Identifying Barriers and Facilitators to Veterans Affairs Whole Health Integration Using the Updated Consolidated Framework for Implementation Research

被引:0
作者
Kimpel, Christine C. [1 ]
Myer, Elizabeth Allen [2 ]
Cupples, Anagha [3 ]
Jones, Joanne Roman [4 ]
Seidler, Katie J. [2 ]
Rick, Chelsea K. [5 ]
Brown, Rebecca [6 ,7 ]
Rawlins, Caitlin [8 ,9 ]
Hadler, Rachel [10 ,11 ]
Tsivitse, Emily [12 ]
Lawlor, Mary Ann C. [13 ]
Ratcliff, Amy [14 ]
Holt, Natalie R. [14 ]
Callaway-Lane, Carol [15 ,16 ]
Godwin, Kyler [17 ,18 ,19 ]
Ecker, Anthony H. [20 ]
机构
[1] Vanderbilt Univ, Med Ctr, Sch Nursing, Nashville, TN 37235 USA
[2] VA Qual Scholars Program, Durham, NC USA
[3] Atlanta VA Qual Scholars Program, Atlanta, GA USA
[4] Univ Massachusetts, Manning Coll Nursing & Hlth Sci, Boston, MA USA
[5] Vanderbilt Univ, Med Ctr, Div Geriatr Med, Nashville, TN USA
[6] Minneapolis Vet Affairs Healthcare Syst, Minneapolis Adapt Design & Engn Program MADE, Ctr Care Delivery & Outcomes Res CCDOR, Minneapolis, MN USA
[7] Univ Minnesota, Sch Nursing, Minneapolis, MN USA
[8] Vet Hlth Adm VHA Innovat Ecosyst, Washington, DC USA
[9] Off Healthcare Innovat & Learning, Washington, DC USA
[10] Emory Univ, Sch Med, Dept Anesthesiol, Atlanta, GA USA
[11] Emory Univ, Sch Med, Dept Family & Prevent Med, Atlanta, GA USA
[12] Case Western Reserve Univ, Frances Payne Bolton Sch Nursing, Cleveland, OH USA
[13] Robert Wood Johnson Fdn, Princeton, NJ USA
[14] Tennessee Valley Healthcare Syst, VA Qual Scholars program, Nashville, TN USA
[15] Nashville VA Qual Scholars Program, Nashville, TN USA
[16] Tennessee Valley Healthcare Syst, US Dept Vet Affairs, Lung Canc Screening Program, Nashville, TN USA
[17] Michael DeBakey Dept Vet Affairs Med Ctr, Ctr Innovat Qual Effectiveness & Safety, Implementat & Innovat Program, Houston, TX USA
[18] VA Qual Scholars Coordinating Ctr, Houston, TX USA
[19] Baylor Coll Med, Dept Med, Houston, TX USA
[20] Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX USA
基金
美国医疗保健研究与质量局;
关键词
whole health; Veterans affairs; quality improvement; CFIR; QUALITY SCHOLARS; IMPROVEMENT;
D O I
10.1097/JHQ.0000000000000419
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background:Veterans Affairs (VA) implemented the Veteran-centered Whole Health System initiative across VA sites with approaches to implementation varying by site.Purpose:Using the Consolidated Framework for Implementation Research (CFIR), we aimed to synthesize systemic barriers and facilitators to Veteran use with the initiative. Relevance to healthcare quality, systematic comparison of implementation procedures across a national healthcare system provides a comprehensive portrait of strengths and opportunities for improvement.Methods:Advanced fellows from 11 VA Quality Scholars sites performed the initial data collection, and the final report includes CFIR-organized results from six sites.Results:Key innovation findings included cost, complexity, offerings, and accessibility. Inner setting barriers and facilitators included relational connections and communication, compatibility, structure and resources, learning centeredness, and information and knowledge access. Finally, results regarding individuals included innovation deliverers, implementation leaders and team, and individual capability, opportunity, and motivation to implement and deliver whole health care.Discussion and implications:Examination of barriers and facilitators suggest that Whole Health coaches are key components of implementation and help to facilitate communication, relationship building, and knowledge access for Veterans and VA employees. Continuous evaluation and improvement of implementation procedures at each site is also recommended.
引用
收藏
页码:137 / 149
页数:13
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