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11/12/2018 Veteran’s Health Administration (VA) National Quality Scholars Fellowship Program Julie Schexnayder, DNP, MPH, CRNP Mary Dolansky, PhD, RN, FAAN Suzie Miltner, PhD, RN Kyler Godwin, PhD Pat Patrician, PhD, RN, FAAN
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Objectives Discuss the history of the VAQS Program
Review the program’s aims and structure Discuss the role of VAQS in advancing QSEN competencies Describe outcomes of fellow enrolled in the program Review future VAQS opportunities
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11/12/2018 Fellowship History Began in 1998 as a collaboration between Dartmouth & the VA Office of Academic Affiliations (OAA) 2-year post-residency fellowship for physicians interested in the scholarship of health care improvement Addition of doctorally-prepared nurses in 2009 with financial support of RWJ and QSEN First RN fellows graduated in 2011 155 alumni (U.S.); 19 (Toronto) 19 fellows graduating Summer 2017
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Fellowship Aims To apply knowledge and methods of health care improvement for the care of Veterans To innovate and continually improve healthcare within and outside of VA To teach health professionals about quality improvement and patient safety To perform scholarly activities that contribute new knowledge to the quality and value of healthcare
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Competencies VAQS QSEN Interprofessional Collaboration and Teamwork
Teamwork and Collaboration Improvement Methods and Skills Quality Improvement Organization and System Leadership for Quality and Safety Evidence-Based Practice Research Patient Centered Care Teaching and Learning Safety Informatics
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Current Sites
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Structure Office of Academic Affiliations At each site:
11/12/2018 Structure Atlanta White River Junction San Francisco Nashville Birmingham Cleveland Iowa City Los Angeles Houston Coordinating Center Office of Academic Affiliations At each site: 2 Senior Faculty Scholars Additional faculty Balanced ratio MD:RN fellows
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Educational Design 1. Fellow Projects 5. Other Learning
11/12/2018 Educational Design 1. Fellow Projects Local, regional, national Site faculty, leaders, staff 5. Other Learning Masters programs VA or other experiences (HFMEA, RCA) 2. Video-Conference Curriculum 3. Special Interest Groups (Online) 4. Annual Summer Institute
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11/12/2018 Fellow Projects Utilization and Standardization of Risk Analysis Index Frailty Screening Across Surgical Clinics: A Quality Improvement Initiative (Atlanta) Women Veteran’s experience with maternity care coordination (White River Junction) Interventions to improve tobacco and alcohol screenings among inpatient Veterans (Birmingham)
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Video-Conference Curriculum
11/12/2018 Video-Conference Curriculum Foundations of QI Skills and Methods Professional Development Fellows’ Forum
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Example Curriculum Topics
11/12/2018 Example Curriculum Topics Systems Thinking QI 101: Improvement Bootcamp Diffusion of Innovations QI vs. Research Conceptual Models Patient Safety in IT Systems Data Fundamentals: Run & SPC Charts Qualitative Methods in QI Survey Measures Intro to Lean Methods Measurement Pitfalls Methods Leadership Theories Preparing for Academic (Job) Talks Conflict Management Reviewing Manuscripts Work/Life Balance Professional Development Foundations
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11/12/2018 QSEN Competency: QI Use data to monitor the outcomes of care processes and improvement methods to test & improve quality and safety Systems Thinking QI 101: Improvement Bootcamp Diffusion of Innovations QI vs. Research Conceptual Models Patient Safety in IT Systems Foundations Data Fundamentals: Run & SPC Charts Qualitative Methods in QI Survey Measures Intro to Lean Methods Measurement Pitfalls Methods
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Special Interest Groups
QI Measurement Advanced SPC chart creation and interpretation QI software exposures/support TeamSTEPPS Group AHRQ TeamSTEPPS Training 10 fellows certified as Master Trainers Lean Six Sigma Opportunity to complete green belt training during curriculum year 8 fellows on track to complete certification by June 30
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Summer Institute
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Other Learning Opportunities
Degrees completed during program Masters (MPH, MSN)- 2 Doctoral (DNP, PhD)- 2 Teaching opportunities at VA and affiliate schools Involvement in mentor’s research Team member, Healthcare Failure Mode and Effect Analyses, Root Cause Analyses The Joint Commission mock survey and prep teams
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Outcomes (2012-2017) 59 articles in peer-reviewed journals
11/12/2018 Outcomes ( ) 59 articles in peer-reviewed journals 16 by Nurse Fellows Example Journals: Advances in Nursing Science American Geriatrics Society Midwifery and Women’s Health 27 National Presentations Example Conferences: Institute for Healthcare Improvement Translational Science Annual Meeting Midwest Nursing Research Society QSEN
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Outcomes On completion of the fellowship:
30% take positions within the federal government 60% in the VA take leadership positions ~40% of alumni contribute to the VA through academic partnerships In 2017, 4 graduating nurse fellows with faculty appointments 10% of alumni contribute to quality improvement as (non-VA) hospital and population health leaders
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11/12/2018 VAQS Alumni Alumni hold leadership positions that directly influence health care improvement Senior Scholar positions with VAQS Faculty positions both within and outside VA Leaders in public health organizations Director level positions of Medical Quality Improvement within VA VA National Leader of Medication Reconciliation Director of Quality Improvement for the US Army Director of Senior Corps
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Future Directions Competing applications this year
Changes in participating VA sites? Increased opportunities for tuition support? Expanding role of pharmacy, psychology Additional pharmacist (1) and psychologist (1) entering July 2017 Stronger focus on developing implementation scientists
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Eligibility Criteria 2-year interdisciplinary fellowship at one of 8 U.S. sites Pre- or Post-doctoral candidates eligible; Pre- docs must be enrolled at local site affiliate university Do not have to be a VA employee to be eligible No VA obligation on fellowship completion
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Senior Nurse Faculty by Site:
More information Website: Senior Nurse Faculty by Site: Atlanta Carolyn Clevenger, RN, DNP, AGPCNP-BC, GNP-BC, FAANP Associate Dean for Clinical and Community Partnerships Nell Hodgson Woodruff School of Nursing, Emory University Birmingham Patricia A. Patrician, PhD, RN, FAAN Donna Brown Banton Endowed Professor School of Nursing, University of Alabama at Birmingham
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Senior Nurse Faculty Iowa City Cleveland
Mary A. Dolansky, RN, PhD, FAAN Associate Professor of Nursing Frances Payne Bolton School of Nursing, Case Western Reserve University Iowa City Jill Scott-Cawiezell PhD, RN, FAAN Professor of Nursing University of Iowa College of Nursing Los Angeles Shelly de Peralta, DNP, ACNP-BC VA Greater Los Angeles Healthcare System
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Senior Nurse Faculty linda.norman@vanderbilt.edu
Nashville Linda D. Norman, RN, DSN, FAAN Valere Potter Menefee Professor of Nursing Dean, School of Nursing Vanderbilt University San Francisco Margaret Wallhagen, PhD, GNP-BC, AGSF, FAAN Professor, Department of Physiological Nursing School of Nursing - University of California, San Francisco White River Junction Brant Oliver, PhD, NP, MSN, MPH, APRN-BC Assistant Professor The Dartmouth Institute, Dartmouth University
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Questions? Contact: Julie Schexnayder
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