Trial Outcomes & Findings for REACH VET Implementation Program Evaluation (NCT NCT03280225)

Results Overview

The average percentage of eligible Veterans across all 23 participating sites having a coordinator assigned within 2 weeks of the monthly REACH VET report being released during the 6 month post-implementation period.

Recruitment status

COMPLETED

Target enrollment

28 participants

Primary outcome timeframe

6 months after implementation was completed

Results posted on

2024-01-25

Participant Flow

VA Medical Centers in five Veteran Integrated Service Networks were identified by leadership as needing additional support in or der to implement REACH VET.

This study focuses on the implementation of an innovative new program to increase suicide prevention within VHA. Twenty-eight (28) VHA medical facilities were identified by leadership from seven Veteran Integrated Service Networks (VISN) for implementation based upon need for additional support in standing up the program. All outcomes were reported at the facility level. No patients were enrolled in this study and no outcomes are reported at the patient level.

Unit of analysis: VAMC

Participant milestones

Participant milestones
Measure	VAMC's Receiving Implementation Support for REACH VET 28 VA Medical Centers were chosen by leadership across seven VISN's for support implementing REACH VET. External facilitation: Facilitation is an evidence-based implementation strategy to support sites that have difficulty implementing innovative programs. Facilitation is a multi-faceted "process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship (Powell et al., 2015)." Facilitation has been used nationally across VA to implement a number of different clinical interventions. The current project will examine this minimally intensive version of implementation facilitation, virtual external facilitation.
Overall Study STARTED	0 28
Overall Study COMPLETED	0 23
Overall Study NOT COMPLETED	0 5

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

REACH VET Implementation Program Evaluation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	VISNs Requesting Implementation Support n=23 VAMC This cohort consists of VA Medical Centers (VAMC's) needing additional implementation support to fully implement REACH VET as identified by Veteran Integrated Service Network (VISN) leadership, and that agreed to participate. External facilitation: Facilitation is an evidence-based implementation strategy to support sites that have difficulty implementing innovative programs. Facilitation is a multi-faceted "process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship (Powell et al., 2015)." Facilitation has been used nationally across VA to implement a number of different clinical interventions. The current project will examine this minimally intensive version of implementation facilitation, virtual external facilitation.
Age, Continuous	NA VAMC STANDARD_DEVIATION NA • n=23 VAMC
Sex: Female, Male Female	NA VAMC n=23 VAMC
Sex: Female, Male Male	NA VAMC n=23 VAMC
Race/Ethnicity, Customized Units	NA VAMC n=23 VAMC
Coordinator Accepted Pre-Implementation	88.5 percent STANDARD_DEVIATION 16.7 • n=23 VAMC
Provider Assigned Pre-Implementation	68.1 percentage STANDARD_DEVIATION 25.5 • n=23 VAMC
Care Evaluation Performed Pre-Implementation	63.4 percentage STANDARD_DEVIATION 23.9 • n=23 VAMC
Outreach Attempted Pre-Implementation	56.2 percent STANDARD_DEVIATION 77.0 • n=23 VAMC

PRIMARY outcome

Timeframe: 6 months after implementation was completed

Population: Data not collected at the participant level

The average percentage of eligible Veterans across all 23 participating sites having a coordinator assigned within 2 weeks of the monthly REACH VET report being released during the 6 month post-implementation period.

Outcome measures

Outcome measures
Measure	VISNs Requesting Implementation Support n=23 VAMC This cohort consists of VA Medical Centers (VAMC's) needing additional implementation support to fully implement REACH VET as identified by Veteran Integrated Service Network (VISN) leadership, and that agreed to participate. External facilitation: Facilitation is an evidence-based implementation strategy to support sites that have difficulty implementing innovative programs. Facilitation is a multi-faceted "process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship (Powell et al., 2015)." Facilitation has been used nationally across VA to implement a number of different clinical interventions. The current project will examine this minimally intensive version of implementation facilitation, virtual external facilitation.	VISN B This VISN group consisted of 55 respondents from 4 of the 23 VAMCs.	VISN C This VISN group consisted of 7 respondents from 2 of the 23 VAMCs with an additional 2 VAMC's in this VISN not responding.	VISN D This group consisted of 59 respondents across 6 of the 23 VAMCs.	VISN E This group consisted of 19 respondents from 5 of the 23 VAMCs.
Coordinator Assigned Post-Implementation	97.6 percentage Standard Deviation 1.0	—	—	—	—

PRIMARY outcome

Timeframe: 6 month period following implementation

Population: Data not collected at the participant level

The average percentage of eligible Veterans across all 23 participating sites having a provider assigned within 2 weeks of the monthly REACH VET report being released during the 6 month post-implementation period .

