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Integrating Mental Health Services into Primary Care [Letter]

Lutwak, Nancy; Dill, Curt
PMID: 28667409
ISSN: 1525-1497
CID: 2614862

Homeless and Older Veterans May Be at Risk for Malnutrition and Food Insecurity

Lutwak, Nancy; Dill, Curt
PMID: 28384012
ISSN: 1942-7905
CID: 2521582

Veterans Administration (VA) healthcare providers must be aware of the risks of fluoxetine [Letter]

Lutwak, Nancy; Dill, Curt
PMID: 28681412
ISSN: 1365-2125
CID: 2617352

Veterans and the National Tragedy of Suicide [Letter]

Lutwak, Nancy; Dill, Curt
PMID: 28935089
ISSN: 1873-2607
CID: 2707872

PTSD and Risk of Suicide

Lutwak, Nancy; Dill, Curt
PMID: 28885928
ISSN: 1930-613x
CID: 2688532

Letter to the Editor regarding "Severe mental illness and emergency department service use nationally in the Veterans Health Administration" [Letter]

Dill, Curt; Gonzalez-Aviles, Arnaldo
PMID: 28185674
ISSN: 1873-7714
CID: 2669892

When I Get Like That Put A Gun To My Head

Lutwak, Nancy; Dill, Curt
Yesterday a 95 year old man with prostate carcinoma and widespread bone metastases was brought to the emergency department because of blood in his urine after he pulled on his foley. At triage he was febrile and hypotensive, moaning incoherently which was not a change in mental status. Despite IV fluid hydration and pressors his blood pressure remained low
PMID: 28168774
ISSN: 1553-2712
CID: 2437372

VA Emergency Department Has Improved Communication to Increase Quality of Care and Patient Satisfaction

Lutwak, Nancy; Dill, Curt
PMID: 28467862
ISSN: 1555-824x
CID: 2572002

Meeting Elderly Patients' Nonmedical Needs [Letter]

Lutwak, Nancy; Dill, Curt
PMID: 28264966
ISSN: 1544-5208
CID: 2476182

Emergency medicine in the Veterans Health Administration-results from a nationwide survey

Ward, Michael J; Collins, Sean P; Pines, Jesse M; Dill, Curt; Tyndall, Gary; Kessler, Chad S
STUDY OBJECTIVE: We describe emergency physician staffing, capabilities, and academic practices in US Veterans Health Administration (VHA) emergency departments (EDs). METHODS: As part of an ongoing process improvement effort for the VHA emergency care system, VHA-wide surveys are conducted among ED medical directors every 3 years. Web-based surveys of VHA ED directors were conducted in 2013 on clinical operations and academic program development. We describe the results from the 2013 survey. When available, we compare responses with the previously administered survey from 2010. RESULTS: A total of 118 of 118 ED directors filled out the survey in 2013 (100% response rate). Respondents reported that 45.5% of VHA emergency physicians are board certified in emergency medicine, and 95% spend most their time in direct patient care. Clinical care is also provided by part-time (<0.5 full-time employee equivalent) emergency physicians in 59.3% of EDs. More than half of EDs (57%) provide on-site tissue plasminogen activator for acute ischemic stroke patients, and only 39% can administer tissue plasminogen activator 24 hours per day, 7 days per week. Less than half (48.3%) of EDs have emergency Obstetrics and Gynecology consultation availability. Most VHA EDs (78.8%) have a university affiliation, but only 21.5% participated in the respective academic emergency medicine program. CONCLUSIONS: Veterans Health Administration emergency physicians have primarily clinical responsibilities, and less than half have formal emergency medicine board certification. Despite most VHA EDs having university affiliations, traditional academic activities (eg, teaching and research) are performed in only 1 in 3 VHA EDs. Less than half of VHA EDs have availability of consulting services, including advanced stroke care and women's health.
PMID: 25936477
ISSN: 1532-8171
CID: 1606222