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Prior to the public health emergency (PHE), there were efforts to advance telemedicine. The hurdles posed by reimbursement were one of the elements limiting its expansion. Billing rules varied pre PHE between private and governmental payers. The major billing changes during PHE sustained the health care system and provided access to care. Anticipated changes in billing post PHE will determine the future of telehealth. The aim of the chapter is to provide an overview of fundamentals of telehealth billing. First, we will focus on providing a basic understanding of all key stake holder payers, and the telehealth billing code system. Subsequently, we will outline telehealth services and coverage prior to and during the PHE. Finally, we attempt to review a sample of the current bills introduced to congress, shaping the future post PHE. © 2023 Elsevier Inc. All rights reserved.
ABSTRACT
The novel coronavirus (COVID-19) pandemic and strategies meant to mitigate infections caused disruptions to healthcare services across the globe. To evaluate the impact of the COVID-19 pandemic on the healthcare of patients with type 2 diabetes in the VA healthcare system, this work enumerated a cohort of patients with type 2 diabetes who utilized care in the VA across all months between March 2018 and February 2022 and analyzed service utilization, medication adherence, and diabetes-related short-term outcomes.The first objective was to determine the effect of the pandemic's interruption on the utilization of diabetes-related outpatient encounters. Results showed that the share of patients with diabetes with at least one virtual care visit increased from 3.4% in the pre- COVID year (March 2019 to February 2020) to 16.4% in the first year during COVID (March 2020 to February 2021) while the percent of patients with diabetes with an in- person diabetes-related outpatient visit fell from 89.8% to 72.3%.Second, large changes in oral antidiabetic medication use, adherence (i.e., proportion of days (PDC) covered >=80%), and discontinuation (zero days covered) were discovered during the pandemic among patients with treated type 2 diabetes. The mean percent adherent was 23.4%, 11.6%, and 30.1% during the pre-pandemic (i.e., March 2018-February 2020), pre-vaccine pandemic (i.e., March 2020-December 2020), and post-vaccine pandemic (i.e., January 2021-February 2020) periods, respectively.Finally, this study evaluated changes in average A1C measurement, glycemic control, and preventable diabetes outcomes before and during the COVID-19 pandemic. The percent of eligible patients with A1C measurement decreased by 8.6% when the pandemic began, trending back to pre-pandemic levels by January 2021, at which point it fell by about 1% per month to end of study. The rate of uncontrolled diabetes averaged 400 per 100,000 before the pandemic, but rose to almost 550 per 100,000 patients during the pandemic. Likewise, the rate of short-term complications averaged 30 per 100,000, but rose to 49 per 100,000 at its high during the pandemic.The pandemic's interruptions caused vast differences in the healthcare routines of patients with diabetes, which initially led to more negative outcomes than before the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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The COVID-19 international crisis has challenged us all in health care systems around the world. But, in military and veteran health care system, it may appear that the challenges are far greater. For example, military health care providers and soldiers have additional responsibility of deploying to defend the nation. Even, when soldiers are not at war, the day-to-day routine involves long hours, coupled with stressful field training exercise. In addition, military personnel typically relocate or move very three to four years from one duty assignment to another. In this chapter, suggestions are made for future research and clinical applications as part of a response to the COVID-19 challenges in the unique military and veteran health clinics. The need to improve treatment engagement and support for health care workers in military and veteran hospitals are provided. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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In this paper, we present formal and informal volunteers' perceived experiences of a mass vaccination clinic for COVID-19 in central Texas. Volunteers at one or more of our team's vaccination events responded to an anonymous survey to share perceptions of their preparedness, training experiences, communication effectiveness and satisfaction, to help us identify opportunities to improve volunteer training and engagement for responses to pandemics. Overall, the volunteers perceived their work to be meaningful, felt prepared and were satisfied with their experiences as volunteers. A dedicated team that communicates well and emphasizes a team approach is key to success, especially in unprecedented situations such as the COVID-19 pandemic. Implications for future volunteer training and involvement in disaster responses are discussed.
