experienced VA researchers. Awardees from this program have become national and international leaders in their research fields. Congrat- ulations to Drs. Blalock and Gutierrez! J. Antonio Gutierrez, MD, MHS

Excellent Care – Earned by Veterans – Delivered Here | OCTOBER 2020 ///////////////////////////////////////// 5 Cutline: Competitive puzzling has become quite the craze at the Charles George VA Medical Center Community Living Center in Asheville, N.C. With all of the precautions being taken to protect Veterans, it provides a substantial and satisfying activity for Veterans.

Salem VA HCS Joins Local Hospitals in COVID Outreach Campaign

Medical officials at the Salem VA Health Care System, Carilion Clinic, and Lew- isGale Regional Health System joined forces in October to deliver a video message designed to encourage people to not become complacent about physical distancing and mask wearing. The partnership is one in a series of events the three health systems have collaborated on since the beginning of the COVID-19 pandemic. The video of medical officials follows a social media campaign #MaskUpSWVA

(BELOW:) VIDEO SCREEN SHOT: Dr. Patrice Weiss, Chief Med- ical Officer, Carilion Clinic, Dr. Carnell Cooper, Chief Medical Officer, LewisGale Regional Health System, and Dr. Thomas Martin, Acting Chief of Staff, Salem VA Health Care System

Video Link: https://youtu.be/ugopiG9D7vg

6 \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\ OCTOBER 2020 | Excellent Care – Earned by Veterans – Delivered Here Clinician Advises Screening AFTER Breast Cancer Treatments By Naomi Moran OTR/L, CLT | FAYETTEVILLE NCVAHCS OCCUPATIONAL THERAPIST, CERTIFIED LYMPHEDEMA THERAPIST

Breast cancer awareness month gave us a developed mild to moderate lymphedema Breast cancer survivors should discuss any great opportunity to highlight lymphedema, a within 5 years of their breast cancer treatment. questions or concerns about lymphedema chronic lymphatic disease resulting in swell- Many women self-reporting early symptoms, with their Primary Care Physicians, Oncolo- ing that can disfigure one or more parts of the like jewelry and clothing feeling tight, arm gists, Plastic Surgeons, Breast Clinics and/or body, according to the Lymphatic Education & swelling after exercise, puffiness or tired, Women’s Health Clinic staff. Research Network, n.d. It can be hereditary or heavy skin, showed a higher occurrence of the result from surgery, physical trauma, infection disease. Some experts suggest that early and “As a breast cancer survivor, a or radiation. timely intervention reduces further develop- Because the disease is often underdi- ment, which could include infection as well as Certified Lymphedema Ther- agnosed by health care professionals, all the swelling. apist, a Veteran, and as VA women and men who undergo surgery and/or With greater awareness of the risks for employee, I can attest to the radiation for breast cancer may benefit from lymphedema, Veterans should access screen- at least one screening appointment. Besides ing and treatment more often, and sooner benefits of the care provided by timely identification and intervention, the after cancer treatments. Specially trained VA the VA for breast-cancer-treat- visit can offer education to decrease risks for occupational and physical therapists con- ment-related lymphedema.” developing lymphedema. Without treatment, duct lymphedema interventions, or Veterans patients can suffer declines in function, inde- can opt for community referrals to Certified — Naomi Moran OTR/L, CLT pendence, health and quality of life. Lymphedema Therapists. The VA also covers Fayetteville NCVAHCS Occupational Therapist, In a recent study, 42 out of 100 women items associated with lymphedema treatment. Certified Lymphedema Therapist

Online resources for lymphedema include: Naomi Moran OTR/L, CLT • https://ww5.komen.org/UnderstandingLymphedemaInformation.html • https://lymphaticnetwork.org/ Occupational Therapist, • https://www.mayoclinic.org/diseases-conditions/lymphedema/symptoms-causes/syc-20374682 Certified Lymphedema Therapist • https://www.cancer.org/content/dam/CRC/PDF/Public/8901.00.pdf [email protected]

