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Identification and PTSD Screening of Military Veteran Patients in Community Healthcare: A Quality Improvement Project

Background: Military veterans are at an increased risk for post-traumatic stress disorder (PTSD) related to their prior military service. Establishing veteran status of patients cared for in civilian healthcare and screening for PTSD will increase the likelihood of identifying symptoms and prompt appropriate treatment. Purpose: The focus of this project is to increase practitioner awareness and knowledge of PTSD in veteran patients as well as to identify and screen veteran patients for PTSD symptoms utilizing the primary care PTSD screen (PC-PTSD). Method: To determine veteran status, patients over the age of 18 years in an internal medicine clinic will be asked during their appointment check-in if they have ever served in the military. Identified veteran patients will be handed a questionnaire with the PC-PTSD screen to fill out and bring into their exam. Analysis and discussion of the PC-PTSD results by providers will reveal risk for PTSD and identify if further treatment or intervention is warranted. Results: Fifteen providers and staff attended the education presentation and eight completed the pre/post-presentation questionnaire. Post-presentation, the questionnaires revealed an increase in knowledge from 90% to 100%. After the intervention was completed, 34 veterans were identified from the total 1434 patients seen during the 30-day implementation timeframe, with one veteran screening positive for PTSD. This reveals 1-2 veteran patients are coming to the clinic per day. Clinical Implication: Identifying patient veteran status will reveal PTSD symptomology that may have otherwise gone unrecognized or overlooked. Identifying even one veteran suffering from PTSD can lead to positive patient outcomes. A sustainable systemic approach to identifying and screening veterans for PTSD in civilian primary care is necessary to thoroughly and holistically care for this vulnerable population.