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Introduction: COVID-19 vaccination substantially reduces morbidity and mortality associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe illness. However, despite effective COVID-19 vaccines many questions remain about the efficacy of vaccines and the durability and robustness of immune responses, especially in immunocompromised persons. The NCI-funded Serological Sciences Network (SeroNet) is a coordinated effort including 11 sites to advance research on the immune response to SARS-CoV-2 infection and COVID-19 vaccination among diverse and vulnerable populations. The goals of the Pooling Project are: (1) to conduct real-world data (RWD) analyses using electronic medical records (EMR) data from four health care systems (Kaiser Permanente Northern California, Northwell Health, Veterans Affairs-Case Western, and Cedars-Sinai) to determine vaccine effectiveness in (a) cancer patients;(b) autoimmune diseases and (c) solid organ transplant recipients (SOTR);(2) to conduct meta-analyses of prospective cohort studies from eight SeroNet institutions (Cedars-Sinai, Johns Hopkins, Northwell Health, Emory University, University of Minnesota, Mount Sinai, Yale University) to determine post-vaccine immune responses in (a) lung cancer patients;(b) hematologic cancers/hematopoietic stem cell transplant (HSCT) recipients;(c) SOTR;(d) lupus. Method(s): For our RWD analyses, data is extracted from EMR using standardized algorithms using ICD-10 codes to identify immunocompromised persons (hematologic and solid organ malignancy;SOTR;autoimmune disease, including inflammatory bowel disease, rheumatoid arthritis, and SLE). We use common case definitions to extract data on demographic, laboratory values, clinical co morbidity, COVID-19 vaccination, SARS-CoV-2 infection and severe COVID-19, and diseasespecific variables. In addition, we pool individual-level data from prospective cohorts enrolling patients with cancer and other immunosuppressed conditions from across network. Surveys and biospecimens from serology and immune profiling are collected at pre-specified timepoints across longitudinal cohorts. Result(s): Currently, we have EMR data extracted from 4 health systems including >715,000 cancer patients, >9,500 SOTR and >180,000 with autoimmune conditions. Prospective cohorts across the network have longitudinal data on >450 patients with lung cancer, >1,200 patients with hematologic malignancies, >400 SOTR and >400 patients with lupus. We will report results examining vaccine effectiveness for prevention of SARS-CoV-2 infection, severe COVID-19 and post-acute sequelae of COVID-19 (PAS-C or long COVID) in cancer patients compared to other immunocompromised conditions. Conclusion(s): Our goal is to inform public health guidelines on COVID-19 vaccine and boosters to reduce SARS-CoV-2 infection and severe illness in immunocompromised populations.
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RATIONALE: Veterans living with dementia in long-term care have complex needs, with variable manifestation of symptoms of dementia that interact with their lived experience. Best practice dementia care prioritises nonpharmacological interventions; of which few have strong evidence. Implementation of evidence is complex, with evaluation of outcomes and processes necessary. AIMS AND OBJECTIVES: This paper details the evaluation of implementation, at veteran and organisational level, of the Weaving Evidence into Action for Veterans with Dementia (WEAVE) programme. METHODS: A Type 2 hybrid effectiveness-implementation design was used, underpinned by the Implementation Framework for Aged Care (IFAC). Programme intervention incorporated music therapy, exercise, reminiscence therapy and/or sensory modulation, offered over a 24-week period. Evaluation components included: (1) programme effectiveness for veterans with dementia for responsive behaviour, physical wellbeing, cognitive status, emotional state, medications and falls (at baseline, 8-week, 16-week and 24-week); and (2) implementation outcomes of reach and adoption, feasibility and acceptability, fidelity (via interviews) and a preliminary cost analysis. RESULTS: Thirty-eight veterans participated in the 24-week programme, with high levels of engagement in interventions of their choice. Statistically significant improvements were seen across all veteran-level outcome measures, for functional capacity and reduced neuro-psychiatric and depressive symptoms. Ten staff members were interviewed, highlighting co-designed core elements were feasible and acceptable, and the momentum generated by resident and staff enthusiasm. Cost analysis included costs of programme set-up and running the 24-week intervention. CONCLUSION: Key components of programme success were the therapeutic leaders, adherence to core elements of programme design, and veterans' choice in meaningful activity. Cost analysis supports deliberations for upscale across further care homes.
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As novel coronavirus 2019 disease (COVID-19) began to spread across the United States in early 2020, health care systems faced extreme demands on resources. As the country's largest single-payer health care system, the U.S. Department of Veterans Affairs (VA) was uniquely positioned to study how the virus impacted different communities and work to improve care provided to all. Early on, a literature review of prior epidemics revealed that occupational exposures and an inability to socially distance could impact some groups more than others. The VA's Office of Health Equity leveraged a general sense of community to create a collaborative research space and a dedicated analytic space to inform pandemic operations. VA researchers and operations staff were able to quickly share information and respond to updates to produce accurate and reliable publications for medical professionals and the general public. Partnerships with VA Medical Centers and Veteran Service Organizations helped to increase communication across the nation and determine the most critical needs. Although COVID-19 was dynamic in nature, VA's intentional examination of social and structural factors was crucial in informing a more equitable approach. Moving forward, these inequities must be intentionally addressed in future pandemic responses.
