Nationwide opioid epidemic prompts VA to implement life-saving idea


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Through VA’s Diffusion of Excellence Initiative, innovators are helping VA prevent Veteran opioid-related deaths by making it easier to deliver life-saving medication.

Opioid overdoses take the lives of thousands of Americans each year, claiming nearly 30,000 in 2014 alone. To complicate matters, Veterans are twice as likely to die from accidental opioid overdose than non-Veterans.

Fortunately, there is a drug, Intranasal Naloxone, known as Narcan, that can effectively reverse opioid overdoses. But Narcan is not typically available at the time of an overdose. A Boston VA Health Care System employee saw an opportunity to improve reaction time, by training nearly 700 Veterans, staff members and VA Police to administer Narcan. They also made Narcan readily available in automated external defibrillator cabinets placed throughout the facility so staff could access it quickly.

IMAGE: Pamela Bellino-Rivera, director of patient safety at the VA Boston Health Care System worked with Steve Elliot, VISN 8 chief of police, to ensure wide-spread availability of Narcan to help save lives.

Pamela Bellino-Rivera, director of patient safety at the VA Boston Health Care System worked with Steve Elliot, VISN 8 chief of police, to ensure wide-spread availability of Narcan to help save lives.

Boston VA’s Pam Bellino-Rivera submitted this practical solution and has overseen its implementation at all Boston sites – Jamaica Plain, West Roxbury, Brockton and the region’s outpatient clinics.

“We saw a number of events where patients were experiencing an opioid overdose,” she said. “There was a delay in administering Narcan while waiting for the ambulance or the medical team to arrive. We needed first responders to have Narcan readily available.”

The results? Since 2014, 98 Veteran lives have been saved as a result of this practice.

Bellino-Rivera’s idea is an example of how VA’s Diffusion of Excellence Initiative not only gives VA employees a forum to suggest solutions, it provides an avenue to spread the best practices from their facilities to VA medical centers across the nation.

Through the Diffusion for Excellence effort, VISN 8 was selected to implement the practices and they are in the process of implementing it across VISN 8.

IMAGE: Diffusion of Excellence logo depicting a sharkVA Secretary Dr. David Shulkin created the initiative during his tenure as undersecretary for Health, to identify and disseminate promising practices, as well as standardize those that promote positive outcomes for Veterans systemwide. The initiative empowers employees to share innovations and drive a supportive culture of continuous improvement.

Since its inception, VA has identified more than 1,000 practices submitted by front-line staff to address health care priorities of improving access, care coordination, employee engagement, quality and safety, and the Veteran experience.

The initiative continues to foster department-wide innovations that can quickly spread from idea to reality in VA facilities across the country not only to meet the needs of Veterans but possibly save their lives.

Author

VA Center for Innovation

Comments

  1. Robert Heurung    

    An even better way to reduce opioid deaths is cannabis.
    Veterans can share innovations and drive a supportive culture of continuous improvement also.

  2. Matthew Neely    

    I know this isn’t the place, but no applicable blog postings have the comments still open.

    Why has my appeal, filed 6/12/2014, done nothing? Status shows they received it but that is all. In over 3 years, nothing. I can’t even upload documents. I read a blog from LAST YEAR stating they were working on claims from July 2014. Yet nothing on mine.

    I have diagnosed fibromyalgia (diagnosed by a civilian doctor and confirmed by the C and P) along with other gastro issues, and others. Along with 2 qualifying deployments to the Persian Gulf/Red Sea making it a Southwest Asia Service. Yet denial. Meets every requirement listed in 38 CFR 3.317.

    Now the appeal is sitting there being ignored by the VA. I have a VSO and she can’t even get anything done on it.

    1. Joe    

      Contact your congressman or congresswomen. They will be able to assist you in getting this resolved or get you answers.

    2. Devin    

      @ Matthew Neely depending on your regional office appeals can take 1-3 years, then to the VA Board of Veterans Appeals, that can take 3-7 years… So its just waiting nothing can be done. This is your time to gather more evidence. If you want you can call your power of attorney over your claim (VFW, American Legion, AMvets Etc.) If you want a new VSO find one. https://www.nacvso.org/find_service_officers/state . Good luck. -A VSO

  3. Steve Russell    

    Myself and several other Veterans I know were simply cut off without warning. I am a disabled Veteran with a service coned knee replacement . I finally got the knee replaced after living in pain for years . Now I don’t even deserve to have any pain relief , guess I am doomed to live in pain and sit at home. .

    1. Matthew Neely    

      Joe, thank you for your suggestion. However, my Congresswoman is useless. I have been waiting to hear back from their staffer (who is never in the office or answers the phone) for 5 months. The VA directly is my last resort before I go to the media.

