A Quality Improvement Initiative for Designing and Implementing a Military Service Screening Tool for a Community Emergency Department.

Journal Article (Journal Article)


Veterans eligible for health care in the Veterans Administration (VA) health system often receive care in community emergency Departments. In line with initiatives from Joining Forces and the American Academy of Nursing, emergency departments have an opportunity to screen for veterans during routine ED visits and provide resource information regarding various VA services.


Our aims were to design and implement a screening process to identify veterans during an ED visit, notify ED providers of veteran status, and develop a Veteran Resource Guide to be distributed at the time of discharge. We embedded the mandatory question, "Have you ever served in the military?" in the electronic medical record (EMR). This question was asked of all patients 18 years and older.


During an 80-day period, we screened 9364 patients and identified 415 veterans who would not be known to the providers using standard methods. We were able to deliver the Veteran Resource Guide to 77 of the 277 veterans discharged home.

Implications for practice

The addition of the mandatory question about military service to the EMR during the primary care assessment successfully identified veterans who presented for care in a community emergency department. Future initiatives should include automated processes to ensure that the Veteran Resource Guide is provided and to foster collaboration between community emergency departments and the VA.

Full Text

Duke Authors

Cited Authors

  • Merkl, MA; Tanabe, P; Sverha, JP; Turner, B

Published Date

  • September 2016

Published In

Volume / Issue

  • 42 / 5

Start / End Page

  • 400 - 407

PubMed ID

  • 27033335

Electronic International Standard Serial Number (EISSN)

  • 1527-2966

International Standard Serial Number (ISSN)

  • 0099-1767

Digital Object Identifier (DOI)

  • 10.1016/j.jen.2015.11.009


  • eng