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In September 2020, the Department of Veterans Affairs (VA) launched a novel volunteer research registry to rapidly recruit eligible study participants for research on SARS-CoV-2 and COVID-19 vaccines and treatments at VA Medical Centers selected as study sites for COVID-19 clinical trials. Targeted multimedia outreach campaigns were used to recruit diverse populations, including those historically under-represented in medical research. By November 2022, 58,561 volunteers were enrolled in the registry, 19% of whom were women, 9% Hispanic/Latino, and 8% Black. The registry's strategic approach to outreach proved successful in recruiting diverse volunteers, with geotargeted e-mails recruiting the most diversity.
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We surveyed 57 nursing home residents to assess the subjective impact of COVID-19 prevention practices. Residents were mostly accepting of testing and symptom screening; however, many would like more choices. Sixty-nine percent want to have some say in when or where to mask. Most (87%) residents want to return to group activities. Residents on long-stay units (58%) are more likely than residents on short-stay units (27%) to accept additional risk of COVID-19 transmission to increase their quality of life.
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Background and Aim: Donepezil is a front-line treatment for Alzheimer's disease. Donepezil treatment is associated with decreased risk of all-cause mortality. Specific protection is observed in pneumonia and cardiovascular disease. We hypothesized that donepezil treatment would improve mortality among Alzheimer's patients following infection with COVID-19. The objective of this study is to assess the influence of ongoing donepezil treatment on survival in Alzheimer's disease patients after polymerase chain reaction (PCR)-confirmed COVID-19 infection. Methods: This is a retrospective cohort study. We conducted a national survey of Veterans with Alzheimer's disease to assess the influence of ongoing donepezil treatment on survival in Alzheimer's disease patients after PCR-confirmed COVID-19 infection. We assessed all-cause 30-day mortality stratified by COVID-19 infection and donepezil use, estimating odds ratios using multivariate logistic regression. Results: Among people with Alzheimer's disease and COVID-19, all-cause 30-day mortality was 29% (47/163) for people taking donepezil compared with 38% (159/419) for those who were not. Among people with Alzheimer's disease without COVID-19, all-cause 30-day mortality was 5% (189/4189) for people taking donepezil compared with 7% (712/10,241) for those who were not. Adjusting for covariates, the decrease in mortality associated with donepezil did not differ between people with and without COVID-19 (interaction p = 0.710). Conclusion: The known survival benefits of donepezil were retained but not found to be specific to COVID-19 among people with Alzheimer's disease.
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Comprehensive medication management (CMM) is increasingly provided by health care teams through telehealth or hybrid modalities. The purpose of this scoping literature review was to assess the published literature and examine the economic, clinical, and humanistic outcomes of CMM services provided by pharmacists via telehealth or hybrid modalities. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Randomized controlled trials (RCTs) and observational studies were included if they: reported on economic, clinical, or humanistic outcomes;were conducted via telehealth or hybrid modalities;included a pharmacist on their interprofessional team;and evaluated CMM services. The search was conducted between January 1, 2000, and September 28, 2021. The search strategy was adapted for use in Medline (PubMed);Embase;Cochrane;Cumulative Index to Nursing and Allied Health Literature;PsychINFO;International Pharmaceutical s;Scopus;and grey literature. Four reviewers extracted data using a screening tool developed for this study and reviewed for risk of bias. Authors screened 3500 articles, from which 11 studies met the inclusion criteria (9 observational studies, 2 RCTs). In seven studies, clinical outcomes improved with telehealth CMM interventions compared to either usual care, face-to-face CMM, or educational controls, as shown by the statistically significant changes in chronic disease clinical outcomes. Two studies evaluated and found increased patient and provider satisfaction. One study described a source of revenue for a telehealth CMM service. Overall, study results indicate that telehealth CMM services, in select cases, may be associated with improved clinical outcomes, but the methods of the included studies were not homogenous enough to conclude that telehealth or hybrid modalities were superior to in-person CMM. To understand the full impact on the Quadruple Aim, additional research is needed to investigate the financial outcomes of CMM conducted using telehealth or hybrid technologies.Copyright © 2022 Pharmacotherapy Publications, Inc.
