February 20, 2015

2014 WBRC Annual Review Available Online

Photo: Cover of the 2014 WBRC Review

The 2014 WBRC Review has just been published and is available online.  The ‘WBRC Review’ is a Fiscal Year (FY) review of the Western Blind Rehabilitation Center (WBRC) for stakeholders including former and current students, prospective students, family and caregivers, VA staff and volunteers, and anyone interested in learning about low vision and blind rehabilitation services available to Veterans and Active Duty Service Members through the VA Palo Alto Health Care System.  The FY 14 edition  includes information about the WBRC including outcome measures and demographics as well as articles about our building construction, special programs, WBRC New Faces, and how to stay up-to-date with WBRC News.  The annual fiscal year ‘Review’ will also be printed and mailed to WBRC students who attended the program during FY 14 as well as to prospective and scheduled students.  It will also be used for WBRC outreach and is available to all stakeholders online on the WBRC Website and WBRC Blog. 

CLICK HERE to view the PDF Version

CLICK HERE to view the Text Only Version

CLICK HERE to view the WBRC Website

February 19, 2015

2014 WBRC Outcomes Summary

The Western Blind Rehabilitation Center (WBRC) measures outcomes in several areas each fiscal year (FY) to ensure quality improvement and service delivery excellence. Outcome measures are collected from a variety of sources representing the WBRC's key stakeholders. This summary reflects the FY 2014 annual analysis of the WBRC outcome measures.

WBRC Admissions:
The WBRC is committed to ensuring that all eligible patients, who require blind rehabilitation training, receive access to care in a timely manner. The FY 2014 performance measure for the WBRC was to have 225 admissions. The following demographics are listed for information about the patients who attended WBRC this year.
WBRC Demographics:
Regular: 48
Computer: 46
Dual: 16
iProgram: 61
CNVR: 22
GPS: 4
Power Mobility: 12
Two Week: 4
Total: 213
Regular: 39 Days
Computer: 28 Days
Dual: 43 Days
iProgram: 21 Days
CNVR: 42 Days
GPS: 23 Days
Power Mobility: 25 Days
Two Week: 14 Days
Average Length of Stay: 29 Days

ARMD: 68
Glaucoma: 47
Diabetic Retinopathy: 21
Optic Atrophy: 15
Retinitis Pigmentosa: 14
Trauma: 14
Stroke: 4
Other: 29

World War II: 36
Pre-Korean: 2
Korean: 28
Post-Korean: 18
Vietnam: 89
Post-Vietnam: 28
Persian Gulf: 11

Teens: 1
20’s: 1
30’s: 4
40’s: 5
50’s: 29
60’s: 66
70’s: 31
80’s: 60
90’s: 16

Male: 197
Female: 16

Access to Service:
While it is imperative to provide quality care to Veterans during their stay at the WBRC, it is also important to be cognizant of those waiting to receive care. In 2012, the Access to Care Initiative: The Right Care. The Right Time. Right now, was launched and continues to be a strategic initiative to ensure that all eligible patients who require blind rehabilitation training have the opportunity to participate in WBRC programs in a timely manner. The concentrated effort by staff to streamline programs, and improve the acceptance/admission process has significantly reduced wait times. The wait list reduced from an average time of 209 days in 2012 to 27 days (end of 2014). This is a remarkable accomplishment that emphasizes our commitment for timely admissions.

Effectiveness Measures:
The WBRC developed clinically based functional assessments and innovative therapies for all disciplines in order to improve the effectiveness of treatment. The performance improvement initiatives established WBRC as the first blind center to produce outcome measures in all programs. The following is a sample of WBRC discipline specific outcome measures from FY 2014:
  • iProgram- Veterans who participate in the WBRC iProgram are surveyed on their satisfaction post-training related to the accessibility software for the iPad or iPhone. All iProgram participants in Fiscal Year 2014, reported an improved level of satisfaction in iPad or iPhone training and use. Most iProgram participants reported a decrease in perceived level of difficulty in using the iPhone or iPad.
  • Orientation & Mobility- In the area of Orientation and Mobility, low vision Veterans demonstrated improved performance for the visual detection of obstacles, hazards and drop down curbs after training. This means greater safety when traveling independently for these Veterans. Outcomes also show a reduction in falls for Veterans on ward through enhanced fall prevention measures and training for all Veterans participating in WBRC programs.
  • Visual Skills- Reading difficulty is the most common complaint among people with vision impairment. Most Veterans and Active Duty Servicemembers who entered the program in FY14 were dissatisfied with simple reading tasks and found them very difficult to complete.  Upon completion of a prescribed one-on-one training program these same individuals stated that simple reading tasks were not difficult at all and they were very satisfied with their ability.
  • Manual Skills- Veterans who participated in Manual Skills in FY 2014 reported improved ability and confidence in using tools and performing house-hold maintenance tasks.  Outcomes also showed most Veterans expressed a higher level of independence and satisfaction in activities in which they had to use their hands.
  • Living Skills– At the conclusion of Veterans’ Living Skills training, FY14 outcome measures show an increase in the Veteran’s confidence and over-all satisfaction with their ability to maintain their personal appearance including managing personal grooming and hygiene, clothing management, and eating skills. The Living Skills’ Department outcome measures have also indicated that the Veterans’ perception of difficulty with meal preparation decreases post-training.
  • Computer Access Training- Providing accessible computer training skills is a strength for the WBRC. For all four quarters in FY 2014, Veterans participated in a one-on-one, comprehensive computer access training program with amazing results. Nearly all of the Veterans participating last year expressed increased confidence, enthusiasm and skills needed to function in their own homes and other environments.
  • Rehabilitative Nursing- All patients trained by WBRC Nursing Services to use the Voice Prodigy Blood Glucose Monitor reported that it was “easy to use” at the end of training.

