Leadership and Organizational Change Learning Network Hub Site

国家努力加强退伍军人事务部心理健康创新和循证实践的实施 系统一直令人失望。研究发现了实施过程中存在的一些障碍， 包括组织层面的障碍和缺乏领导支持。有必要实施 培养强有力的组织变革领导力的战略，支持 VA 的战略重点以改进 领导能力并发挥学习医疗保健系统的作用。领导和组织 实施变革 (LOCI) 是一项实施策略，旨在培训各个领域的领导者并与他们合作 组织层面改善组织氛围并促进与改善护理相关的活动。 LOCI 专门针对 VA 进行了调整，并听取了来自心理健康办公室的一组合作伙伴的意见和建议 自杀预防 VISN 和机构心理健康主管，以及 VA 心理治疗师和领导 卫生机构，并且已经表达了将 LOCI 纳入 VA 的巨大需求。学习 Network Hub 将有两个关键目标：(1) 成功实施培训培训 (TTT) 计划，以构建 培训和支持 LOCI 的能力，以及 (2) 在 VA 内实施 LOCI 培训计划以支持 循证实践和干预措施 (EBP) 的采用和扩大范围。建设内部能力 为了进行 LOCI 培训，到第 3 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，初始组 5 VA LOCI 培训师和教练将观察 LOCI 开发人员主持研讨会（“见一个”），并将共同- 领导对第一批 12 名 VA 项目负责人（来自 6 个机构）的培训后辅导。在这第一 今年，LOCI 材料将继续为 VA 完善，目标是提供全面的培训 培训师手册和更新的教练手册。这些活动将有助于：1) 培训和准备 LOCI VA 系统内的促进者，2) 在 VA 心理健康项目中试点和完善 LOCI，以及 3) 识别和 在首批设施和项目中为潜在的未来 LOCI 教练做好准备。第二年将侧重于进行 LOCI 研讨会和 VA 项目负责人的辅导并扩大辅导能力。 VA 培训师将 领导 LOCI 研讨会并为下一波 VA 心理健康计划领导（“做一个”）提供辅导， LOCI 开发人员的观察、支持和保真度评估。原来的 5 名 VA 教练将培训 另外 3 名教练由 LOCI 开发人员提供指导。 16 名 VA 员工/8 名项目负责人 设施将参加 LOCI 培训计划。第三年的重点是实现独立于 LOCI的开发者和推动者进一步传播。 VA LOCI 协调员将在支持下主持 LOCI 研讨会 LOCI 开发人员的 LOCI 保真度评估。在第一年接受培训的 VA LOCI 培训师将 培训另外 7 名教练，他们将与他们共同主持辅导电话会议。第 3 年末，5 个 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，并开展 68 项 VA 心理健康计划 领导者在改变组织环境以改善组织环境时将完成 LOCI 培训计划 其设施中循证实践和黄金状态计划的覆盖范围和质量。附加 将向实施 LOCI 的金牌研究员和研究团队提供指导，以支持 重要的退伍军人事务部举措。该中心还将提供在线 LOCI 工具和资源，并在 团队网站。将使用混合方法来评估该中心对计划实施水平的影响 领导力、实施氛围以及反映科学证据和交付系统的实践的使用 优先事项。学习网络中心团队包括 LOCI 开发人员和 VA 研究人员，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 方案评估。它支持 VA 的关键战略重点，包括充当学习医疗保健机构 系统、提高领导能力以及获得循证心理保健的机会。

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.