Outcome measures

Outcome measures
Measure	VISNs Requesting Implementation Support n=23 VAMC This cohort consists of VA Medical Centers (VAMC's) needing additional implementation support to fully implement REACH VET as identified by Veteran Integrated Service Network (VISN) leadership, and that agreed to participate. External facilitation: Facilitation is an evidence-based implementation strategy to support sites that have difficulty implementing innovative programs. Facilitation is a multi-faceted "process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship (Powell et al., 2015)." Facilitation has been used nationally across VA to implement a number of different clinical interventions. The current project will examine this minimally intensive version of implementation facilitation, virtual external facilitation.	VISN B This VISN group consisted of 55 respondents from 4 of the 23 VAMCs.	VISN C This VISN group consisted of 7 respondents from 2 of the 23 VAMCs with an additional 2 VAMC's in this VISN not responding.	VISN D This group consisted of 59 respondents across 6 of the 23 VAMCs.	VISN E This group consisted of 19 respondents from 5 of the 23 VAMCs.
Provider Assigned Post-Implementation	87.2 percent Standard Deviation 17.3	—	—	—	—

PRIMARY outcome

Timeframe: 6 month period following implementation

Population: Data not collected at the participant level

The average percentage of eligible Veterans across all 23 participating sites receiving a care evaluation within 2 weeks of the monthly REACH VET report being released during the 6 month post-implementation period.

Outcome measures

Outcome measures
Measure	VISNs Requesting Implementation Support n=23 VAMC This cohort consists of VA Medical Centers (VAMC's) needing additional implementation support to fully implement REACH VET as identified by Veteran Integrated Service Network (VISN) leadership, and that agreed to participate. External facilitation: Facilitation is an evidence-based implementation strategy to support sites that have difficulty implementing innovative programs. Facilitation is a multi-faceted "process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship (Powell et al., 2015)." Facilitation has been used nationally across VA to implement a number of different clinical interventions. The current project will examine this minimally intensive version of implementation facilitation, virtual external facilitation.	VISN B This VISN group consisted of 55 respondents from 4 of the 23 VAMCs.	VISN C This VISN group consisted of 7 respondents from 2 of the 23 VAMCs with an additional 2 VAMC's in this VISN not responding.	VISN D This group consisted of 59 respondents across 6 of the 23 VAMCs.	VISN E This group consisted of 19 respondents from 5 of the 23 VAMCs.
Care Evaluation Performed Post-Implementation	83.6 percent Standard Deviation 18.9	—	—	—	—

PRIMARY outcome

Timeframe: 6 month period following implementation

Population: Data not collected at the participant level

The average percentage of eligible Veterans across all 23 participating sites where outreach was attempted within 2 weeks of the monthly REACH VET report being released during the 6 month post-implementation period.

Outcome measures

Outcome measures
Measure	VISNs Requesting Implementation Support n=23 VAMC This cohort consists of VA Medical Centers (VAMC's) needing additional implementation support to fully implement REACH VET as identified by Veteran Integrated Service Network (VISN) leadership, and that agreed to participate. External facilitation: Facilitation is an evidence-based implementation strategy to support sites that have difficulty implementing innovative programs. Facilitation is a multi-faceted "process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship (Powell et al., 2015)." Facilitation has been used nationally across VA to implement a number of different clinical interventions. The current project will examine this minimally intensive version of implementation facilitation, virtual external facilitation.	VISN B This VISN group consisted of 55 respondents from 4 of the 23 VAMCs.	VISN C This VISN group consisted of 7 respondents from 2 of the 23 VAMCs with an additional 2 VAMC's in this VISN not responding.	VISN D This group consisted of 59 respondents across 6 of the 23 VAMCs.	VISN E This group consisted of 19 respondents from 5 of the 23 VAMCs.
Attempted Outreach Post-Implementation	77.0 percent Standard Deviation 20.6	—	—	—	—

SECONDARY outcome

Timeframe: 1 month

Population: Eligible staff from all participating facilities were solicited to complete the modified Texas Christian University Organizational Readiness for Change for Staff (TCU ORC-S). Eligible staff were not considered enrolled but did contribute to this assessment.

Eligible staff at participating VA facilities were solicited to complete a modified version of the Texas Christian University Organizational Readiness for Change - Staff (TCU ORC-S). We abbreviated the original instrument to 62 items and modified text for contextual relevance. Responses were collected from 22 sites across five Veteran Integrated Service Networks (VISN). The responses were scored on ten scales: Program Needs (10 - 50 higher is preferred), Training Needs (10 - 50 higher is preferred), Pressure for Change (10 - 50 higher is preferred), Staffing (10 - 50 higher is preferred), Mission (10 - 50 higher is preferred), Cohesion (10 - 50 higher is preferred), Autonomy (10 - 50 higher is preferred), Communication (10 - 50 higher is preferred), Stress (10 - 50 lower is preferred) and Change (10 - 50 lower is preferred).