CGVAMC Social Worker Deploys to Lake Charles

By Amber Brown | CGVAMC SYSTEMS REDESIGN she and other DEMPS staff assisted with well- ASHEVILLE, NC — A little more than a ness checks, distribution of food, water and month ago, Hurricane Laura hit the Gulf Coast. other essential items, and supported those who That hurricane tied with an 1856 hurricane were seeking shelter. as the strongest on record to make landfall in Bartley also worked to link Veterans and Louisiana. community members with free services such as Our Disaster Emergency Medical Person- tree removal and roofing repairs. nel Services (DEMPS) put out a request for “The pandemic, [along with the] natural volunteers to come to the hardest-hit areas and disasters, have created a crisis and turned offer support. people’s lives upside down,” she said. “These Living in a makeshift tent in the parking individuals are going through some of the most lot next to a Community Based Outpatient difficult times of their lives, and I hope to be Clinic (CBOC), she and other DEMPS staff able to do what I can to ease that burden even assisted with wellness checks. if it’s to make them smile or laugh in the face For the first time this year, we sent a Social of a crisis.” Worker — Danielle “Dani” Bartley. Bartley said she wanted to provide sup- Bartley arrived in Lake Charles, La., port and hope to those she is serving during where she remained for several weeks. Living her deployment. She also hoped to learn from in a makeshift tent in the parking lot next to a those she met along with way and said that Community Based Outpatient Clinic (CBOC), their resiliency taught her as well.

(TOP-RIGHT) Dani Bartley deployed from Charles George VA Medical Center in Asheville, N.C., to Lake Charles, La., as part of the Disaster Emergency Medical Personnel Services. (BOTTOM-RIGHT) Living in a makeshift tent in the parking lot next to a Community Based Outpatient Clinic (CBOC), she and other DEMPS staff assisted with wellness checks. Excellent Care – Earned by Veterans – Delivered Here | OCTORBER 2020 ///////////////////////////////////////// 7 A Time for Innovation

By Vance Janes | WESTERN NORTH CAROLINA VA HCS PUBLIC AFFAIRS

ASHEVILLE, NC — The Western North on campus without requiring their physical Carolina VA Health Care System team is all presence in a waiting area. about innovation. That has been especially helpful, given This year, Veterans Health Administra- the physical distancing requirements in place The VHA Shark Tank Competition encourages tion (VHA) leadership reviewed more than due to the COVID-19 pandemic. medical centers to utilize their top performers to 400 submissions and selected the top 15 help develop solutions to clinical and operational challenges nationwide. practices that address key priorities, including WHAT IS SHARK TANK? increased access to care, suicide prevention • Barcode software for administering According to the VHA Innovation and health care after COVID-19. medications safely; Ecosystem website, the Veterans Health According to Dr. Anne Bailey, Pharmacist • The implantable cardiac pacemaker; Administration’s Shark Tank Competition Provider and Emerging Tech Clinical Special- • The first successful liver transplants; provides medical centers across the country ist, Western North Carolina VA Health Care • The nicotine patch to help smokers an opportunity to recognize top performers System submitted five of the 400 Shark Tank quit; and who are solving some of the toughest clinical applications this year, and though they were • Artificial limbs that move naturally and operational challenges across VHA. not selected among the final top 15, two did when stimulated by electrical brain To be eligible, applicants must have stand out as emerging strong practices. impulses. Those two practices were both led by successfully implemented their practice in Ms. Stephanie Young, Western North Pharmacist Providers — Dr. Eric Gibbs and at least one facility, and the practice must Carolina VA Health Care System Director, al- Dr. Erica Asaro. address one of the VHA Priority Categories ways says, “Improving our work is our work.” “Dr. Asaro’s best practice increases access defined each year. And this year’s Shark Tank submissions are to care for Veterans with rheumatoid arthritis Those submitted processes are evaluated living up to Young’s mantra. After all, the team while also improving patient safety, decreas- by VHA subject matter experts. at the Western North Carolina VA Health ing medication-related risks, and allowing Applicants compete for the opportunity Care System are all about innovation. for increased direct communication between to be one of 15 Finalists who pitch their prac- Veterans and their provider,” Bailey said. tices at the live competition to Medical Center “Dr. Gibb’s best practice focused on and Veterans Integrated Service Network helping Veterans with Substance Use Disor- Director “Sharks.” November is ders access care when, where, and how they During the competition, Sharks bid are ready,” she added. “Through a pharma- resources — such as funding, staff, or time — cist-managed, in-home alcohol detoxification to implement the practices they want in their protocol, Gibbs uses virtual care models facilities. to help Veterans safely navigate the detox VHA senior leaders select approximately process.” 10 Finalists and 10 Sharks as winners of the Each of those practices continues to grow competition. The winning practices proceed locally with the potential of spreading broadly with facilitated replication in the winning to other VAs across the country. Sharks’ facilities. If the implementation is suc- “We also submitted 12 Spark-Seed- cessful, VHA leaders may select the practice Military Family Spread applications, six of which were select- for national rollout. ed for the fiscal year 2021 Spark-Seed-Spread To date, the competition has identified Appreciation Month! Innovation Investment program,” Bailey 59 clinical and operational practices, eight of said. “Spark-Seed-Spread is the VA’s way of which are being implemented nationally. building that innovation muscle by investing The practices have impacted more than directly into the creativity of frontline staff.” 100,000 Veterans across the health care sys- One project — texting for pharmacy re- tem and are helping position VHA as a leader fills and tracking — is in response to a multi- in health care innovation and progress. site, human-centered design project led by the Health Care System and is in collaboration RESPONSIBLE FOR CHANGE with the Innovators Network and the Veterans The VA has a long history of innovation Experience Office. while providing health care to generations “This project is a direct response to chal- of Veterans. Many of those innovations have lenges that we’ve heard Veterans themselves been adopted throughout the health care express nationwide,” Bailey said. industry to better treat patients. VA medical The Health Care system also adopted professionals pioneered breakthrough inno- the VEText Patient Tracking Tool that allows vations like: Veterans to check in for appointments while 8 \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\ OCTOBER 2020 | Excellent Care – Earned by Veterans – Delivered Here rTMS Services at Hampton VAMC Continue to Grow

