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

1 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

TODAY’S OBJECTIVES 2 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

DISCLAIMER 3  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

ACKNOWLEDGEMENTS 4 A HUGE thank you to: Chelsea Leonard Robert Burke Brandi Lippman Andrew Coy Marina McCreight Michael Ho Ashlea Mayberry Lynette Kelley Emily Lawrence

D&I – STAFF ENGAGEMENT 5 D&I strategies must be sensitive to the context in which implementation efforts occur

6 VA RURAL TRANSITION NURSE PROGRAM Nurse-led intervention to improve transitions of care for rural Veterans

PREMORTEM 7 [pre mawr- tuh m] A method to identify threats and weaknesses in a project prior to implementation

PSYCHOLOGICAL SAFETY 8 [sahy-k uh -loj-i-k uh l / seyf-tee] The degree to which employees believe they will not be penalized for making errors, asking for help, or seeking feedback

BRAINSTORMING 9 [breyn-stawr-ming] Group of people gathered together to solve a problem with new ideas – a creative free for all

BRAINWRITING 10 [breyn-rahy-ting] The silent (non-verbal) written generation of ideas by a group

BRAINWRITING PREMORTEM 11

12 PRE-IMPLEMENTATION SITE VISITS 5 VA Hospitals 5 VA Primary Care Clinics 116 front-line clinicians Range: 4 – 26 clinicians

PERFORMANCE 13 Total barriers to implementation Original Ideas Ideas that received agreement Expanded ideas

BARRIERS IDENTIFIED 14

BARRIERS ADAPTATIONS 15 • Improved program Transition Nurse Role Definition materials Relationship with • Funding for site Primary Care visits to clinics Clinics

PARTICIPANT SATISFACTION 16 Satisfaction with group productivity Satisfaction with work processes No fear or worry when sharing ideas No fear or worry of criticism

FACILITATOR COMMENTS 17 Engaged participants Saw ‘aha’ Challenging to keep them on task moments Rich and ready Team building Venting session data

SUMMARY 18 Socially and cognitively stimulating Respectful Study limitations -- Lack of comparison

NEXT STEPS 19 Trial in diverse Create settings training Publish video findings and Train protocol Transition Brainwriting Nurses to Premortem facilitate sessions

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21 THANK YOU! Heather M. Gilmartin, PhD, NP Denver Center of Innovation - Department of Veterans Affairs Heather.gilmartin@va.gov @ hgrnepi