Resource Center

The Louis Stokes Cleveland VA Medical Center is "Transforming Out-Patient Care" (TOPC) by creating and enabling physicians, nurse practitioners and associated health learners to lead and participate in patient-centered interprofessional teams. The mission recognizes the importance of a comprehensive care model and the need for care transitions across venues (e.g. coordination of acute care to out-patient environment). The site has developed a competency based curriculum to support this model guided by CoEPCE/enterprise core domains. Cleveland also identified six critical dimensions to guide curriculum development: Culture and Health Care, Proactive Care, Quality Care Improvement, Real-time Real-Patient, Unified Care, and Virtual Health Care. Cleveland has also incorporated a year-long Nurse Practitioner Residency program.

Program Highlights

Culture of Health Care Dimension - By developing the mindful practitioner, this dimension strives to increase the overall awareness of the COE Learners. Reflective and adaptive reasoning exercises occur both in clinical and non-traditional settings.

Proactive Care Dimension - Underscores the principle that ultimately the patient is in charge of his or her health and prepares trainees to support and empower the patient to drive their health care.

Real-Time Real-Patient Dimension - This longitudinal curriculum recognizes the patient as a valuable mentor through structuring reflection activities around workplace learning, focusing on the patient's experiences. Patient journeys and Patient Video recordings are the two main learning components comprising this dimension.

Quality Care Improvement Dimension - Emphasizes systems thinking and improvement to delivery of care to provide patients with continuous quality care. Panel Management sessions are also utilized under this dimension.

Unified Care Dimension - Conceptually emphasizes a unified health model where all participants including the patient have common goals and shared understanding. This emphasizes coordination of outpatient care with other components of healthcare such as specialists and inpatient care.

Virtual Health Care Dimension - Non-traditional methods beyond the face-to-face visit deliver quality care, such as Specialty Care Access Network (SCAN) & Extension of Community Health Outcomes (ECHO) VISN10 network Clinics, along with the utilization of telehealth assistive technology devices.