Ensuring the Safety of Chronically Ill Veterans Enrolled in Home-Based Primary Care

PEER REVIEWED

A map depicts the path of Hurricane Irma as it approaches the Florida coastline on September 7, 2017. The map shows where tropical weather watches or warnings are in place. The map also shows the location of the storm at different time points, on September 6 and 7, 2017, and its projected path as it heads toward Florida. The Orlando VA Medical Center, located in Central Florida, is shown on the map in relation to the approaching storm.

Figure 1.Hurricane Irma approaching Florida coastline, September 7, 2017, based on data collected September 6 and September 7, 2017. The registered nurse, a patient care manager, also served as geographic information system mapmaker (RNCM/mapmaker) for the Orlando Veterans Health Administration Home Based Primary Care program (OVAMC-HBPC), tracking the path of Hurricane Irma. Irma made landfall in the Florida Keys as a Category 4 hurricane with 132 mph winds. This powerful image of the looming threat helped inform the nurse manager, who supervised the OVAMC–HBPC nursing staff, of the severity of the storm. The RNCM/mapmaker also used the maps, in combination with patient information and other data, to educate and manage her patients. Map source: Portal for ArcGIS version 10.5 (2017), created for the Veterans Health Administration by Environmental Systems Research Institute (Esri). Additional sources: National Geographic, Environmental Systems Research Institute, Garmin, HERE Technologies, United Nations Environment World Conservation Monitoring Center, United States Geological Survey, National Aeronautics and Space Administration, European Space Agency, Micro Engineering Tech Inc., Natural Resources Canada, General Bathymetric Chart of the Oceans, National Oceanic and Atmospheric Administration, Increment P Corporation.

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A map shows the Florida peninsula coded with locations of oxygen-dependent patients and ventilator-dependent patients. The location of the Orlando VA Medical Center (OVAMC) in relation to these patients, who are considered at high-risk, is also shown. The distance of some of oxygen-dependent patients from the OVAMC is as far south as Palm Bay on the eastern coast (67 miles).

Figure 2.Oxygen-dependent and ventilator-dependent patients in home-based primary care, September 7, 2017. In preparation for Hurricane Irma, the nurse care manager, serving as the geographic information system mapmaker for the Orlando Veterans Health Administration Home Based Primary Care (OVAMC–HBPC) program, made maps for program leadership, including this map of oxygen-dependent and ventilator-dependent veterans. Leadership used these types of maps together with other clinical and care manager information in a dynamic process to make decisions regarding patient management in preparation for the storm. Map source: Portal for ArcGIS version 10.5 (2017) created for the Veterans Health Administration by Environmental Systems Research Institute. Additional Sources: Earthstar Geographics LLC, Environmental Systems Research Institute, HERE Technologies, Garmin.

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