Leadership and Organizational Change Learning Network Hub Site

加强在退伍军人精神卫生领域实施创新和循证做法的国家努力 系统一直令人失望。研究已经确定了实施这些措施的一些障碍， 包括组织层面的障碍和缺乏领导支持。有必要实施 培养组织变革的强大领导力的战略，支持退伍军人管理局改进的战略优先事项 领导能力，并作为一个学习型医疗系统发挥作用。领导力和组织性 变更为实施(LOCI)是一种实施战略，它与以下领域的领导者一起进行培训和合作 组织层面，以改善组织氛围，促进与改善护理相关的活动。 在来自心理健康办公室的一组合作伙伴的投入下，LOGI专门针对VA进行了调整 自杀预防VISN和设施精神健康领导，以及来自退伍军人管理局精神治疗师和领导 卫生环境，并表达了将基因座引入退伍军人管理局的相当大的需求。《学习》 网络中心将有两个关键目标：(1)成功实施培训(TTT)计划以建立 培训和支持地点的能力；(2)在退伍军人事务部内实施地点培训计划，以支持 采用和扩大循证做法和干预措施(EBP)的覆盖范围。建设内部能力 为了进行地点培训，到第三年，地点开发人员将采用“见一做一教一”的方式， 辅以模拟，以培训和发展VA基因座训练员和教练员。在第一年，第一批 5位VA基因座培训师和教练将观察基因座开发人员，领导一个研讨会(“看一眼”)，并将与 领导第一批12名退伍军人项目负责人(来自6个设施)的培训后培训。在这第一次 年，地点材料将继续为退伍军人管理局完善，目标是有一个全面发展的培训 教练员手册和最新的教练手册。这些活动将有助于：1)培训和准备地点 退伍军人制度内的促进者，2)引导和完善退伍军人精神健康计划中的基因座，以及3)识别和 在第一批设施和项目中准备潜在的未来地点教练。第二年将专注于进行 与退伍军人管理局项目负责人一起举办LOGI研讨会和进行指导，并扩大指导能力。退伍军人事务部培训师将 领导下一波退伍军人精神健康计划领导人员的现场研讨会和指导(Do One)， 来自位置开发人员的观察、支持和保真度评估。最初的5名退伍军人教练员将培训 额外的3名教练从现场开发人员的指导。8年中有16名退伍军人管理局员工/计划负责人 设施将参加现场培训计划。第三年将专注于实现独立于 点位开发商，促进进一步传播。退伍军人事务部地点辅导员将在支持下领导地点研讨会 以及来自地点开发人员的地点保真度评估。在第一年接受培训的退伍军人事务部地点培训员将 另外培训7名教练，他们将与他们共同领导辅导电话会议。在第三年末，5个VA基因座 培训员/教练和至少10名额外的现场教练将接受全面培训和68名退伍军人精神健康计划 领导者将完成现场培训计划，因为他们将改变组织环境以改善 循证实践和金牌计划在其设施中的覆盖面和质量。其他内容 将为实施Loci的金牌会员和研究团队提供指导以支持 重要的退伍军人事务部倡议。该中心还将提供在线地点工具和资源，并在 团队站点。将使用混合方法来评估中心对方案实施水平的影响 领导力、实施环境以及对反映科学证据和交付系统的做法的使用 优先事项。学习网络中心团队包括具有以下专业知识的现场开发人员和退伍军人管理局调查人员 实施科学、有效性研究、卫生服务、组织变革和混合方法 计划评估。它支持退伍军人管理局的关键战略优先事项，包括作为学习型医疗保健发挥作用 提高领导能力和获得循证精神卫生保健服务。

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.