1315 Improving Access to Nightmare Therapy: A QI Initiative for Veterans
Sleep May 1, 2025 Lefulesele Kholoane, Roberta Jacobs, Nichole Mogharreban et al.
A quality improvement project at a Veterans Affairs sleep clinic evaluated whether a group format for narrative-enhanced imagery rehearsal therapy (N-IRT) could improve access to nightmare treatment for US Veterans. After revising triage workflows and eligibility criteria, wait times for individual sleep psychologist appointments dropped from 79.3 days in January 2024 to 28.9 days by March 2024. However, group utilization remained low: between September and October 2024, only 4 of 20 referred patients attended group N-IRT. Barriers included scheduling conflicts, medical complexity, and patient preference for individual care. The authors argue that multiple interventions and patient and provider education are needed to overcome these barriers.