Leadership and Organizational Change Learning Network Hub Site

国家努力增加VA心理健康创新和循证实践的实施 系统令人失望。研究发现了执行这些建议的一些障碍， 包括组织层面的障碍和缺乏领导层的支持。需要执行 战略，以培养强有力的领导，为组织变革，以支持VA的战略重点，以改善 领导能力，并作为一个学习型医疗保健系统发挥作用。领导与组织 变革促进实施（LOCI）是一项实施战略， 在组织层面，改善组织氛围，促进与改善护理相关的活动。 LOCI是专门为VA改编的，来自精神卫生办公室的一组合作伙伴提供了投入， 自杀预防VISN和设施心理健康领导，以及治疗师和领导人从VA精神 健康环境，并已表示将LOCI纳入VA的需求相当大。学习 Network Hub将有两个关键目标：（1）成功实施培训培训（TTT）计划， 培训和支持LOCI的能力;（2）在VA内实施LOCI培训计划，以支持 采用循证做法和干预措施并扩大其覆盖面。建设内部能力 为了进行LOCI培训，到第三年，LOCI开发人员将采用"看一个，做一个，教一个"的方法， 辅以模拟，培训和发展VA LOCI培训师和教练。在第一年， 5名VA LOCI培训师和教练将观察LOCI开发人员领导的研讨会（"见一"），并将共同 领导第一批12名VA项目负责人（来自6家机构）的培训后辅导。在该第一 2010年，LOCI材料将继续为退伍军人管理局改进，目标是全面发展培训 培训员手册和最新的辅导手册。这些活动将有助于：1）培训和准备LOCI 在VA系统内的促进者，2）试点和完善LOCI在VA心理健康计划，和3）确定和 在第一批设施和项目中培养潜在的未来LOCI教练。第二年将重点进行 LOCI研讨会和教练与VA计划领导人和扩大教练能力。教练将 领导LOCI研讨会，并为下一波VA心理健康计划领导（“做一个”）提供指导， 来自LOCI开发人员的观察、支持和保真度评估。原来的5个VA教练将训练一个 另外3名教练，由LOCI开发人员提供指导。16名退伍军人事务部员工/项目负责人， 工厂将参加LOCI培训计划。第三年的重点是实现独立， LOCI的开发商和推广进一步蔓延。VA LOCI主持人将在支持下领导LOCI研讨会 和LOCI开发人员的LOCI保真度评估。在第1年接受培训的VA LOCI培训师将 培训额外的7名教练，他们将与他们共同领导教练电话。第3年末，5 VA LOCI 培训师/教练和至少10名额外的LOCI教练将接受全面培训，68名退伍军人心理健康计划 领导者将在改变组织环境以改善 在他们的设施中，循证实践和黄金状态计划的范围和质量。额外 将为实施LOCI的黄金级研究员和研究团队提供指导，以支持 重要举措。该中心还将提供在线LOCI工具和资源， 团队网站。将使用混合方法来评估枢纽对项目实施水平的影响 领导力、实施氛围以及采用反映科学证据和交付系统的做法 优先事项学习网络中心团队包括LOCI开发人员和VA调查人员，他们具有以下方面的专业知识： 实施科学，有效性研究，卫生服务，组织变革和混合方法 方案评价它支持关键的VA战略优先事项，包括作为学习型医疗保健机构 系统，提高领导能力，并获得循证精神卫生保健。

National efforts to increase implementation of innovative and evidence-based practices in VA mental health systems have been disappointing. Studies have identified a number of barriers to their implementation, including organization-level barriers and lack of leadership support. There is a need for implementation strategies to foster strong leadership for organizational change, to support VA’s strategic priorities to improve leadership competence and to function as a Learning Healthcare System. The Leadership and Organizational Change for Implementation (LOCI) is an implementation strategy that trains and works with leaders across organizational levels to improve organizational climate and promote activities associated with improved care. LOCI was adapted specifically for VA with input from a group of partners from the Office of Mental Health and Suicide Prevention VISN and facility mental health leads, as well as therapists and leaders from VA mental health settings, and considerable demand has been expressed for bringing LOCI into the VA. The Learning Network Hub will have two key goals: (1) to successfully implement a Train the Training (TTT) Program to build capacity to train and support LOCI and (2) to implement the LOCI training program within VA to support the uptake and increased reach of evidence-based practices and interventions (EBPs). To build internal capacity to conduct LOCI training, by Year 3, the LOCI developers will use a “see one, do one, teach one” approach, supplemented with simulation, to train and develop VA LOCI trainers and coaches. In Year 1 the initial group of 5 VA LOCI trainers and coaches will observe the LOCI developers lead a workshop (“see one”) and will co- lead the post-training coaching for the first cohort of 12 VA program leaders (from 6 facilities). During this first year, LOCI materials will continue to be refined for the VA, with a goal to have a fully developed training manual for trainers and an updated coaching manual. These activities will serve to: 1) train and prepare LOCI facilitators within the VA system, 2) pilot and refine LOCI in VA mental health programs, and 3) identify and prepare potential future LOCI coaches among the first facilities and programs. Year 2 will focus on conducting LOCI workshops and coaching with VA program leaders and expanding coaching capacity. VA trainers will lead the LOCI workshops and coaching for the next wave of VA Mental Health Program Leads (“do one”), with observation, support, and fidelity assessment from LOCI developers. The original 5 VA coaches will train an additional 3 coaches with guidance from the LOCI developers. Sixteen VA employees/program leads in 8 facilities will participate in the LOCI training program. Year 3 will focus on achieving independence from the LOCI developers and promoting further spread. VA LOCI facilitators will lead the LOCI workshops with support and LOCI fidelity assessment from the LOCI developers. The VA LOCI Trainers who were trained in Year 1 will train an additional 7 coaches, who will co-lead coaching calls with them. At the end of Year 3, 5 VA LOCI trainers/coaches and at least 10 additional LOCI coaches will be fully trained and 68 VA mental health program leaders will have completed the LOCI training program as they change organizational context to improve the reach and quality of evidence-based practices and Gold Status Programs at their facilities. Additional mentoring will be provided to Gold Status Fellows and research teams that implement LOCI to support important VA initiatives. The Hub will also provide online LOCI tools and resources with a message on a Teams site. Mixed methods will be used to evaluate the Hub’s impacts on program levels of implementation leadership, implementation climate, and use of practices that reflect scientific evidence and delivery system priorities. The Learning Network Hub team includes the LOCI developers and VA investigators with expertise in implementation science, effectiveness research, health services, organizational change, and mixed methods program evaluation. It supports key VA strategic priorities, including functioning as a Learning Healthcare System, increasing leadership competence, and access to evidence-based mental health care.