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Implementation of the Acute Inpatient Medicine-High Reliability, Learning Environment, and Workforce Development
Heather M Gilmartin1,2, Brigid Connelly1, Marguerite Daus1
1Denver/Seattle Center of Innovation for Veteran-Centered and Value Driven Care, VA Eastern Colorado Healthcare System, Aurora, Colorado, USA.
Journal of Hospital Medicine
|August 16, 2024
Summary
This study introduces the Acute Inpatient Medicine-High Reliability, Learning Environment, and Workforce Development Initiative (AIM-HI) to enhance rural hospital medicine teams. AIM-HI aims to improve staff satisfaction and reduce burnout through supportive learning environments.
Area of Science:
- Healthcare Management
- Workforce Development
- Implementation Science
Background:
- Rural hospital medicine programs often lack workforce development training for interdisciplinary teams.
- Limited programs focus on creating supportive learning environments to boost staff satisfaction and reduce burnout.
- The Acute Inpatient Medicine-High Reliability, Learning Environment, and Workforce Development Initiative (AIM-HI) addresses this gap in Veterans Health Administration (VA) rural settings.
Purpose of the Study:
- To evaluate the Relational Playbook, a workforce development intervention, within rural VA hospital medicine teams.
- To assess the effectiveness of implementation strategies including behavioral nudges, collaboratives, and coaching.
- To establish the acceptability, appropriateness, and feasibility of AIM-HI before wider adoption.
Main Methods:
- A type II hybrid implementation study using a convergent mixed methods approach.
- Wave-based implementation starting with three tertiary VA hospitals.
- Primary outcomes in year 1: acceptability, appropriateness, and feasibility via surveys and interviews.
- Subsequent years: assessment of learning environment, job satisfaction, burnout, and turnover trends using linear mixed-effect models.
Main Results:
- Year 1 data will focus on the acceptability, appropriateness, and feasibility of the AIM-HI intervention and strategies.
- Longitudinal analysis will track trends in key outcomes such as staff satisfaction, burnout, and turnover.
- The Relational Playbook demonstrates strong face validity, indicating potential for positive impact.
Conclusions:
- AIM-HI is designed to evaluate specific implementation strategies and intervention outcomes in rural VA hospitals.
- Establishing the feasibility and acceptability of AIM-HI is crucial before enterprise-wide implementation.
- Data gathered will inform the effectiveness of supportive learning environments on hospital medicine team performance and well-being.
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