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Background: Chronic pain and problematic substance use are commonly co-occurring and highly detrimental issues that are especially prevalent in U.S. veteran populations. Although COVID-19 made clinical management of these conditions potentially difficult, some research suggests that certain veterans with these conditions did not experience this period as negatively as others. It is thus important to consider whether resilience factors, such as the increasingly-studied process of psychological flexibility, might have led to better outcomes for veterans managing pain and problematic substance use during this time of global crisis. Methods: This planned sub-analysis of a larger cross-sectional, anonymous, and nationally-distributed survey (N = 409) was collected during the first year of the COVID-19 pandemic. Veteran participants completed a short screener and battery of online surveys assessing pain severity and interference, substance use, psychological flexibility, mental health functioning, and pandemic-related quality of life. Results: For veterans with chronic pain and problematic substance use, the pandemic resulted in a significant lowering of their quality of life related to meeting basic needs, emotional health, and physical health compared to veterans with problematic substance use but no chronic pain diagnosis. However, moderation analyses revealed that veterans with these comorbid conditions experienced less negative impacts from the pandemic on quality of life and mental health when they reported greater psychological flexibility. For veterans with problematic substance use only, psychological flexibility was also related to better mental health functioning, but did not significantly correlate with their quality of life. Conclusion: Results highlight how COVID-19 differentially impacted veterans with both problematic substance use and chronic pain, such that this group reported particularly negative impacts of the pandemic on multiple areas of quality of life. However, our findings further emphasize that psychological flexibility, a modifiable resiliency process, also buffered against some of the negative impacts of the pandemic on mental health and quality of life. Given this, future research into the impact of natural crises and healthcare management should investigate how psychological flexibility can be targeted to help increase resiliency for veterans with chronic pain and problematic substance use.
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Prison reentry programs attempt to equip justice-involved veterans with life skills necessary for their transition out of prison. This qualitative study addressed the scant understanding of the impact pre-released prison reentry programs have on justice-involved veterans' transition and reintegration back to the community. The purpose of this qualitative study was to describe the perceptions of justice-involved veterans regarding prison reentry programs that have impacted their transition out of prison. The well-being development model and Castro's military-to-civilian transition model provided the conceptual framework for this qualitative study, using semistructured questions to interview 11 justice-involved veterans regarding their participation in prison reentry programs. Directed content analysis was used to categorize, synthesize, and interpret data. The first theme revealed that prison reentry programs helped with transition when there was family support, when one participated in industry reentry training, when there is community support, and housing. The second theme that emerged from the data revealed that prison reentry programs did not help with transition when prison reentry programs were cancelled due to SARS-CoV-2 (COVID-19), prisoners faced difficulty in adjusting, had no knowledge of community resources, received no help from prison, and did not have access to housing, transportation, or healthcare. The research findings may contribute to positive social change by engaging justice-involved veteran stakeholders to review and revise prison reentry policies for justice-involved veterans. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
Veterans of the U.S. Armed Forces are an at-risk population given their increased mental health concerns resulting from their military service. However, there has been limited research conducted with this population during the novel coronavirus (COVID-19) pandemic. The purpose of this exploratory study was to examine aspects of positive psychological functioning with 132 U.S. veterans during COVID-19 using Lazarus and Folkman's (1984) transactional model of stress and coping. Specifically, we examined the personal resources of hope and proactive personality, two coping styles, and satisfaction with life. We performed correlation analyses to determine how these constructs related to each other. We also conducted a regression analysis to examine if the two dimensions of hope, proactive personality, adaptive coping, and maladaptive coping predicted veterans' satisfaction with life. Lastly, we utilized a mediation analysis to investigate whether two coping styles mediated the relationships among personal resources and satisfaction with life. Findings from the regression analysis suggested hope pathways and proactive personality were significant predictors of satisfaction with life. Results from the mediation analysis suggested that adaptive and maladaptive coping did not mediate the relationships among personal resources and satisfaction with life. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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OBJECTIVE: Three rounds of stimulus checks were distributed to middle- and low-income U.S. adults during the COVID-19 pandemic. This 15-month longitudinal study examined rates of receipt of these stimulus checks, planned expenses, and associations with clinical outcomes among three veteran groups. METHODS: In total, 158 veterans, consisting of 59 with a psychotic disorder, 49 recently homeless veterans, and a comparison group of 50 veterans without a history of psychosis or homelessness, were assessed five times between May 2020 and July 2021. Bivariate analyses were used to compare receipt of stimulus checks and planned expenses among the groups, and multivariable analyses examined how receipt of checks was related to mental health and substance use over time. RESULTS: No group difference was found in receipt of stimulus checks, and 74%-84% of veterans reported receipt of more than one check. Most participants reported plans to use their stimulus checks to pay for bills, groceries, credit card debt, and rent or mortgage or to save the money. Over time, participants who received a greater number of stimulus checks reported significantly decreased symptoms of depression (B=-0.48) and anxiety (B=-0.84) and improved social functioning (B=0.24). For the recently homeless group, a greater number of stimulus checks received was associated with decreases in days of alcohol intoxication and drug use, but the reverse was found for the psychosis group. CONCLUSIONS: Multiple short-term unconditional government cash transfers may improve mental and social functioning among vulnerable populations during major crises, a finding that contributes to the research literature and has policy implications for pandemic and emergency preparedness.
