Polytrauma/TBI System of Care
Frequently Asked Questions
- How many facilities are in the Polytrauma System of Care and where are they located?
- Where do patients go after they leave a Polytrauma Rehabilitation Center? How is their health care program maintained?
- How is VA helping the families of seriously injured Servicemembers in the Polytrauma System of Care?
- How does VA communicate with the Department of Defense regarding Servicemembers in the Polytrauma System of Care?
- Why is there such an emphasis on brain injuries?
- What do the military liaisons do in Polytrauma facilities?
- How does the Center for the Intrepid in San Antonio fit into the Polytrauma System of Care?
- How does the Center for the Intrepid differ from the San Antonio Polytrauma Rehabilitation Center?
- How do the different facilities in the Polytrauma System of Care communicate with each other?
- How does VA compare with the private sector in this area?
There are 5 Polytrauma Rehabilitation Centers (PRCs). The 5 PRCs and Polytrauma Transitional Rehabilitation Programs (PTRP) are co-located on the same VA medical campus:
- Richmond,VA PRC
- Richmond PTRP
- Tampa, FL PRC
- Tampa PTRP
- Minneapolis, MN PRC
- Minneapolis PTRP
- Palo Alto, CA PRC
- Palo Alto PTRP
- San Antonio, TX PRC
- San Antotnio PTRP
Each PRC location houses a Polytrauma Network Site as well. There are 18 additional Network Sites.
- Boston, MA
- San Juan, PR
- Houston, TX
- Syracuse, NY
- Lexington, KY
- Dallas, TX
- Bronx, NY
- Cleveland, OH
- Tucson, AZ
- Philadelphia, PA
- Indianapolis, IN
- Denver, CO
- Washington, DC
- Hines, IL
- Seattle, WA
- Augusta, GA
- St. Louis, MO
- West Los Angeles, CA
In addition to the Polytrauma Rehabilitation Centers, Polytrauma Transitional Rehabilitation programs, and Polytrauma Network Sites, there are 87 Polytrauma Support Clinic Teams located throughout the VA Healthcare System.
2. Where do patients go after they leave a Polytrauma Rehabilitation Center? How is their health care program maintained?
The majority of patients are discharged home and receive their specialized follow-up care at a Polytrauma Network Site, or another VA facility in the Polytrauma System of Care. However, some patients, due to the severity of their injuries, require ongoing sub-acute or long term care. Some patients return to a military treatment facility for follow-up after VA discharge. Some patients return to Active Duty within the military.
Polytrauma Rehabilitation Teams develop individualized follow-up plans for each patient after discharge. These include recommendations for continued medical care, therapy services, mental health, prosthetic devices and aids, and community re-entry services and resources. The plans are developed with patients and families and communicated to the receiving medical facilities, as well as with military case managers. Polytrauma Case Managers make phone calls following the discharge of a patient to ensure that follow-up plans are implemented and to help resolve any issues that might emerge.
3. How is VA helping the families of seriously injured Servicemembers in the Polytrauma System of Care?
VA considers family support a priority. Medical Center leadership is visible and available for meetings with families throughout their stay in the Polytrauma System of Care. Case managers provide active support by coordinating the efforts of clinical staff, voluntary services, and service organizations. They also work with community organizations and businesses to provide lodging, transportation, meals, and recreational activities for families, if needed. Each polytrauma team has a clinical psychologist and a neuropsychologist who are available to provide counseling, education, and support services to families.
4. How does VA communicate with the Department of Defense regarding Servicemembers in the Polytrauma System of Care?
The VA Seamless Transition social worker assigned to the military treatment facility currently caring for the patient makes contact with staff at the receiving Polytrauma System of Care facility. Vital clinical information is then transmitted to the Admission case manager at the Polytrauma Rehabilitation Center for review. The Admission case manager remains in contact with the Seamless Transition social worker and the clinical team at the military treatment facility until the patient is transferred to the receiving VA Polytrauma facility. During the Servicemember's stay, the VA case manager remains in contact with the patient's military branch to keep them informed of progress and changes in the patient's condition. VA and DoD use phone calls, secure records transfers, and meetings to ensure open communication and effective coordination. Physicians in the Polytrauma System of Care and at Military Treatment Facilities contact each other directly through teleconferencing, videoconferencing, and through VA social workers assigned to each facility.
It has been said that traumatic brain injuries - caused by improvised explosive devices, mortars, vehicle accidents, grenades, bullets, mines, falls and more - may be the hallmark injury faced by Veterans of Iraq and Afghanistan. Even those who were not obviously wounded in explosions or accidents may have sustained a brain injury. Therefore, it's important that the military, families, Servicemembers and the community understand some of the subtle signs and encourage Servicemembers to get screened at their local VA facility or from the military.
Military liaisons are an important resource for active duty families and VA staff. They coordinate care and service benefits for Servicemembers and their families. They also work to resolve administrative issues involving travel for family members, lodging, reimbursement and pay issues, and transportation and/or shipment of household and personal goods.
The Center for the Intrepid (CFI) in San Antonio was financed and constructed by the Fisher House Foundation and by private donations as a non-profit rehabilitation center to care for Servicemembers and Veterans with amputations, severe trauma, and serious burns. The Department of Defense (DoD) agencies and VA are working together in the CFI to provide clinical care and research for those recovering wounded warriors.
Employees from the Veterans Health Administration (VHA) and the Veterans Benefits Administration (VBA) work side-by-side with Army colleagues to provide the best possible rehabilitative services to severely injured Servicemembers and Veterans. VHA provides physical therapy, occupational therapy, prosthetics services, social work case management, and seamless transition liaison services. VBA offers information and education about benefits and vocational rehabilitation services, and provides assistance with benefits claims. Physicians and staff at the CFI work with VA and DoD to provide educational and research opportunities for employees to improve the quality of care provided by all rehabilitation specialists in the military or civilian systems.
8. How does the Center for the Intrepid differ from the San Antonio Polytrauma Rehabilitation Center?
The San Antonio Polytrauma Rehabilitation Center provides both inpatient and outpatient care whereas the CFI provides only outpatient care. Both facilities treat Servicemembers and Veterans, with acceptance criteria based on clinical standards and the individual needs of the patient and their family.
The Polytrauma Rehabilitation Centers, Polytrauma Transitional Rehabilitation Programs and Polytrauma Network Sites participate in regular conference calls. These calls include representatives from the different services and departments involved in supporting the Polytrauma System of Care, including Social Work Services, Nursing Services, the Office of Seamless Transition, Mental Health Strategic Health Group, Voluntary Services, and the Prosthetics and Sensory Aides Service. The leadership teams of the five Polytrauma Rehabilitation Centers are involved in bi-weekly conference calls of the Traumatic Brain Injury Strategic Group. These calls address ongoing clinical and administrative issues at the centers. Our Polytrauma Network Sites regularly consult with the Polytrauma Rehabilitation Centers by tele-conferencing, phone, and email, and VA's system of electronic health records allow physicians to consult each other easily on any case.
Today's veterans with TBI injuries receive are receiving state-of-the-art treatment and rehabilitation in the Polytrauma System of Care. Combat injured Servicemembers with TBI are faring as well as in their day-to-day activities as those in the private sector according to a report from the VA Inspector General. That is especially noteworthy because patients treated at VA facilities typically have more severe injuries than those in the private sector.