By Hampton VAMC Public Affairs ulation uses a small handheld device or hel- percent for the extended treatment, but lower Hampton VA Medical Center is celebrat- met called a “treatment coil” to deliver energy for the shorter acute course. Remission of ing the progress of a program in its Neuro to the brain using pulsed “magnetic fields.” their depressive condition is seen in approx- Modulation Clinic that has helped Veterans Similar to magnetic fields used in magnetic imately 30 percent of those who have com- cope with and heal from treatment resistant resonance imaging (MRI) machines, the de- pleted the six-to-eight-week treatment course. depression. vice applies a series of pulses called “rTMS” The clinic currently has two deep rTMS Since the Repetitive Transcranial to stimulate the brain, without surgery. The devices: BrainsWay H1 Coils that treat major Magnetic Stimulation (rTMS) ribbon cutting treatment does not require anesthesia or depression, and a new coil, H7, that treats ceremony in March 2018, Hampton’s rTMS sedation. Patients remain awake and alert. Obsessive Compulsive Disorder (OCD) and services at Hampton have flourished and rTMS is a noninvasive treatment with potentially other addiction disorders. expanded. Deemed an essential treatment for minimal procedural side effects. Veterans can Team Hampton looks forward to the those who have had significant depression return to daily activities after their 20-minute expansion of Somatic/Neuromodulation and, in many cases, suicidal ideations, the treatment session. Veterans have reported services at Hampton VAMC main campus rTMS Clinic has remained open throughout a positive effect on their mood, clarity of and South Hampton Roads Clinics to include the COVID-19 period. thought, sleep, and energy. There is also a Chesapeake, Virginia Beach and Portsmouth. Dr. Kenneth Miller, Director of the significant reduction or absence of suicidal Hampton’s clinic director, Dr. Kenneth J. rTMS Clinic, also reports, “VISN 6’s support thoughts. Hampton’s Neuro Modulation Miller M.D. DLFAPA, DANPA, is a board-cer- for the growth and expansion of psychiatric clinic has provided approximately 1900 treat- tified psychiatrist. Dr. Miller is also boarded noninvasive interventions neuromodulation ment sessions since 2018, for Veterans with in neuropsychiatry and behavioral neurology interventions here at Hampton is incredible.” complex treatment resistant depression. and he directs his professional team, which Repetitive Transcranial Magnetic Stim- The success response rate is up to 70 includes certified nurses and technicians.

