How will the Rural Transitions Nurse Program Fail? A brainwriting - - PowerPoint PPT Presentation

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How will the Rural Transitions Nurse Program Fail?

A brainwriting premortem exercise

Heather M. Gilmartin, PhD, NP Denver Center of Innovation Department of Veterans Affairs

@ hgrnepi

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TODAY’S OBJECTIVES

Introduce the VA Rural Transitions Nurse Program

• Evidence-based implementation project

Tour through development of brainwriting premortem

• Developed for pre-implementation site visits

Present findings and next steps

• Brainwriting premortem protocol

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DISCLAIMER

• The contents of this presentation do not represent the views of

the Department of Veterans Affairs or the United States Government

• Conflicts of Interest - None

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ACKNOWLEDGEMENTS

A HUGE thank you to: Robert Burke Andrew Coy Michael Ho Lynette Kelley Emily Lawrence Chelsea Leonard Brandi Lippman Marina McCreight Ashlea Mayberry

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D&I – STAFF ENGAGEMENT

D&I strategies must be sensitive to the context in which implementation efforts occur

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VA RURAL TRANSITION NURSE PROGRAM

Nurse-led intervention to improve transitions

• f care for rural

Veterans

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PREMORTEM

[pre mawr-tuh m]

A method to identify threats and weaknesses in a project prior to implementation

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PSYCHOLOGICAL SAFETY

[sahy-kuh-loj-i-kuh l / seyf-tee]

The degree to which employees believe they will not be penalized for making errors, asking for help, or seeking feedback

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BRAINSTORMING

[breyn-stawr-ming]

Group of people gathered together to solve a problem with new ideas – a creative free for all

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BRAINWRITING

[breyn-rahy-ting]

The silent (non-verbal) written generation of ideas by a group

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BRAINWRITING PREMORTEM

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PRE-IMPLEMENTATION SITE VISITS

5 VA Hospitals 5 VA Primary Care Clinics 116 front-line clinicians Range: 4 – 26 clinicians

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PERFORMANCE

Total barriers to implementation Original Ideas Ideas that received agreement Expanded ideas

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BARRIERS IDENTIFIED

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BARRIERS ADAPTATIONS

• Improved program

materials

Transition Nurse Role Definition

• Funding for site

visits to clinics

Relationship with Primary Care Clinics

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PARTICIPANT SATISFACTION

Satisfaction with group productivity Satisfaction with work processes No fear or worry when sharing ideas No fear or worry of criticism

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FACILITATOR COMMENTS

Engaged participants

Challenging to keep them on task

Rich and ready data Team building Saw ‘aha’ moments Venting session

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SUMMARY

Socially and cognitively stimulating Respectful Study limitations -- Lack of comparison

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NEXT STEPS

Train Transition Nurses to facilitate sessions Publish findings and protocol Create training video Trial in diverse settings

Brainwriting Premortem

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REFERENCES

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THANK YOU!

Heather M. Gilmartin, PhD, NP Denver Center of Innovation - Department of Veterans Affairs Heather.gilmartin@va.gov

@ hgrnepi