The VA Polytrauma System of Care: Serving those who served with multiple disabilities

The types of care the VA provides to returning veterans are reviewed.

By Erin E. Andrews, PsyD

The Veterans Health Administration developed the Polytrauma System of Care in 2004 in order to respond to the multiple and complex injuries sustained by veterans of Operations Enduring Freedom, Iraqi Freedom and New Dawn (the recent and current conflicts in Afghanistan and Iraq). Because of the nature of warfare, which includes blasts from improvised explosive devices and rocket propelled grenades, coupled with improvements in protective gear and rapid medical response in the field, more service members survive serious injuries sustained in combat than ever before. However, they are often left with significant physical, cognitive and psychological disabilities. 

The VA Polytrauma System of Care aims to provide comprehensive, high-quality and interdisciplinary care to veterans who have sustained injuries to multiple body systems. Some of the most common diagnoses are traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), amputation and chronic pain, including musculoskeletal and headache pain. 

There are five Polytrauma Rehabilitation Centers (PRCs), which are co-located on the same VA medical campus the five Polytrauma Transitional Rehabilitation Programs (PTRP). The PRCs, located in Tampa, Fla., Richmond, Va., Minneapolis, San Antonio and Palo Alto, Calif., provide acute, comprehensive, inpatient rehabilitation and serve as consultants to other VA facilities. The PTRPs offer structured residential rehabilitation with a focus on progressive return to independent living. These programs serve the most severely injured veterans.

Acute rehabilitation services provided at the PRCs is the first step in the journey toward recovery for veterans with severe injuries. The next step is often one of the 23 Polytrauma Network Sites (PNS), located throughout the United States. The PNSs offer continued medical care and rehabilitation services for veterans and service members who are transitioning closer to home following discharge from a PRC. PNS programs are also the entry point for rehabilitation services for those who have experienced a mild-moderate TBI or polytraumatic injury. 

There are 87 Polytrauma Support Clinic Teams (PSCT) located in VA medical centers across the country. The PSCTs provide continued, specialized outpatient care in coordination with their PNS, PSCTs may offer continued medical and rehabilitation care and support closer to your home community. VA Polytrauma Points of Contact are available at 39 VA medical centers without specialized rehabilitation teams, but are knowledgeable about the VA Polytrauma System of Care and coordinate case management and referrals locally.

Integrated care makes the most sense for veterans dealing with multiple disabilities. Interdisciplinary teams in the VA Polytrauma System of Care collaborate to develop comprehensive treatment plans and share knowledge in order to provide high levels of state-of-the-art care. Psychology plays an important role of these teams. Neuropsychologists provide assessment of cognitive functioning and are able to offer recommendations for rehabilitation, including cognitive remediation and compensatory techniques. Rehabilitation psychologists often provide such intervention and assist veterans in adapting to their injuries and coping with limitations, and provide support to families and caretakers. Other psychologists, such as those specializing in psychological trauma, often participate in the treatment and care of veterans with polytrauma. Psychologists in the VA Polytrauma System of Care are frequently team leaders, and have program and outcome evaluation responsibilities.

The VA Polytrauma System of Care is an exciting innovation with important roles for psychologists. You can learn more about this type of care on the United States Department of Veterans Affairs website.