(PHOTO ABOVE) On October 14th, Dr. Miller and his Neuro Modulation Clinic team welcomed Psychology Colleagues from Naval Medical Center Portsmouth Hospital as part of training and collaboration on joint PTSD Patients. Pictured are (from L to R) Ameshia Latham – Psych Tech; Serina Neumann PhD – Research Psychologist; Claribel Lopez RN, NP; Kira Derby, RN, PMHNP; Conner King, Field Engineer – BrainsWay; William Lemley, MD – Psychiatrist

Excellent Care – Earned by Veterans – Delivered Here | OCTOBER 2020 ///////////////////////////////////////// 9 VEText Mobile Check-in is Convenient, Easy

By Vance Janes | WESTERN NORTH CAROLINA VA HEALTH CARE SYSTEM PUBLIC AFFAIRS OFFICER

ASHEVILLE, NC — Some Veterans at Due to restrictions associated with the will text the word “here” to 53079. That will the Charles George VA Medical Center are pandemic, the capacity for waiting areas in alert the care team that the Veteran is at the being greeted in the parking lot by employees all VA facilities has been reduced. VEText facility and is waiting to be called to his or who are out to spread the word about VEText Mobile Check-in provides an option for her appointment. Mobile Check-in — an app that allows the Veterans to check in using their cell phones The Veteran will receive a text response medical center to see more patients face and then wait in their vehicles until their verifying that the care team is aware that he to face by reducing congestion in waiting providers are ready to see them. or she is on site. areas and turning Veterans’ cars into virtual Once the care team is ready, the Veteran waiting rooms. How It Works will receive a text instructing him or her The VA is following Centers for Disease to enter the building and proceed to their Control and Prevention (CDC) guidelines, Veterans must have a text-capable cell appointment. When the Veteran enters the and that means reducing unnecessary foot phone number on file with the VA. Veter- facility, he or she will report to the clinic as traffic and congestion in its facilities. ans unsure of whether their number is on scheduled. The new process which is based on the file should contact their care team or verify This program provides a way for the VEText platform that has been used to send the information when they’re contacted to health care system to see more Veterans Veterans updates and reminders for a while, schedule an appointment. The number used while complying with the CDC guidelines so the program is not something radically for texting must be the same number in a regarding physical distancing. It increases new for Veterans. What is new is using it to Veteran’s file. the safety for the Veterans and staff, and it check in for doctors’ appointments. Once Veterans arrive to the facility for reduces the wait time inside the facility. their scheduled appointment and park, they

Note: If a Veteran does not have a text-capable cell phone or a vehicle to wait in, he or she can proceed to the entrance to receive assistance from our screeners. Veterans should allow enough time for COVID-19 screening and report to the clinic of their scheduled appointment no more than 15 minutes before the appointment time.

Annette Melton, Charles George VA Medical Center Eye Clinic supervisor (left), and Amber Brown, Systems Redesign Coordinator, talk with a Veteran in the parking lot about our new service VEText Mobile Check-in. The app, which has been used to push notifications to Veterans can now be used to let doctors know when Veterans have arrived for an appointment.

10 \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\ OCTOBER 2020 | Excellent Care – Earned by Veterans – Delivered Here Diabetes Awareness Month

