by Dr. Penelope Gorsuch, Dr. Lynn Gallagher-Ford, Dr. Sheila Cox-Sullivan and Dr. Colleen Walsh-Irwin
In 2017, the Department of Veterans Affairs (VA) Office of Nursing Services (ONS) recognized the need to increase the cadence of disseminating standardized implementation of evidence-based practice (EBP). Fortunately, the ONS Director of Research and EBP was invited to the Helene Fuld Health Trust National Institute for Evidence-based Practice’s (the Fuld) inaugural National Summit at The Ohio State University. Subsequently, members of the national nursing leadership team attended an immersion at the Dayton, Ohio Veterans Affairs Medical Center. This exposure and experience ignited a leadership commitment to fund a strategic initiative to develop EBP mentors at each VA medical center site in collaboration with the Fuld.
After completing the contracting process, the sites that were piloting the VA High Reliability Organization (HRO) initiative were selected to attend the Fuld EBP mentor development program (five-day immersion) due to the strong link between HRO and EBP. Because travel costs would have been prohibitive, the VA and the Fuld collaborated to conduct a hybrid immersion for 162 participants representing 18 VA agencies; 15 attended virtually and three of the closest facilities attended in-person in Columbus. The Fuld team worked at a rapid pace to convert the traditional in-person immersion to a fully virtual option in order to meet this need. Expert EBP mentors from the Fuld traveled to each virtual site to facilitate in-person engagement and learning.
This first VA immersion took place in September 2019, and participants reported feeling energized and inspired. As they spread the word about the immersion experience, more facilities wanted to take advantage of this opportunity. In 2020, ONS secured funding for 30 additional facilities to attend an immersion. Two immersions were held in 2020, and positive evaluations stimulated support for another immersion in August 2021.
Interestingly, 2020 brought the unique challenges related to the COVID-19 pandemic, which for the Fuld meant all in-person business has to cease and pivot to virtual. The work that the Fuld had done to meet the needs of the VA in 2019 was fortuitous, as the Fuld was completely prepared to run virtual immersions for all organizations.
At this writing, a total of 88 VA facilities have sent participants to an immersion. The demand is so strong due to the positive response from these educational and skill-building programs that the VA has scheduled three more immersions for 2021-22!
The most powerful part of these immersions is the changes that have occurred following their attendance. Of the 30 facilities attending in FY 2020, 29 have created infrastructures to support facility-level review and support of EBP initiatives, and more than 60% of participants have improved at least one metric at their organization using the evidence-based methodology learned at the immersion, positively affecting care provided to Veterans.
The partnership between the Fuld and VA ONS has greatly enhanced the quality of care provided to Veterans across the country. Both ONS and the Fuld are extremely committed to providing VA nurses the needed educational and skill-building programs to create EBP mentors at each VA medical center to increase the implementation and dissemination of standardized best practices. Additionally, the work that the Fuld and VA did together in creating the initial virtual immersion platform laid the groundwork for the Fuld having the means to rapidly pivot to a virtual educational environment for all Fuld courses during the COVID-19 pandemic. This allowed critical education for developing EBP mentors to continue not only in VA facilities, but for any healthcare organization across the country.
