Ten-Year Outcomes of a Systems-Based Approach to Longitudinal Amputation Care in the US Department of Veteran Affairs

Joseph Webster; Joel Scholten; Patricia Young; Billie J Randolph

doi:10.12788/fp.0024

Ten-Year Outcomes of a Systems-Based Approach to Longitudinal Amputation Care in the US Department of Veteran Affairs

Fed Pract. 2020 Aug;37(8):360-367. doi: 10.12788/fp.0024.

Authors

Joseph Webster¹, Joel Scholten¹, Patricia Young¹, Billie J Randolph¹

Affiliation

¹ is a Staff Physician, and is National Amputation Program Manager at Central Virginia Veterans Affairs Health Care System in Richmond. is Physical Medicine and Rehabilitation National Program Director at Rehabilitation and Prosthetic Services, US Department of Veterans Affairs in Washington, DC. is Deputy Director at the Veterans Affairs Extremity Trauma and Amputation Center of Excellence in Washington, DC. Joseph Webster is a Professor in the Department of Physical Medicine and Rehabilitation at the School of Medicine at Virginia Commonwealth University in Richmond.

Abstract

Background: The goal of the US Department of Veterans Affairs (VA) Amputation System of Care (ASoC) is to enhance the quality and consistency of amputation rehabilitation care for veterans with limb loss.

Objective: The ASoC provides specialized expertise in amputation rehabilitation incorporating the latest practices in medical management, rehabilitation, and artificial limbs in order to minimize disability and to enable the highest level of social, vocational, and recreational success for veterans with amputation.

Discussion: The ASoC serves veterans with limb amputation from any etiology. Between 2009 and 2019, the VA experienced a 34% increase in the number of veterans with amputation who received care. During the same 10-year period, the percentage of veterans with major limb amputation seen in an outpatient amputation specialty clinic each year increased from 4.8 to 26%. This article highlights how the mission of the ASoC has been accomplished over the past decade through prioritization and implementation of key strategic initiatives in learning organization creation, trust in VA care, modernization, and development of a high-performance network with enhanced access and customer service.

Conclusions: This synopsis of the VA amputation care program serves as a model of amputation care that can be utilized outside the federal sector and has the potential to serve as a systems-based example for providing longitudinal care to other populations within the VA.