By Vance Janes | WESTERN NORTH CAROLINA VA HEALTH CARE SYSTEM PUBLIC AFFAIRS OFFICER

November is Diabetes Awareness Things you can do to prevent diabetes: Month, and we want to increase your Don’t smoke or use tobacco in any form. awareness of this serious disease. Veterans Eat a healthy diet including plenty of are twice as likely to have diabetes than the vegetables, as well as fruits in moderation. general population. About a quarter of VA Eat foods that are low in animal fat. Make patients have diabetes. most or all of your breads and cereals whole grain products. Limit your intake of sweet Diabetes is a chronic disease in which foods and drinks. Avoid overeating. Limit or the body can’t produce or properly use in- avoid alcoholic beverages and make water sulin. Normally, insulin brings sugar out of your beverage of choice. the bloodstream and into cells. If the body cannot make insulin or does not respond Get plenty of exercise. to it, the sugar stays in the bloodstream. As You should do at least 150 minutes each a result of high blood sugar levels, damage week of moderate-intensity physical activity. eventually occurs to blood vessels and or- gans. The most commonly affected parts of Maintain a healthy weight. your body are the eyes, kidneys and feet. Eating a healthy diet and getting lots of physical activity are the keys to doing this. COMMON SYMPTOMS ARE: Losing extra weight is especially helpful. • Feeling very thirsty or hungry • Frequent urination Take steps to reduce your stress. • Extreme fatigue If you or a loved one experiences any of the • Blurry vision above symptoms, talk to your health care • Cuts or bruises that are slow to provider to rule out diabetes. If you are di- heal agnosed with diabetes, there is medication • Weight loss available to help manage the disease. By • Tingling, pain or numbness in the taking the proper care, you and your loved hands or feet ones can live healthy lives.

Excellent Care – Earned by Veterans – Delivered Here | OCTOBER 2020 ///////////////////////////////////////// 11 VISN 6 Sites Of Care & VA Vet Centers

