Creating a High Reliability Organization at VEO

The Veterans Experience Office (VEO) has an opportunity to enhance the reliability of Veteran experiences across VA, increase the effectiveness of integrated project teams, and improve other areas of health care service delivery. It is taking advantage of this opportunity by working to build trusting, life-long relationships with Veterans, their families, caregivers and supporters.

Female carer helping disabled senior man to get up from wheelchair at care home

We supported VEO in this effort through helping the office 1) understand and support Veterans’ experiences and 2) develop and implement programs to enhance that experience.

Choose Home is one of those programs. We partnered with VEO to launch the program that empowers facilities and external caregivers to coordinate and deliver a customized, home-based suite of services and programs. Through the Choose Home initiative, we improved outcomes and decreased the need for institutional care for Veterans who are aging or have complex care needs, developed a better client service model, and improved customer access. We achieved these results by streamlining processes for navigating, coordinating, and receiving VA and community-based care and services for Veterans, family members and caregivers.

We reviewed and revised the VA-wide Service Recovery process. This work included providing industry-level expertise to VA to allow for a streamlined modernization effort and enterprise implementation of the program. In order to identify major improvement opportunities, our program/project management capabilities enabled us to analyze the current state of service delivery, service recovery processes, organizational structures, data, and information. We identified a balanced set of high reliability goals, objectives and definitions. We developed continuous process improvement and root cause analysis processes and potential solutions. We also identified key performance indicators/critical success factors for a variety of service recovery and patient experience goals.

Additionally, we supported VEO in the following ways, among others:

  • Established the VA Outreach Council/ Integrated Project Team to identify promising practices, create streamlined processes and roll out consistent outreach strategies VA-wide.
  • Led the development of communications materials (briefings and infographics) for the White House, Congress, VA leadership, VA staff and Veterans to increase understanding of, and participation in, VEO initiatives and activities.
  • Developed and implemented a communications strategy and plan to ensure effective VHA-wide implementation of Patient Experience initiatives, which strive to support VA medical centers in delivering excellent patient experience.
  • Created a stakeholder coordination plan for the Vet360 major initiative, which streamlines the Veteran experience by integrating the data silos for all common Veteran information across VA information technology platforms.

Assessing Women’s Care at VA Medical Centers

The U.S. Department of Veterans Affairs (VA) is working to provide better care to women Veterans at its medical centers. We supported VA in this endeavor through a thorough assessment of care delivery.

We used our extensive health care industry knowledge and expertise to evaluate care at each VA medical center (VAMC). We collected quantitative and qualitative data to identify and document trends, opportunities, and recommendations for quality improvement. Our team assessed primary care, mental health, inpatient, and specialty services; process documentation and clinical care pathways; care coordination; women’s health program structure, oversight, and leadership support; outreach and communication; academic affiliations; education and training; and facility culture and environments of care. Our research included in-depth interviews, document and policy reviews, review of quantitative data sources, facility tours, and case-based clinical discussions.

By coordinating the data from 140 VAMCs, we built a national-level database that allows for broader analyses and opportunities to share best practices. In respond to the identified opportunities for improvement, we developed a Women’s Health Evaluation Based Quality Improvement (EBQI) initiative to develop tailored quality improvement action plans and provide intensive technical assistance (TA) at select VAMCs. Using our unique experience in health care analytics and regulatory compliance, we were also able to promote compliance with VHA Women’s Health program directives and standards and industry best practices.

There are a rising number of women Veterans and the outcomes of this assessment will continue to support women’s health services, outreach, and care. For one, the assessment increased the exposure of health programs, so VA can better meet women’s unique health needs.

Modernizing VA with VA’s Modernization Office

Uniformed Soldier With Amputee Leg Alone In Bunker

The mission of the Department of Veterans Affairs (VA) Modernization Office is to transform VA into a modern, high-performing organization that simplifies VA operations and improves service delivery to Veterans. To help VA in this effort, we partnered with VA’s Modernization Office on enterprise-level, cross-department priority initiatives designed to improve VA’s infrastructure, operations, and customer service. We provided VA with strategic advisory, programmatic, and implementation support on these initiatives.

  • We stood-up the Transformation Program Office and established programmatic rigor through program concepts of operations, dependency matrices, and enterprise risk registries. We deployed a repeatable risk, issue, and action item management approach focused on proactive identification and mitigation of technical and business integration. We developed an assessment model that identifies and analyzes the courses of actions and recommendations through the lens of project scope, budget, risks, benefits and schedule. The team defined the decision-making process that is driven by the Leadership Integration Forum to allow for escalation of risks, issues and recommendations. These activities ensured program planning success in the future and proper reporting and decision-making by the Deputy Secretary of VA in the VA Modernization Board.
  • We established and stood-up a change management service offering as part of the modernization portfolio and capability set. We developed change management with VA leaders through Prosci toolkits. The change management services ranged from providing high-level change assessment and advisement to full change implementation support for customers across the Veterans Health Administration (VHA), Veterans Benefits Administration and Board of Veterans’ Appeals. This included change management support across VA priority initiatives, such as Electronic Health Record Modernization (EHRM), VA Logistics Redesign, and Financial Management Business Transformation (FMBT). In addition, we also built internal capability within the Modernization Office though training sessions, shadowing, and Community of Practice activities.
  • We leveraged expertise in systems thinking. We did this work through evaluating business processes, business architectures, program requirements, and milestones/ sequencing plans for three Enterprise Resource Planning system deployments – acquisitions (Defense Medical Logistics Standard Support), FMBT, and EHRM – to assist in developing a digital integration strategy. We established a Leadership Integration Forum (LIF), Systems Integration Working Group, and Business Process Improvement working group to address the integration of priority initiative schedules, requirements, risks/issues, dependencies, constraints, strategic communications, change management efforts, training plans, and interfaces, etc. The team developed the charter and concept of operations for LIF, coordinated integration activities and ensured cross-initiative engagement between enterprise modernization initiative.
  • We created and implemented a communications and engagement strategy with the development of a Modernization brand. This strategy was executed in order to communicate the achievements, benefits, and current status of the modernization effort at VA. We created a modernization brand and brand strategy: the logo, theme line, and messaging. We built a modernization website and strategy: design & layout, copy & content, code development, launch strategy, and maintenance/LOE plan. Additionally, we provided strategic communications and enterprise change management services through the development of external stakeholder briefings, brochures, fact sheets, and infographics; application of the ProsciTM change management framework; and Ted Talk-like videos.
  • We developed and contributed to more than three strategic planning documents focused on VHA Health Care for MISSION Act, VA Modernization, and GAO’s High Risk List. We built a structure and feedback loop between the internal and external stakeholders of the VA. This required the development of a strategic plan – a report to Congress regarding how VHA plans to meet Veteran health care needs in the coming years. The report described anticipated Veteran demand for health care services based on Veteran demographics, incidence and prevalence of disease, reliance on VHA, and emerging health care trends. The report presented current health care facility capacity and presented a new integrated health care delivery model and approach for meeting Veteran needs. The team designed the report, guided and wrote significant sections, developed a journey map illustrating how a Veteran would move through the new model, and created a roadmap for implementation of the new model, with key milestones and timeframes.