Abstract
PurposeRural Veterans who receive inpatient care at a Veterans Health Administration (VA) tertiary facility can face significant barriers to a safe transition home. The VA rural Transitions Nurse Program (TNP) is a national, intensive care coordination quality improvement program for rural Veterans. To communicate the reach of TNP into rural communities, we developed geographic information system (GIS) maps. This study evaluated TNP transitions nurse and site champion perceptions of GIS as a communication tool for illustrating the reach of TNP into rural communities.MethodsUsing residence information for TNP enrollees, we built GIS maps using ArcGIS Enterprise, a mapping and analytics platform. Residential addresses were matched to Rural-Urban Commuting Area geographical categories. Transitions nurse and site champion perceptions of the local and national GIS maps were assessed through surveys and interviews. The data were analyzed using descriptive and content analytic methods to identify themes.ResultsTransitions nurses and site champions perceived GIS maps as a valuable, easy to understand, acceptable, and appropriate communication tool to illustrate the reach of TNP into rural communities. Interviews revealed three common themes: a picture is worth a thousand words, the GIS maps are an effective communication tool, and the GIS maps revealed surprising and promising information.ConclusionsGIS is a useful communication tool to support to illustrate the reach of an intervention. The GIS maps engaged transitions nurses and site champions in discussion. The availability of open access software programs and publicly available location data will increase access to GIS for researchers and practitioners.
Highlights
2.7 million Veterans live in rural communities and use the Veterans Health Administration (VA) for healthcare [1]
Transitions nurses and site champions perceived geographic information systems (GIS) maps as a valuable, easy to understand, acceptable, and appropriate communication tool to illustrate the reach of Transitions Nurse Program (TNP) into rural communities
GIS is a useful communication tool to support to illustrate the reach of an intervention
Summary
2.7 million Veterans live in rural communities and use the Veterans Health Administration (VA) for healthcare [1]. Access to care for this population is a challenge due to significant geographic distances between VA tertiary hospitals, located in urban settings, and VA clinics and hospitals, commonly located in rural settings [1, 2]. The transition for rural Veterans from hub VA hospitals back home to VA primary care clinics is complicated by communication and logistical barriers as well as limited health resources in rural communities [2]. Compared to the urban Veteran population, rural Veterans experience a higher disease prevalence and lower physical and mental quality-of-life scores [3]. The VA rural Transitions Nurse Program (TNP), a nurse-led intensive care coordination quality improvement project, was designed to address the geographical barriers to care rural Veterans experience after discharge from urban VA hospitals. At each VA hospital, TNP is led by a transitions nurse, who completes the TNP intervention, and a site champion, who serves as a liaison between the transitions nurse and VA site leadership
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