Dissemination of a Care Collaboration Project
Although the evaluation is an essential component to tracking project impact and should be carried out in some form, it is recognized that not all facilities will need or want to conduct such a structured and time-intensive evaluation. In this case, evaluation included before-and-after presentation feedback forms and a telephone call 3 to 6 months after attendance.
Immediately following the presentation, participants were asked to rerate their VA-specific knowledge and identify the presentation elements they found most important. At the 3-month follow-up call, attendees were asked to give feedback about any situations in which they had comanaged care with VA, explain how any interactions had gone, and discuss whether they used any of the printed handouts. As of February 28, 2015, 101 presentations were made to more than 1,700 individuals. A total of 1,183 feedback forms (598 before and 585 after) were returned. The results showed a dramatic increase in self-rated knowledge of VA-specific topics and procedures (Table 2). Open-ended comments articulated appreciation for the VA teams’ willingness to openly share information, respectfully hear concerns from the community, and proactively work to improve care for veteran patients.
Presentation demeanor is very important but has some flexibility. The presenter does not have to be a seasoned public speaker. However, the presenter should adopt an unassuming, genuine, open stance and be willing to hear comments and criticisms in a gracious way. In those cases where a participant shares a bad experience in dealing with VA, the presenter must assure the speaker that the intention is to improve collaboration.
Green Lights
Event scheduling and identification of potential presentation sites was largely left up to the local VAMC and CBOC teams. Methods included contacting nearby health care facilities, leveraging existing professional and personal relationships, and targeting community facilities that were known to treat veterans. The status of presentations was reviewed at each team meeting. Finding the time to schedule and arrange presentations was difficult for many of the teams. The core project team enlisted the help of the Geospatial Outcomes Division at the Malcom Randall VAMC in Gainesville, Florida, to use geographic information system technology to create a list of facilities in the area of each VAMC. This allowed the teams to further target potential attendees.
Various other tasks were still noteworthy in their significance to the project’s success in VISN 1. The VISN 1 Care Collaboration project required portable projectors for each team. Funds for the projectors were sent to each participating facility to procure the projector locally. Salary support funding was sent to each participating VAMC to allow overtime as needed for presentations. Funding was also sent to each medical center to cover travel expenses related to project activities. Printing of presentation booklets was handled centrally, using the GPOExpress program, which allows printing at any FedEx office location and provides deep discounts for printed products. The ability to print on demand to a remote location with very short turnaround times was crucial in many instances.
Conculsions
This project began as a pilot implemented at a single medical center in 2009 and grew into a VISN-wide initiative. After expansion, all 8 VISN 1 sites, the core project team was able to have substantive discussions about the project’s components, their relative importance in the dissemination process, and suggestions for alternatives to identified barriers.14
In FY15, the VISN 1 core project team has helped expand the project in VISN 19. The new project team, located at the Salt Lake City VAMC in Utah, has long been interested in improving communication and collaboration with the non-VA health care community. However, interest and enthusiasm alone are not sufficient for successful uptake. Many sites likely will not have special funding to implement this program.
As a tool to support successful implementation, essential implementation components were identified, based on experience. Local facilities can use the information included in Table 1 to consider and assess their assets, identify enthusiastic staff in their facility, consider creative local partnerships that would support implementation, and reach out to local rural health resources for assistance. Efforts to build collegial relationships with community providers will enhance communication and improve the quality of care received by all veterans.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.
