Building Seamless Care Coordination Along the Continuum

Timeslot: Thursday, October 13, 2022 - 11:15 AM to 12:15 PM
Session Type: Concurrent Session


The Veterans Health Administration (VHA) cares for over 9 million Veterans nationwide. The increasing prevalence of chronic conditions escalates safety risks, resource utilization and cost of care (RAND, 2017). Specialized care and case management programs improved health equities and outcomes over the decades, however, the current enterprise-wide silo approach to care coordination across the care continuum may result in increased safety risks, inefficient capital management, inconsistent communication, gaps in access to quality care and Veteran frustrations. Fragmented care delivery is not unique to VHA and is experienced throughout the healthcare industry. A U.S. study estimated communication failures were responsible for at least 30% of all malpractice claims, resulting in over 1,700 deaths and $1.7 billion in malpractice costs over five years (CRICO Strategies, 2015).

VHA developed a Care Coordination & Integrated Case Management (CC&ICM) framework that was tested in key VA Healthcare Systems from 2016 to 2019 (Singer, 2019). The national initiative establishes standard care coordination definitions, roles, processes, and tools that supports the healthcare facility in building a seamless continuum to integrate communication, collaboration, and coordination for safer patient care transitions. This session will describe the outcomes achieved and the endorsement for enterprise-wide deployment of the framework that is expected to reach all VHA facilities by Spring 2023.

Learning Outcomes

  • Differentiate the key components of the Veterans Health Administration (VHA) Care Coordination and Integrated Case Management (CC&ICM) framework for systems and clinical integrationĀ 

  • Identify the impact and benefits of the Lead Coordinator roleĀ 

  • Illustrate how the CC&ICM model enhances the experience of the Veteran and the employee