A Dayton veteran required additional evaluation and care for a complex total occlusion of an artery in his heart. The Vet was referred to the Cleveland VA. I spoke with the Veteran, and he informed me that he does not qualify for Beneficiary Travel, his wife had health issues that prevented her from making the trip as a driver, and he had no other family members to assist with transportation to Cleveland. I reached out to Andrea Hooks, RN at Dayton VA Cardiology Department, in Dayton, Ohio, via TEAMS. She was covering the RN who had originally placed the consult, who was on vacation, and admitted she had not come across the process for Interfacility Consult (IFC) transportation. However, Andrea immediately went to work on this transportation issue. She reached out to the Social Worker in Dayton VA and was guided to have a Beneficiary Travel Consult placed by the physician requesting the care at Cleveland, VA. The request was denied because the Veteran was not eligible for travel. Ms. Hooks did not stop there. She expressed some frustration and reached out to the Attending requesting the higher echelon of care, and Dayton VA Chief of Cardiology for some suggestions. She reached out to the social worker, who reached out to the Dayton VA Patient Advocate for suggestions. The Patient Advocate reached out to the Mobility Manager, and it went on and on with no definite answer. Some continued to say, “He is not eligible”, and some said, “If he gets to Cleveland VA, they have to provide transportation back to Dayton.” I informed Andrea per our transportation manager; we would provide the return trip. Andrea remained in constant communication with the Veteran and me. Time was of the essence because the Veteran started to express, that his symptoms were increasing. Andrea wrote a heartfelt email to ALL party’s involved, regarding transportation. She asked for clarity with the line of care for a Veteran who is not eligible for travel benefits when the Vet requires a higher echelon of care at another VA.

In the end, Andrea came up with a plan/workaround and shared it with the physicians from Dayton VA, and Cleveland VA. Her suggestion was to happen over the weekend. Andrea was so worried the plan would fall apart and she would not be able to help the process. The physicians put Andrea’s suggestion into motion (without asking any more questions about transportation) and admitted the Veteran over the weekend. He was admitted on a Saturday to Dayton VA and was transferred Sunday afternoon to Cleveland VA. The Veterans’ procedure was the first case Monday morning. He was back home in Dayton on Tuesday, doing well. Andrea expressed her insight into the transportation system from VA to VA and will follow up on how to improve the process.

Andrea displayed ALL the ICARE values in this situation. Her tenacity to see this through to the end was evident from the beginning. She encompassed Integrity, Commitment, Advocacy, Respect, and Excellence in ensuring the Veteran was provided the best care. As a Veteran, it was humbling to see such authenticity in the care Andrea put forth, for this Veteran. I have no doubt she displays this character in all people she may meet. Mr. C may never meet Andrea face to face, but he expressed his gratitude, and his smile was worth a million dollars thanks to her. The above incident is why I believe Andrea Hook is deserving of this DAISY Award.