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Nurse researcher Emily Boltey is the second consecutive patient safety fellow from VA Pittsburgh Healthcare System (VAPHS) to win the Gold Capstone Award for their fellowship project. VA’s

National Center for Patient Safety presents the annual awards as part of a program to foster and recognize innovative projects that help advance the quality and safety of care to Veterans.

Boltey, a doctorate level critical care nurse, said the project will help ensure more Veterans with congestive heart failure are referred for palliative care. “We hope to test what we

learned with other cardiology providers to ensure all Veterans in need of palliative care services are identified and referred to palliative care services appropriately,” said Boltey.

Palliative care is given to improve the quality of life of patients who have a serious or life-threatening disease. It is an approach to care that addresses the person as a whole, not just

their disease. VA Pittsburgh has been pioneering approaches to palliative care based on whole health principals that also look at a Veteran’s quality of life and life goals. Early in her

fellowship, Boltey had spoken to VA Pittsburgh’s chief of hospice and palliative care and its palliative care coordinator to see where there is a need for more targeted care. Together they

saw there was a gap in the use of outpatient palliative care services in cardiology. “We focused on identifying Veterans with congestive heart failure who could benefit from palliative care

services because this patient population is a high-risk group cared for by cardiology,” said Boltey. VA Pittsburgh’s capstone project was an interdisciplinary and interprofessional team

effort, said Boltey. Project team members included: * Marilyn Bell, CNS, CRNP, an advanced practice nurse who presides over an outpatient specialty heart failure clinic. * Christine

Pruszynski, CRNP, a nurse practitioner for palliative care who provides outpatient palliative care services to Veterans. * Dr. Gavin Hickey, director of heart failure services. * Dr. Sandra

Blakowski, chief of hospice and palliative care. * Deborah Goral, palliative care coordinator. * Jamie Estock, co-director of VAPHS’s Advanced Fellowship in Patient Safety and a human

factors scientist with expertise in quality improvement. * Dr. Dave Eibling, co-director of VAPHS’s Advanced Fellowship in Patient Safety. Every team member was involved in the design and

evaluation of the project, said Boltey. Bell implemented the process-change in her clinic to increase referrals to outpatient palliative care services among Veterans with congestive heart

failure. Eibling said the back-to-back awards show VA Pittsburgh is a leader in patient safety fellowship programs. He noted VA Pittsburgh received the top two awards in 2021 (Gold and

Silver), along with a Gold award this year. “This year we are particularly fortunate in that not only did Emily Boltey win the top prize, but she was also selected to serve as an advanced

fellow in the VA Pittsburgh simulation fellowship this coming year,” said Eibling. “We are overjoyed that she will be remaining with VA Pittsburgh.” Confirming she will continue her training

at VA Pittsburgh, Boltey said the fellowship provides invaluable mentorship and the opportunity to work with an interdisciplinary team of clinicians committed to improving processes to

ensure Veterans receive the highest quality of care.