Veterans Affairs Hailed as ‘Bright Spot’ in ALS Care

SAVANNAH, GEORGIA — Teamwork and interdisciplinary collaboration create an effective system of care for children amyotrophic lateral sclerosis Achieving better health (ALS) is possible for both patients and clinicians, an expert has said.

In his general assembly speech on October 17 American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) 2024Ileana Howard, MD, medical co-director of the ALS Center of Excellence at the VA Puget Sound in Seattle, said in a recently published National Academies report: “Living with ALS” He cited the Veterans Administration as “a bright spot in the ALS care landscape for its interdisciplinary, holistic, and proactive approach to care.”

Since the early 2000s and the publication of several studies linking active military service to ALS, the U.S. Department of Veterans Affairs (VA) opened an ALS registry, a tissue and brain biobank, and in 2008 granted 100% probable service linkage to any ALS registry. said one person who served more than 90 days of active duty and was later diagnosed with ALS.

“We currently serve approximately 4,000 ALS veterans systemwide and count 47 fully interdisciplinary clinics at the VA nationwide; ALS coordinators are assigned to all 170 VA facilities, regardless of whether an ALS clinic is the closest ALS facility available to patients and their families to meet their needs.” “A guide to identify the clinic.”

Multidisciplinary and Interdisciplinary

Howard emphasized that interdisciplinary collaboration is essential to maintaining an effective system. He pointed out that the term “multidisciplinary” is no longer valid for teams working independently but in parallel on the same topic.

In contrast, interdisciplinary teams integrate their assessments into a coherent care plan, while interdisciplinary teams take this further by combining both their assessments and care plans, allowing for more intentional overlap.

He said the VA’s ALS manual lists about 20 essential clinicians for a VA ALS clinic, including recreational therapists, assistive technologists and senior assistance service workers who will help administer disability benefits.

The essence of this collaboration is “role sharing”, which deliberately blurs the boundaries between disciplines. “The future of our field of expertise depends on effective and dedicated collaboration,” he said.

Howard encouraged ALS healthcare providers to move away from outdated terminology based on hierarchical team models and break down silos that no longer benefit either patients or care teams.

He noted that teamwork can improve patient outcomes and overall health, but is also associated with better health among healthcare providers. He said it is well known that neurologists and physical therapists are among the specialties with the highest burnout rates, and ALS teams in particular experience significant levels of stress and burnout.

Better Together

A. latest Canadian study Survey on resilience and burnout in ALS clinics surveyed a wide range of practitioners in ALS centers and found that participants benefited from resilience through relationships with patients and colleagues, and a strongly expressed desire for increased resources, team building/debriefing, and formal training on emotional issues . fatigue and burnout.

“A consistent theme was the lack of adequate allied health supports (nursing, social work, occupational therapy) to meet patients’ complex needs,” said the report’s senior author, Kerri Lynn Schellenberg, medical director of ALS/Motor Neurone Diseases. Clinical and associate professor at the University of Saskatchewan School of Medicine in Saskatoon, Saskatchewan, Canada.

“The majority of participants felt they would benefit from more consistent team-building exercises and debriefings,” the authors said.

Schellenberg agreed, emphasizing that care teams perform best when there is mutual appreciation and support among members. By learning from each other and reaching consensus together, the care plan draws on the collective expertise of the team. “We are stronger together,” he said.

Howard and Schellenberg did not report any statements.