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Objectives: To understand the impact of the coronavirus disease-2019 pandemic on sleep services within the United States Department of Veterans Affairs using separate surveys from "pre-COVID" and pandemic periods. Methods: Data from a pre-pandemic survey (September to November 2019) were combined with data from a pandemic-period survey (August to November 2020) to Veterans Affairs sleep medicine providers about their local sleep services within 140 Veterans Affairs facilities). Results: A total of 67 (47.9%) facilities responded to the pandemic online survey. In-lab diagnostic and titration sleep studies were stopped at 91.1% of facilities during the pandemic; 76.5% of facilities resumed diagnostic studies and 60.8% resumed titration studies by the time of the second survey. Half of the facilities suspended home sleep testing; all facilities resumed these services. In-person positive airway pressure clinics were stopped at 76.3% of facilities; 46.7% resumed these clinics. Video telehealth was either available or in development at 86.6% of facilities and was considered a lasting addition to sleep services. Coronavirus disease-2019 transmission precautions occurred at high rates. Sleep personnel experienced high levels of stress, anxiety, fear, and burnout because of the pandemic and in response to unexpected changes in sleep medicine care delivery. Conclusions: Sleep medicine services within the Veterans Affairs evolved during the pandemic with many key services being interrupted, including in-lab studies and in-person positive airway pressure clinics. Expansion and initiation of telehealth sleep services occurred commonly. The pandemic adversely affected sleep medicine personnel as they sought to maintain access to care.
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RATIONALE: Challenges associated with translating evidence into practice are well recognised and calls for effective strategies to reduce the time lag and successfully embed evidence-based practices into usual care are loud and clear. While a plethora of nonpharmacological interventions for people with dementia exist; few are based on strong evidence and there is little consideration for programme operationalisation in the complex environment of long-term care. AIMS AND OBJECTIVES: This paper describes the preparation for the implementation of the Weaving Evidence into Action for Veterans with dementia project, incorporating the codesign of delivery of four evidence-based, nonpharmacological interventions. METHOD: Implementation preparation for this type 2 hybrid effectiveness-implementation project was underpinned by the Implementation Framework for Aged Care (IFAC). A sociocultural-political contextual scan was undertaken, and reflection on the IFAC question 'why change?' with key stakeholders. Delivery of the four interventions of music therapy, exercise, reminiscence therapy and sensory modulation was explored using codesign methodology. Preparation of both intervention delivery personnel and recipients was via training, establishment of a change team and promotional/awareness-raising strategies. RESULTS: The contextual scan revealed Australian government reforms and organisational imperatives facing long-term care services, while reflections on 'why change' flagged best practice dementia care at the local care home level. Several codesign sessions involved veterans with dementia, family members, care home staff members and volunteers to ensure programme alignment with needs and preferences, accounting for existing activities. Training was designed and delivered before programme commencement. A change team was established and strategies to support behaviour change instigated. Implementation evaluation is reported elsewhere. CONCLUSION: The extended preparatory period for implementation, afforded by the COVID-19 pandemic on programme commencement, enabled time for widespread understanding of the programme and necessary upskill of staff. Comprehensive codesign with all stakeholders of programme components identified core and flexible elements necessary for fidelity of implementation.