    2. Dennis Savage    

      Since when are opioids dispensed by the VA? I have to see a pain management doctor on my dime to get the pain relief I need. I am 61 years old. Why should a bunch of dumb asses who don’t follow the dispensing instructions and od, good. We don’t need them anyhow. I have been taking pain meds for 30 years with no ill effects, yet now I have been cut back tremendously by the ignorant DEA, FDA and the CDC. I plan on killing myself this year as I can not live (you call this living?). Maybe if enough people “martyr” themselves for this reason, things may change.

  4. Kathleen McGreal    

    Not only should cannabis be prescribed by the VA for PTSD but for chronic pain and other health issues. Jeff Sessions must have had a bad trip in the 60’s.

  5. Roger Brewer    

    Maybe it’s my generation, but I’m not taking cannabis, even though I’m roughly 1 hr away from CO. Every few years there’s a crackdown on opioid usage. Like the guy above who has severe knee pain and can’t get relief. I take 30 mg MS Contin twice a day, 20 mg oxy as needed, 20 mg diazepam as needed, and ~100 mg tramadol. That doesn’t even count the antidepressants. I do have Narcan, my wife knows where it is – unlike all my narcotics, it’s not locked up. People need to function, and until something better comes along, opiates help us function with severe chronic pain.

  6. Devin    

    @ Matthew Neely depending on your regional office appeals can take 1-3 years, then to the VA Board of Veterans Appeals, that can take 3-7 years… So its just waiting nothing can be done. This is your time to gather more evidence. If you want you can call your power of attorney over your claim (VFW, American Legion, AMvets Etc.) If you want a new VSO find one. https://www.nacvso.org/find_service_officers/state . Good luck. -A VSO

    1. Matthew Neely    

      I know the time frame Devin. I am past the 3 year mark at the RO already. I cannot even submit the evidence I have because it isn’t accepting anything from me or my VSO. My VSO has already contacted the VA on why it isn’t moving and they refuse to reply to her about this either.

  7. Kim Danek    

    You have a typo in the first sentence of your third paragraph. “Fortunately, there is a drug, Intranasal Naloxone, know as Narcan, that can effectively reverse opioid overdoses. But Narcan is not typically available at the time of an overdose.”

    It shoudl read “Fortunately, there is a drug, Intranasal Naloxone, KNOWN as….”

    We would also like to consider reprinting this article in another federal newsletter. Is there someone I can contact?

    1. Megan Moloney    

      Kim, please send us a request and contact information at newmedia@va.gov.

  8. Jon    

    Veterans should get a voucher to the gym of their choice, stipend for work-out clothes, and supplied a professionally qualified medical trainer to help with our issues and health. Maybe all the clinics could even start a health club or group. Veterans tend to do better around eachother instead of sometimes “seemly careless civilians”. We also need more attention from doctors visits and check ups. As for the claim process putting it mildly, it sucks. We need a better way to identify “critical cases” and service them first. No veteran should be “waiting in the dark” wondering if their case was forgotten. The mindset is “we can’t help them all” but the fact is we can try a lot better. ODS Vet

  9. Daniel Like Lasater    

    I been in Pain for 4 years since I came into the VA System from the Civilian side because I lost my Health Insurance. I can’t get any Pain meds. I’ve been poked , MRI’d injected, electrofied, Still no pain meds. I lost count how many Doctors I’ve seen. I have 3 bulging discs, chipped L-3 verbera, L-2-3 I have no disc L4-5 No Disc. How Hard is this to Diagnose Doctors ? My Pain Affects my Right leg ,I can’t walk at times , My pain level is at 8-10 at all times. I can’t sleep because of the Pain.
    It’s to get dressed , I can’t stand too long , I can’t walk too far , I can’t bend over , I can’t go up stairs , I can’t get dressed on the Right side. The Meds I’m on I sleep most of the Day but in Pain. 4 Years of Pain I’m Tired of It. There’s some of Us who need the Pain Meds and what you’ve done is hurt us, thanks.

    1. Robert Daley    

      You can get narcotics through the VA. I do and my primary is an NP. Hydrocodone 4x a day , muscle relaxers and gabapentin. L3-s2 degenerative, spinal stenosis, both sciatic nerves compressed, constant pain, RA in back. Your primary can give you lower levels of narcotics before sending you to pain management

  10. David Emerson O'Mara    

    Once again and again and again the honest men and women who “always” follow the rules get the shaft for people who don’t follow the rules. This goes on and on and on.
    Will it ever stop?

  11. David Ramer    

    I’d like to add my two cents I’m rated at 90% my VA doctor says in wrote I cannot work the VA Administration says I can three and a half years ago they cut my pain medicine in half laughed and said live with it oh by the way get a job unable to work I’ve lost my savings and maxed out my credit card and I’m running out of money time in patient although I have a lot of good going on in my life I’ve never tried marijuana but each day it gets closer and closer to just use it along with suicide each day it gets closer and closer and it’s because of the pain I’m in and the frustration for the VA and no relief I had relief

  12. David Ramer    

    Oh yes I forgot to mention that I’ve been taking opiates for over 20 years with no problems

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