From implementation to sustainment: A large-scale adverse event disclosure support program generated through embedded research in the Veterans Health Administration
dc.contributor.author | Elwy, A. Rani | |
dc.contributor.author | Bokhour, Barbara G | |
dc.date | 2022-08-11T08:10:00.000 | |
dc.date.accessioned | 2022-08-23T16:52:05Z | |
dc.date.available | 2022-08-23T16:52:05Z | |
dc.date.issued | 2021-06-23 | |
dc.date.submitted | 2021-10-27 | |
dc.identifier.citation | <p>Elwy AR, Maguire EM, McCullough M, George J, Bokhour BG, Durfee JM, Martinello RA, Wagner TH, Asch SM, Gifford AL, Gallagher TH, Walker Y, Sharpe VA, Geppert C, Holodniy M, West G. From implementation to sustainment: A large-scale adverse event disclosure support program generated through embedded research in the Veterans Health Administration. Healthc (Amst). 2021 Jun;8 Suppl 1:100496. doi: 10.1016/j.hjdsi.2020.100496. Epub 2021 Jun 23. PMID: 34175102. <a href="https://doi.org/10.1016/j.hjdsi.2020.100496">Link to article on publisher's site</a></p> | |
dc.identifier.issn | 2213-0764 (Linking) | |
dc.identifier.doi | 10.1016/j.hjdsi.2020.100496 | |
dc.identifier.pmid | 34175102 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/41983 | |
dc.description | <p>Full author list omitted for brevity. For the full list of authors, see article.</p> | |
dc.description.abstract | In 2008, the Veterans Health Administration published a groundbreaking policy on disclosing large-scale adverse events to patients in order to promote transparent communication in cases where harm may not be obvious or even certain. Without embedded research, the evidence on whether or not implementation of this policy was generating more harm than good among Veteran patients was unknown. Through an embedded research-operations partnership, we conducted four research projects that led to the development of an evidence-based large-scale disclosure toolkit and disclosure support program, and its implementation across VA healthcare. Guided by the Consolidated Framework for Implementation Research, we identified specific activities corresponding to planning, engaging, executing, reflecting and evaluating phases in the process of implementation. These activities included planning with operational leaders to establish a shared research agenda; engaging with stakeholders to discuss early results, establishing buy-in of our efforts and receiving feedback; joining existing operational teams to execute the toolkit implementation; partnering with clinical operations to evaluate the toolkit during real-time disclosures; and redesigning the toolkit to meet stakeholders' needs. Critical lessons learned for implementation success included a need for stakeholder collaboration and engagement, an organizational culture involving a strong belief in evidence, a willingness to embed researchers in clinical operation activities, allowing for testing and evaluation of innovative practices, and researchers open to constructive feedback. At the conclusion of the research, VA operations worked with the researchers to continue to support efforts to spread, scale-up and sustain toolkit use across the VA healthcare system, with the final goal to establish long-term sustainability. | |
dc.language.iso | en_US | |
dc.relation | <p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=34175102&dopt=Abstract">Link to Article in PubMed</a></p> | |
dc.rights | © 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.subject | health communication | |
dc.subject | adverse events | |
dc.subject | disclosure | |
dc.subject | embedded research | |
dc.subject | Veterans Health Administration | |
dc.subject | Community-Based Research | |
dc.subject | Health Communication | |
dc.subject | Health Policy | |
dc.subject | Health Services Administration | |
dc.subject | Health Services Research | |
dc.subject | Military and Veterans Studies | |
dc.title | From implementation to sustainment: A large-scale adverse event disclosure support program generated through embedded research in the Veterans Health Administration | |
dc.type | Journal Article | |
dc.source.journaltitle | Healthcare (Amsterdam, Netherlands) | |
dc.source.volume | 8 Suppl 1 | |
dc.identifier.legacyfulltext | https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=5819&context=oapubs&unstamped=1 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/oapubs/4786 | |
dc.identifier.contextkey | 25625672 | |
refterms.dateFOA | 2022-08-23T16:52:05Z | |
html.description.abstract | <p>In 2008, the Veterans Health Administration published a groundbreaking policy on disclosing large-scale adverse events to patients in order to promote transparent communication in cases where harm may not be obvious or even certain. Without embedded research, the evidence on whether or not implementation of this policy was generating more harm than good among Veteran patients was unknown. Through an embedded research-operations partnership, we conducted four research projects that led to the development of an evidence-based large-scale disclosure toolkit and disclosure support program, and its implementation across VA healthcare. Guided by the Consolidated Framework for Implementation Research, we identified specific activities corresponding to planning, engaging, executing, reflecting and evaluating phases in the process of implementation. These activities included planning with operational leaders to establish a shared research agenda; engaging with stakeholders to discuss early results, establishing buy-in of our efforts and receiving feedback; joining existing operational teams to execute the toolkit implementation; partnering with clinical operations to evaluate the toolkit during real-time disclosures; and redesigning the toolkit to meet stakeholders' needs. Critical lessons learned for implementation success included a need for stakeholder collaboration and engagement, an organizational culture involving a strong belief in evidence, a willingness to embed researchers in clinical operation activities, allowing for testing and evaluation of innovative practices, and researchers open to constructive feedback. At the conclusion of the research, VA operations worked with the researchers to continue to support efforts to spread, scale-up and sustain toolkit use across the VA healthcare system, with the final goal to establish long-term sustainability.</p> | |
dc.identifier.submissionpath | oapubs/4786 | |
dc.contributor.department | Department of Population and Quantitative Health Sciences | |
dc.source.pages | 100496 |