The Department of Veterans Affairs (VA) is continuing to adapt its programs to meet the needs of veterans from the Global War on Terror, with a variety of new services in place or underway.

The latest innovations for treating traumatic brain injury (TBI) in the newest generation of combat veterans returning from Iraq and Afghanistan includes mandatory TBI training for all VA health care professionals, screening all recent combat vets for TBI and creating an outside panel of experts to review VA’s TBI services.

Traumatic brain injury (TBI) can be caused without any visible injuries when explosives jar the brain inside the skull. VA has developed a TBI course that is mandatory for all health care professionals. The course teaches primary care providers ways to diagnose TBI in patients who might not otherwise be aware they suffer from it.

Also starting this spring is a program to screen all patients who served in the combat theaters of Iraq or Afghanistan for TBI. The new screening will be offered at all 155 VA medical centers.

To ensure VA is taking advantage of the latest technology, treatment innovations and diagnostic insights, the Department will establish a panel of outside experts to review VA’s complete polytrauma system of care, including its TBI programs.

“Polytrauma” is a term that includes TBI and encompasses the other injuries typically found in blast victims, including amputations, burns, hearing and vision problems and psychological trauma.
VA operates four major polytrauma centers — in Minneapolis; Tampa, Fla.; Richmond, Va.; and Palo Alto, Calif. — that have interdisciplinary teams of specialists working together on the complex medical needs of each patient. VA also has 17 regionally-based polytrauma facilities that provide specialized care closer to veterans’ homes.

Each of VA’s 21 regional health care networks is establishing polytrauma support clinic teams to further improve case management for veterans with TBI as they return home from the hospital, and to help them in their transition to their communities.

VA’s innovations in the diagnosis and treatment of TBI patients began in 1992, when four VA medical centers dedicated special facilities to treatment, rehabilitation, professional education and research regarding brain injuries. In March 2003, those facilities received their first patients from the Global War on Terror, and in April 2005, they were officially designated as polytrauma centers, featuring teams of specialists in various medical disciplines and case managers working together to help veterans overcome severe injuries.

“Inpatient care in one of our four polytrauma centers is the beginning of a long road to recovery,” said Dr. Michael J. Kussman, VA’s Acting Under Secretary for Health. “We are establishing an extensive continuum of care that will enable our patients to achieve the highest level of function and ability.”
Among the special adaptations VA is providing for the care of TBI and polytrauma patients are case managers assigned to each patient, a greater emphasis and understanding of the problems of families during the initial care and long-term recovery, and state-of-the-art video-conferencing that permits top specialists to take an active role in the treatment of remote patients.

VA treated more than 5.4 million patients last year, accounting for about 55 million outpatient visits and 600,000 hospitalizations. About 205,000 of the 630,000 veterans who have served in Iraq and Afghanistan have come to VA for health care, with fewer than 7,000 being hospitalized.

All combat veterans have access to free health care from VA for two years after their separation from service, bypassing rules that require determinations of service-connected injuries or income levels.