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.

Using Strategic Communication to Transform Veterans’ Relationship with VA

The U.S. Department of Veterans Affairs (VA) is undergoing modernization and transformation to improve care and service delivery for Veterans. Through the myVA campaign, launched in 2016, VA embarked on a journey to change the way Veterans interact with the Department by putting them in charge of how, when, and where they are served.

We partnered with VA to help tackle this undertaking through a robust communications and organization change management effort focused on the internal adoption and implementation of myVA. To ensure the VA workforce and stakeholders were aware of their vital role in the campaign, we developed an integrated communications and engagement plan. This plan contained robust strategic communications tactics, including developing audience segmentation reports, conducting online behavior analyses and communication channel assessments, and testing messages with specific audiences.

As part of the plan, we attended key VA leadership meetings to understand the latest campaign messaging and prepared leadership for important engagements by working with them on strategy. We also created communication materials to ensure optimal message impact with the intended audience. For instance, our expert team hosted virtual training workshops and provided PowerPoint briefings, posters, newsletters, brochures, talking points, fact sheets, infographics, motion graphics, videos and online content to aide in the dissemination of campaign messaging. These materials focused on how VA engaged and impacted Veterans and employees and were delivered through an omni-channel approach, including in-person at town halls and online via VA social media platforms and intranet sites. The monthly campaign cadence integrated communications and information products that contained ten pieces of content, seven communications products, and three videos.

In addition, we established and managed central channels to communicate VA messages. This involved researching, cataloging and analyzing a list of VA communication channels and conducting message testing to assess audience understanding and use of the information. It also included media engagement and social media support and creating a landing page on the VA intranet that housed key information on myVA.

We also established clear communication metrics to monitor reach, effectiveness, and impact; efficacy of existing and new tools; and refine communication strategies. This review was used to develop a road map on ways to further evolve and expand the reach and influence of internal communications within VA.

Our communications efforts continue to bring employee awareness and support, as MyVA evolved into the broader Choose VA campaign. We built a replicable internal and external communications process that VA could maintain so it could continue to articulate its status and achievements to Veterans, employees, and the public in a way that promoted engagement and action.

Promoting Healthcare Innovations throughout VHA Network

The Veterans Health Administration (VHA) Innovation Ecosystem is an outcome-driven operating model that fosters new innovations and allows them to scale throughout the VHA, beyond any one team or health system. It empowers employees, builds trust within the Veteran community, and transforms VHA into a high-reliability organization driven by value-based principles.

To support the ongoing success of the Innovation Ecosystem, we provided VHA with strategy development, program and project management expertise, human-centered design, stakeholder engagement services, and enterprise-level organizational change management.

Through our forward-thinking design process, we guided VHA in integrating two programs for fostering and spreading innovative improvements – the Diffusion of Excellence Initiative and the VHA Innovators Network – under the VHA Innovation Ecosystem. We also provided policy support to facilitate the national rollout of practices selected through Ecosystem programs.

To assess success and impact of innovation diffusion at an enterprise-level, we designed a long-term strategy to enable the institutionalization of diffusion as an efficient mechanism for the identification and implementation of best practices, including incentives and performance requirements. In order to implement this strategy, we developed training materials focusing on developing innovation competencies to train Innovation Specialists.

We also built multiple transformative communications campaigns to raise awareness of the Ecosystem and how it is helping to drive innovation that is changing the lives of Veterans, caregivers, and employees.  For instance, we developed conference, event, and planning objectives to engage and motivate employees, build public support and trust, and enable industry adoption of VHA best practices. These campaigns included conference/event branding; product creation; stakeholder engagement; logo, template, banner, and graphics development; and hundreds of communications materials (e.g., speeches, presentations and templates).

In August 2018, the Ecosystem held its largest event– the VHA Innovation Experience. The event featured keynote speaker Toby Cosgrove, Executive Advisor for Healthcare and Life Science at Google Cloud and former President and CEO of the Cleveland clinic. It covered topics ranging from suicide prevention to mobile health technology. It also included demos from almost 100 frontline employees across VHA, where they showcased their efforts in innovation and transformation, and talks that showcased inspiring stories from employees.

We promoted and supported audience engagement at the event – and nationwide−through mainstream and social media platforms, including Twitter, Facebook, and YouTube. Twitter posts achieved a total of 48,900 impressions, with the event-specific hashtag #VHAIE reaching more than two million users through approximately 1,200 posts. We also supported VHA in achieving their goal of gaining online, print, and radio coverage across mainstream outlets, which included eight local news outlets, online, print, and radio coverage on Federal News Radio, FierceHealthcare, and Daily Nurse; and Veteran-specific outlets, including Connecting Vets and Task & Purpose. Additionally, we produced video footage of event sessions and topic-specific presentation tracks. The event was such a success that it is serving as a blueprint for future events aimed at fostering a culture of continuous learning across VHA.