Satisfaction Survey Information:
The goal of the WBRC is to meet the individualized expectations of each participant and stakeholder; the WBRC uses a variety of measures to insure this including the u-SPEQ and Family Training Program (FTP) Satisfaction Survey.

Veteran Satisfaction-u-SPEQ
The goal of the WBRC is to meet the individualized expectations of each participant.  The u-SPEQ questions that are used to track satisfaction are questions, 5.1 “Would recommend to a friend?, ”5.2 “Services met my expectations”, and 5.4 “Services enabled me to do things better”.  For FY 2014 there were 93 participants and the goal of 90% was surpassed for all 3 questions:
  • 99% of participants indicated that their goals were met
  • 99% of participants stated they would recommend the program to others
  • 100% stated that services enabled them to do things better
Family Training Program (FTP) Satisfaction Survey
The WBRC provides a Family Training Program (FTP), if prescribed by the rehabilitation team, to a close family member or caregiver. The purpose of this program is to educate the participant on the implications of sight loss and the patient’s adjustment to sight loss. The family member or caregiver engages in direct individual interactions with members of the patient's treatment team. The objectives of the program are to demonstrate the new capabilities gained, provide education on prosthetic devices and specific supportive techniques, and to assist the family member or caregiver with the patient’s successful transition back to the home environment.

“This has been a wonderful experience for the both of us. It has given my husband confidence and self-assurance. It was important for him to meet other people with similar problems.” - Wife of a Veteran

“Thank you for putting a smile back on my dad's face!” - Daughter of Veteran

“Thank you so much for the care and new devices to manage his (our) life. New adventures ahead! Thank you VA. This experience was beyond what I expected. He will be back.”     - Wife of Veteran
"This experience has been a wonderful "eye" opener for me and our son who lives with us, and we both will be able to help my husband continue to utilize all the aids he has learned to use here and I know he and we will also benefit a lot. Thanks so much to everyone on the staff here at WBRC." - Wife of Veteran
"Thank you for all the WBRC staff that they are all compassionate and understanding of our situation while we are coping with the loss of my husband's eyesight. We are blessed that VA WBRC is the best government organization." - Wife of Veteran

February 11, 2015

February Construction Update: WBRC Administration Tours New Building

Photo: Members of the WBRC Administration during their recent tour of B-500.
WBRC administration had the pleasure of touring the new home of the WBRC (B-500) earlier this month.  They reported that the new space is ‘state of the art’ and will have much more room than our current building.  Some of the new features will include private bedrooms and bathrooms for inpatients, 3 large shared courtyards, a ‘green’ living roof, a greenhouse, and a bocce ball court.  
Photo: The B-500 Main Courtyard in February 2015.
At 174,000 square feet, this new facility is the largest consolidated rehabilitation center in the VA and will include 24 beds for the polytruama program, 32 beds for the blind rehabilitation program, and 12 beds for the polytruama transitional rehabilitation program. The center will also have an outpatient physical therapy/occupational therapy clinic, an outpatient physical medicine and rehabilitation clinic, and clinical programs for Operation Enduring Freedom/Operation Iraqi Freedom Veterans.
Photo: The exterior of B-500 as seen in February 2015.
Construction is anticipated to complete in Summer of 2015 with the building becoming operational in Winter of 2015.


February 5, 2015

February is Low Vision Awareness Month

Woman looking at a monitor
Photo: A WBRC Veteran learns to use a CCTV to read printed material. 
Here's eye-opening news: Currently, 4.2 million Americans ages 40 and older are visually impaired. Of these, 3 million have low vision. By 2030, when the last baby boomers turn 65, the number of Americans who have visual impairments is projected to reach 7.2 million, with 5 million having low vision.

For the millions of people who currently live or will live with low vision, the good news is there is help. Vision rehabilitation can make a big difference to a person adjusting to vision loss and should be considered a key part of a patient’s overall care.

Vision rehabilitation can include the following:
  • Training to use magnifying and adaptive devices
  • Teaching new daily living skills to remain safe and live independently
  • Developing strategies to navigate around the home and in public
  • Providing resources and support

But, what is low vision? Low vision is when even with regular glasses, contact lenses, medicine, or surgery, people have difficulty seeing, which makes everyday tasks difficult to do. Activities that used to be simple like reading the mail, shopping, cooking, and writing can become challenging.

Most people with low vision are age 65 or older. The leading causes of vision loss in older adults are age related macular degeneration, diabetic retinopathy, cataract, and glaucoma. Among younger people, vision loss is most often caused by inherited eye conditions, infectious and autoimmune eye diseases, or trauma.

For people with low vision, maximizing their remaining sight is key to helping them continue to live safe, productive, and rewarding lives.

The first step is to seek help.

For Veterans and Active Duty Service Members with vision loss there are a wide range of resources available through the VA Health Care System. The first step is contacting one of the VA’s VIST Coordinators.

The Visual Impairment Services Team (VIST) Coordinators are case managers who have responsibility for the coordination of services for visually impaired Veterans and active duty Service Members.  VIST coordinator duties include providing and/or arranging the provision of appropriate treatment in order to enhance functioning such as making referrals to Blind Rehabilitation Centers, Blind Rehabilitation Outpatient Services, VICTORS, VISOR, and low vision clinics.  Other VIST coordinator duties include identifying newly identified individuals who have severely disabling visual impairment, providing counseling, problem resolution, arranging a review of benefits and needed services, and conducting educational and outreach programs relating to VIST and blindness.

Veterans and eligible active duty Service Members should contact the VIST Coordinator in the VA facility nearest their home or by contacting the Blind Rehabilitation Service Program office at 202-461-7317. 

The VAPAHCS VIST Website is also an excellent resource and can be viewed by CLICKING HERE.