Affiliation:
1. Denver/Seattle Center of Innovation for Veteran‐Centered and Value Driven Care, VA Eastern Colorado Healthcare System Aurora Colorado USA
2. Department of Health Systems, Management and Policy Colorado School of Public Health, University of Colorado, Anschutz Medical Campus Aurora Colorado USA
3. Independent Researcher, Veteran Partner El Dorado Arkansas USA
4. VHA Hospital Medicine, Specialty Care Program Office, Veterans Health Administration Washington District of Columbia USA
5. VA Eastern Colorado Healthcare System Hospital Medicine Section Aurora Colorado USA
6. Division of Hospital Medicine University of Colorado Anschutz School of Medicine Aurora Colorado USA
Abstract
AbstractIntroductionFew rural hospital medicine programs include workforce development training that provides social and professional support for interdisciplinary teams. Even fewer include training that creates supportive learning environments that result in higher staff satisfaction, lower burnout, and reduced turnover. The Acute Inpatient Medicine—High Reliability, Learning Environment, and Workforce Development Initiative (AIM‐HI) aims to create supportive learning environments in Veterans Health Administration (VA) rural hospital medicine teams.MethodsAIM‐HI is a type II hybrid implementation study utilizing a convergent mixed methods approach to evaluate the Relational Playbook, a workforce development intervention, and three implementation strategies: behavioral nudges, learning and leadership collaboratives, and leadership coaching. AIM‐HI implementation will occur in waves, enrolling additional hospitals every 12 months. In the first wave, AIM‐HI will be implemented at three tertiary VA hospitals that treat at least 1000 rural Veterans annually and have an active inpatient hospital medicine program. The primary outcomes in year 1 will be the acceptability, appropriateness, and feasibility of AIM‐HI assessed through participant surveys and interviews. In subsequent years, trends in the learning environment, job satisfaction, burnout, and turnover scores will be assessed using a linear mixed‐effect model.DiscussionThe anticipated impact of AIM‐HI is to evaluate the utility of the implementation strategies and assess trends in Playbook intervention outcomes. The Playbook has strong face validity; however, before large‐scale adoption across the VA enterprise, it is essential to establish the acceptability, appropriateness, and feasibility of the Playbook and implementation strategies, as well as to gather data on AIM‐HI effectiveness.