MEDICAL CENTERS Charlotte HCC Goldsboro CBOC Raleigh II Annex VA Dialysis Clinic Fayetteville 3506 W. Tyvola Rd. 2610 Hospital Road 3040 Hammond Business Place 2301 Robeson Street, Ste. 101 Charlotte, NC 28208 Goldsboro, NC 27909 Raleigh, NC 27603 Fayetteville, NC 28305, 910-483-9727 Asheville VAMC 704-329-1300 919-731-4809 919-899-6259 1100 Tunnel Road Asheville, NC 28805 Raleigh III CBOC 828- 298-7911 | 800-932-6408 Charlottesville CBOC Greenville HCC 2600 Atlantic Ave, Ste 200 VET CENTERS 590 Peter Jefferson Pkwy 401 Moye Blvd. Raleigh, NC 27604 www.asheville.va.gov Charlottesville, VA 22911 Greenville, NC 27834 919-755-2620 Charlotte Vet Center 434-293-3890 252-830-2149 2114 Ben Craig Dr. Durham VAMC Robeson County CBOC Charlotte, NC 28262 508 Fulton Street Chesapeake CBOC Hamlet CBOC 139 Three Hunts Drive 704-549-8025 Durham, NC 27705 1987 S. Military Highway 100 Jefferson Street Pembroke, NC 28372 919-286-0411 | 888-878-6890 Chesapeake, Va 23320 Hamlet, NC 28345 910-272-3220 www.durham.va.gov Fayetteville Vet Center 757-722-9961 910-582-3536 2301 Robeson Street Rutherford County CBOC Fayetteville, NC 28305 Fayetteville VAMC Clayton CBOC Hickory CBOC 2270 College Avenue, Suite 145 910-488-6252 2300 Ramsey Street 11618 US Hwy 70 Business Highway West, 2440 Century Place, Forest City, NC 28043-2459 Fayetteville, NC 28301 Suites 100 & 200 SE Hickory, NC 28602 828-288-2780 Greensboro Vet Center 910-488-2120 | 800-771-6106 Clayton, NC 27520 828-431-5600 3515 W Market Street, Suite 120 www.fayettevillenc.va.gov Sanford CBOC Greensboro, NC 27403 Danville CBOC Hillandale Rd. Annex 3112 Tramway 336-333-5366 Hampton VAMC 705 Piney Forest Rd. 1824 Hillandale Road Durham Road Sanford, NC 27332 100 Emancipation Dr. Danville, VA 24540 North Carolina 27705 919-775-6160 Greenville Vet Center Hampton, VA 23667 434-710-4210 919-383-6107 1021 W.H. Smith Blvd. 757-722-9961 | 866-544-9961 Staunton CBOC Greenville, NC 27834 www.hampton.va.gov Emporia CBOC Jacksonville CBOC 102 Lacy B. King Way 252-355-7920 1746 East Atlantic Street 2580 Henderson Drive Staunton, VA 24401 Richmond VAMC Emporia, VA 23847 Jacksonville, NC 28546 540-886-5777 Jacksonville, N.C. Vet Center 1201 Broad Rock Blvd. 434-348-1500 910-353-6406 110-A Branchwood Drive Richmond, VA 23249 Tazewell CBOC Jacksonville, NC 28546 804-675-5000 | 800-784-8381 Fayetteville HCC Jacksonville 2 VA Clinic 141 Ben Bolt Ave. 910-577-1100 www.richmond.va.gov 7300 So. Raeford Rd 306 Brynn Marr Road Tazewell, VA 24651 Fayetteville NC 28304 Jacksonville, NC 28546 276-988-8860 Norfolk Vet Center Salem VAMC 910-488-2120 | 800-771-6106 910-353-6406 1711 Church Street 1970 Roanoke Blvd. Virginia Beach CBOC Norfolk, VA 23504 Salem, VA 24153 Fayetteville Jacksonville 3 VA Clinic 244 Clearfield Avenue 757-623-7584 540-982-2463 | 888-982-2463 Rehabilitation Clinic 4 Josh Court Virginia Beach, VA www.salem.va.gov 4101 Raeford Rd. Ste 100-B Jacksonville, NC 28546 757-722-9961 Raleigh Vet Center Fayetteville NC 28304 910-353-6406 8851 Ellstree Lane Salisbury VAMC 910-908-2222 Wilmington HCC Raleigh, NC 27617 1601 Brenner Ave. Kernersville HCC 1705 Gardner Rd. (919) 361-6419 Salisbury, NC 28144 Franklin CBOC 1695 Kernersville Medical Pkwy Wilmington, NC 28405 704-638-9000 | 800-469-8262 647 Wayah Street Kernersville, NC 27284 910-343-5300 www.salisbury.va.gov Roanoke Vet Center Franklin, NC 28734-3390 336-515-5000 1401 Franklin Rd SW 828-369-1781 Wytheville CBOC OUTPATIENT CLINICS Roanoke, VA 24016 Lynchburg CBOC 165 Peppers Ferry Rd. 540-342-9726 Fredericksburg CBOC 1600 Lakeside Drive Wytheville, VA 24382-2363 Albemarle CBOC 130 Executive Center Pkwy Lynchburg, VA 24501 276-223-5400 Virginia Beach Vet Center 1845 W City Drive Fredericksburg, VA 22401 434-316-5000 324 Southport Circle, Suite 102 Elizabeth City, NC 27909 540-370-4468 DIALYSIS CENTERS Virginia Beach, VA 23452 252-331-2191 Morehead City CBOC 757-248-3665 Fredericksburg at 5420 U.S. 70 VA Dialysis and Blind Brunswick County CBOC Southpoint CBOC Morehead City, NC 28557 Rehabilitation Clinics at 18 Doctors Cl., Units 2 & 3 10401 Spotsylvania Ave, Ste 300 252-240-2349 Supply, NC 28462 | 910-754-6141 Brier Creek Fredericksburg, VA 22408 8081 Arco Corporate Drive 540-370-4468 Raleigh CBOC Raleigh, NC 27617 Charlotte CBOC 3305 Sungate Blvd. 919-286-5220 8601 University East Drive Raleigh, NC 27610 Charlotte, NC 28213 919-212-0129 704-597-3500

VISN 6 Newsletter VISN 6 EDITORIAL PRODUCTION TEAM Voices of VISN 6 is published monthly by DeAnne Seekins // VISN 6 Network Director Fanning Communications VA Mid-Atlantic Health Care Network. Tara Ricks // Director of Communications John Fanning // President + CEO Questions or comments about the newsletter, email Steve Wilkins // Editor DeAnna Clark // Graphic Designer [email protected] or call 919-956-5541 Karl J. Paloucek // Editor + Copywriter

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