Mapping the reach of a rural Transitions Nurse Program for veterans with geographic information systems

Rural Veterans who receive inpatient care at a Veterans Health Administration (VA) tertiary facility can face significant barriers to a safe transition home. The VA rural Transitions Nurse Program (TNP) is a national, intensive care coordination quality improvement program for rural Veterans. To communicate the reach of TNP into rural communities, we developed geographic information system (GIS) maps. This study evaluated TNP transitions nurse and site champion perceptions of GIS as a communication tool for illustrating the reach of TNP into rural communities. Using residence information for TNP enrollees, we built GIS maps using ArcGIS Enterprise, a mapping and analytics platform. Residential addresses were matched to Rural-Urban Commuting Area geographical categories. Transitions nurse and site champion perceptions of the local and national GIS maps were assessed through surveys and interviews. The data were analyzed using descriptive and content analytic methods to identify themes. Transitions nurses and site champions perceived GIS maps as a valuable, easy to understand, acceptable, and appropriate communication tool to illustrate the reach of TNP into rural communities. Interviews revealed three common themes: a picture is worth a thousand words, the GIS maps are an effective communication tool, and the GIS maps revealed surprising and promising information. GIS is a useful communication tool to support to illustrate the reach of an intervention. The GIS maps engaged transitions nurses and site champions in discussion. The availability of open access software programs and publicly available location data will increase access to GIS for researchers and practitioners.