80X - Building a Movement for Change: Implementing High Reliability Principles and Practices

Wednesday, March 22

9:00–10:30 a.m.

This session will describe the Veterans Healthcare Administration’s enterprisewide journey to incorporate high reliability into operations across its central office, 18 regional networks and 163 hospital facilities. The journey formally commenced in 2019, starting with a group of 18 lead facilities, followed by subsequent cohorts of in 2020 and 2021. The onset of COVID-19 in the United States required significant adaptation to high reliability organization implementation plans due to increased operational demands and safety concerns at hospital facilities.

This session will focus on how VHA leaders orchestrated change management and implementation activities across the system, including a wide range of training activities, executing site-specific assessments, creating venues for peer-to-peer learning, and supporting leaders through executive coaching. Presenters will spotlight early results showing change in four foundational leadership behaviors and will illustrate how sponsorship at multiple levels of VHA helped to support change, maintain momentum to implement high reliablity despite COVID-related challenges, and embed principles and practices into daily operations.

Attendees will review specific frameworks, tools and lessons learned from 18 lead facilities that informed the activities of years two and three of the high reliability journey. In addition, presenters will describe ways in which VHA adapted plans and delivery models to enable continued progress throughout the COVID-19 pandemic. They will also show how a three-year, cohort-based rollout served to create a true learning environment by identifying and disseminating strong practices, refining HRO practices, creating tools for sharing across all sites, and advancing the state of the science of HRO through peer-reviewed publications and presentations.

Learning Objectives

• Describe how the VHA’s change management model facilitated the deployment of HRO principles and practices in a large, integrated healthcare system.
• Demonstrate how HRO practices supported patient and staff safety during the COVID-19 pandemic.