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Introduction: The COVID-19 pandemic has interrupted participation in the labour force and may have affected mental health, both directly through the effects of illness and isolation and indirectly through negative effects on employment. Former military personnel may be at particular risk as a result of both additional exposure to risk factors for poor mental health and barriers to labour market participation raised by the transition from military to civilian working environments. This article examines furlough and unemployment as a result of the COVID-19 pandemic among UK working-age ex-service personnel and its associations with poor mental health. Methods: Participants from an existing cohort study of Iraq- and Afghanistan-era UK Armed Forces personnel were invited to provide information on employment before the COVID-19 pandemic and how it has changed since the pandemic. Mental health was measured using the General Health Questionnaire and compared with data collected pre-pandemic. Results: Although Veteran unemployment is not higher than civilian unemployment (4.7% and 4.8%, respectively, in September 2020), it rose during the pandemic from a lower level (1.3%). Part-time and self-employed Veterans were more likely than full-time employees to experience furlough or unemployment. A negative impact on employment was associated with the onset of new mental ill health. Discussion: Employment of ex-service personnel was more negatively affected by the COVID-19 pandemic, possibly because ex-service personnel are mostly men, and men were more affected in the UK general population. This employment instability has negative consequences for mental health that are not mitigated by furlough. LAY SUMMARYThis article examines how employment status changed for working-age UK ex-military personnel in the early period of the COVID-19 pandemic and how this relates to their mental health. Overall, the unemployment rate among ex-military personnel was not worse than that in the general population;however, because ex-military personnel generally have a lower unemployment rate than the general population, this suggests they were worse hit by the pandemic. Part-time and self-employed personnel were more likely to experience negative changes to their employment situation. Both becoming unemployed and being furloughed were correlated with negative changes in mental health. However, it should be noted that the mental health data used for this comparison predate the onset of the pandemic;hence, other factors related to both change in employment status and change in mental health could be the cause of this apparent relationship.
ABSTRACT
LAY SUMMARYThe COVID-19 pandemic influenced ways in which individuals volunteered and created barriers for participation because of differing restrictions. The research assessing how Veterans volunteer is limited, but there may be aspects of military culture that encourage service to others. The authors investigated volunteering among UK Veterans during the COVID-19 pandemic and what factors made Veterans more or less likely to volunteer. The study found that 60% of Veterans had volunteered in the past 12 months, a level similar to that among the UK general population. Overall, Veterans volunteered more often through formal organizations rather than on an informal basis, such as helping individuals such as neighbours. However, in relative terms, levels of formal volunteering decreased and levels of informal volunteering increased during the pandemic. Veterans were more likely to volunteer if they were officers or to increase volunteering if they felt lonely. Veterans who reduced volunteering were more likely to have mental health problems. Understanding volunteering among Veterans may open up more opportunities for participation. Introduction: The COVID-19 pandemic facilitated new methods of and motivations for volunteering and created barriers to participation through social restrictions and lockdowns. The research assessing the volunteering behaviours of ex-service personnel (Veterans) is limited;however, as a group they may be more likely to volunteer because of aspects of military culture that encourage pro-social behaviours. The authors investigated levels of formal and informal volunteering among UK Veterans during the pandemic, factors associated with volunteering, and whether the pandemic affected Veterans' volunteering behaviours. Methods: An additional wave of data was collected from a longitudinal cohort study of the UK Armed Forces through an online survey conducted from June to September 2020. Participants were included if they had left the armed forces after regular service and were living in the United Kingdom. Invitation emails were sent to 3,547 Veterans, with a 44% response rate (N = 1,562). Results: Overall, 60% of Veterans reported volunteering in the past 12 months. Of those who volunteered, 41% reported formal volunteering, and 44% reported informal volunteering. Veterans reported reducing formal volunteering because of the pandemic (45%), but they also reported increasing informal volunteering (66%). Discussion: During the pandemic, UK Veterans volunteered at a level similar to the UK general population. They reported higher levels of formal volunteering and lower levels of informal volunteering compared with the UK general population. Understanding who among Veterans is likely to engage in volunteering could support future strategies to engage volunteers and open more opportunities for participation.
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In response to the COVID-19 pandemic, an interprofessional team from the Department of Veterans Affairs, Office of Nursing Informatics and Office of Nursing Service was established to create standardized nursing documentation notes reflective of electronic health record modernization efforts. This foundational work established an enterprise methodology to electronically define and measure essential nursing documentation discrete data within an integrated complex health care system.