Outcome measures

Outcome measures
Measure	VISNs Requesting Implementation Support n=4 VAMC This cohort consists of VA Medical Centers (VAMC's) needing additional implementation support to fully implement REACH VET as identified by Veteran Integrated Service Network (VISN) leadership, and that agreed to participate. External facilitation: Facilitation is an evidence-based implementation strategy to support sites that have difficulty implementing innovative programs. Facilitation is a multi-faceted "process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship (Powell et al., 2015)." Facilitation has been used nationally across VA to implement a number of different clinical interventions. The current project will examine this minimally intensive version of implementation facilitation, virtual external facilitation.	VISN B n=4 VAMC This VISN group consisted of 55 respondents from 4 of the 23 VAMCs.	VISN C n=4 VAMC This VISN group consisted of 7 respondents from 2 of the 23 VAMCs with an additional 2 VAMC's in this VISN not responding.	VISN D n=6 VAMC This group consisted of 59 respondents across 6 of the 23 VAMCs.	VISN E n=5 VAMC This group consisted of 19 respondents from 5 of the 23 VAMCs.
Organizational Readiness for Change Survey Staffing	29.86 score on a scale Standard Deviation 6.61	28.23 score on a scale Standard Deviation 6.64	30.00 score on a scale Standard Deviation 6.08	31.15 score on a scale Standard Deviation 6.37	26.67 score on a scale Standard Deviation 4.84
Organizational Readiness for Change Survey Mission	33.46 score on a scale Standard Deviation 6.94	31.38 score on a scale Standard Deviation 6.96	32.29 score on a scale Standard Deviation 10.09	33.27 score on a scale Standard Deviation 6.48	30.21 score on a scale Standard Deviation 7.45
Organizational Readiness for Change Survey Cohesion	31.67 score on a scale Standard Deviation 10.30	32.36 score on a scale Standard Deviation 8.00	35.24 score on a scale Standard Deviation 8.58	33.75 score on a scale Standard Deviation 7.56	33.32 score on a scale Standard Deviation 8.49
Organizational Readiness for Change Survey Autonomy	34.78 score on a scale Standard Deviation 5.71	32.47 score on a scale Standard Deviation 5.75	32.00 score on a scale Standard Deviation 7.83	35.98 score on a scale Standard Deviation 4.80	32.24 score on a scale Standard Deviation 5.22
Organizational Readiness for Change Survey Communication	31.74 score on a scale Standard Deviation 7.27	28.18 score on a scale Standard Deviation 6.87	29.86 score on a scale Standard Deviation 6.99	30.80 score on a scale Standard Deviation 7.27	30.32 score on a scale Standard Deviation 7.16
Organizational Readiness for Change Survey Stress	33.19 score on a scale Standard Deviation 8.14	34.63 score on a scale Standard Deviation 6.93	30.71 score on a scale Standard Deviation 11.79	31.31 score on a scale Standard Deviation 8.11	36.97 score on a scale Standard Deviation 8.32
Organizational Readiness for Change Survey Change	31.30 score on a scale Standard Deviation 5.74	29.52 score on a scale Standard Deviation 6.30	29.71 score on a scale Standard Deviation 11.97	32.72 score on a scale Standard Deviation 5.82	31.47 score on a scale Standard Deviation 4.63
Organizational Readiness for Change Survey Program Needs	25.77 score on a scale Standard Deviation 7.78	31.74 score on a scale Standard Deviation 7.27	32.86 score on a scale Standard Deviation 11.47	28.96 score on a scale Standard Deviation 7.55	27.17 score on a scale Standard Deviation 10.29
Organizational Readiness for Change Survey Training Needs	21.90 score on a scale Standard Deviation 5.25	25.94 score on a scale Standard Deviation 8.49	30.00 score on a scale Standard Deviation 13.84	25.93 score on a scale Standard Deviation 7.33	24.78 score on a scale Standard Deviation 9.64
Organizational Readiness for Change Survey Pressure for Change	29.91 score on a scale Standard Deviation 5.04	30.56 score on a scale Standard Deviation 6.16	30.00 score on a scale Standard Deviation 6.80	29.29 score on a scale Standard Deviation 6.03	28.87 score on a scale Standard Deviation 8.74

Adverse Events

VISNs Requesting Implementation Support

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Sara J. Landes

Central Arkansas Veterans Healthcare System

Phone: 501-257-3385

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place