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Patient-Aligned Care Teams (PACT) - Veterans Affairs PACT is a team-based model of care in which a team of health professionals, led by a provider, works collaboratively with the patient to provide for all of the patient's healthcare needs—or appropriately coordinates care with other qualified professionals Issues being studied include methods of improving care coordination, how to automate
DEFINING THE ROLE OF THE RN CARE MANAGER IN PACT - Veterans Affairs PACT Task List by Role and the Nursing Non-Medication Protocol Implementation Guide for Patient Aligned Care Team (PACT) (both dated December 2017) Almost all tasks identified in these two documents can be carried out by various PACT team members, including RNs, LPNs, Unlicensed Assistive Personnel (UAP), pharmacists, or dietitians
PACT Social Work Staffing Program Evaluated by SERVE QUERI The product of the SERVE QUERI evaluation will be an in-depth appraisal of the Social Work PACT Staffing Program This evaluation will influence VA national practice by improving implementation of the Social Work Practice Model; targeting high-risk Veterans through case finding with the Care Assessment Needs (CAN) score and evaluation using
A PRIMARY CARE PACT TO IMPROVE THE HEALTH CARE OF PATIENTS WITH SERIOUS . . . First controlled trial in serious mental illness of a primary care medical home with integrated, collaborative care Specialized PACT for SMI is feasible, safe, more effective than usual care Addresses healthcare challenges faced by people with serious mental illness Tools available for implementation
Outcomes Associated with VA Implementation of PACT – Publication Brief The extent of PACT implementation was highly associated with important outcomes for both patients and providers Significant trends were observed in the quality of care in relation to the Pi2 score: 77 sites that achieved the most effective implementation exhibited higher clinical quality outcome measures than less successful sites
What is the Optimal Panel Size in Primary Care? A Systematic Review In 2 studies the mean panel size was substantially below this value,13,16 in 3 studies the lower end of the range of panel sizes was about 1,200 (with upper limits 2, 3, or even 4 times that),7,12,15 and in 1 VA study the actual panel size was reported as being above or below the “optimal” panel size 9
What do Patient-Aligned Care Teams (PACT) Need to Better Manage Care . . . PACT clinicians stressed importance of personnel willing to do intensive case management, flexible about role boundaries “We would need PACT team members that were willing to go above and beyond So, I just happen to have PACT team members that will do anything, and so they can get close to doing some of the tasks the PIM team did
Patient-Aligned Care Teams Tailored to the Homeless Can Reduce Acute . . . The Homeless PACT program is now operational in 54 VA medical centers, Community-Based Outpatient Clinics, and Community Resource and Referral Centers across the country In Fiscal Year 2019, more than 17,600 homeless and at-risk Veterans were enrolled in the 80 H-PACT teams across the country, and approximately 22,000 are served annually
Implementation of the Geriatric Patient-Aligned Care Team (GeriPACT) in . . . Patient Assignment By PACT referral only By patient request Only newly enrolled to VA: aged-based Current PACT patients: condition-focused Current PACT patients: aged based Only newly enrolled to VA: condition-based Other Structures Report comprehensive geriatric evaluation Percent 75% 57% 49% 43% 42% 21% Percent
Tools Used to Improve Care Coordination for High-Risk Veterans across . . . The ED-PACT Tool has been used to coordinate care following more than 24,000 ED visits across three VA sites (Los Angeles, New Jersey and West Palm Beach), and has been further adapted to support COVID care in Los Angeles, CA and inpatient and Clinical Contact Center communications in West Palm Beach, FL Questions about the HSR website?