Abstract
Sleep VA-ECHO (Veterans Affairs–Extension for Community Healthcare Outcomes) is a national telementorship program intended to improve knowledge about sleep disorders among non-specialty providers. The project goal was to describe the characteristics of Sleep VA-ECHO participants from primary care and their use of program-obtained knowledge in practice. Sleep VA-ECHO consisted of 10 voluntary, 75-min teleconference sessions combining didactics and case discussion. Out of 86 participants, 21 self-identified as primary care team members and completed a program evaluation. Participants self-reported their application of knowledge gained, including changes to practice as a result of program participation. These 21 participants represented 18 sites in 11 states and attended a median of 5.0 sessions. They included physicians (29%), nurse practitioners (24%), and registered nurses (24%). Nearly all participants (95%) reported using acquired knowledge to care for their own patients at least once a month; 67% shared knowledge with colleagues at least once a month. Eighty-five percent reported improved quality of sleep care for their patients, and 76% reported an expanded clinical skillset. The greatest self-reported change in practice occurred in patient education about sleep disorders (95%) and non-pharmacologic management of insomnia (81%).
Highlights
Our analysis suggests that knowledge gains did not universally translate to increased self-efficacy in sleep disorder management or to changes in clinical practice
Sleep Veterans Affairs (VA)-ECHO may increase the visibility of and demand for specialty services at the program facility (58% of our program respondents reported an increase in sleep referrals) that could lead to further strain on limited resources
This program likely has a complex impact on sleep care delivery that should be evaluated further, with an attempt to discern the impact of a community of practice development as well as knowledge gains
Summary
Res. Public Health 2021, 18, 9914 somnia [4,8,9,10,11] most primary care providers receive little or no formal education in sleep medicine limiting their delivery of sleep care [1,12,13]. The VA initially established seven VA-ECHO hubs, focusing on a variety of disease states, including chronic renal failure, pulmonary nodules, cancer, and pain management in addition to hepatitis C Several programs expanded their focus over time. We present our program’s second-year evaluation, describing the primary care team members (PCTMs) who participated, ways in which they applied knowledge gained, and self-reported changes in their clinical practice within specific domains of sleep medicine
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