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2023 HSR&D/QUERI National Conference Abstract

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1147 — Partnership building for scale-up and spread in the Veterans Sponsorship Initiative: Strategies for harnessing collaboration to accelerate impact

Lead/Presenter: Erin Finley,  COIN - Los Angeles
All Authors: Finley EP (Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles; UT Health San Antonio), Frankfurt SB (VISN 17 Center of Excellence on Research for Returning War Veterans; Central Texas Veterans Healthcare System) Weistreich TL (VHA National Center for Healthcare Advancement and Partnerships) Eickhoff C (VHA National Center for Healthcare Advancement and Partnerships) Krauss A (VISN 17 Center of Excellence on Research for Returning War Veterans; Central Texas Veterans Healthcare System) Goodrich DE (Center for Health Equity Research and Promotion, VA Pittsburgh) Kamdar N (Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center) Seim RW (VISN 17 Center of Excellence on Research for Returning War Veterans) Goodman M (Transitioning Servicemember and Suicide Prevention Center, VISN 2 MIRECC/VISN 17 COE) Geraci J (Transitioning Servicemember and Suicide Prevention Center, VISN 2 MIRECC/VISN 17 COE; Teacher’s College, Columbia University)

Objectives:
The Veterans Sponsorship Initiative (VSI) is an evidence-based intervention that combines peer sponsorship with linkages to U.S. Department of Veterans Affairs (VA) and community-based resources to ensure critical support during the military-to-civilian transition period. Scaling VSI nationally requires establishing non-monetary partnerships across the VA and U.S. Department of Defense with a diverse array of public and private Veteran-serving organizations. Effective partnerships are critical to improve implementation, coordination, efficiency, resource-sharing, and sensemaking; however, there are few published data on specific partnership-building strategies. We report an in-depth analysis of implementation strategies and approaches associated with successful partnership-building in scale-up and spread of VSI.

Methods:
We assessed the number of active partnerships in support of VSI (i.e., those formalized with a memorandum of agreement and/or informal structured framework) and the number of service members enrolled during the period of early VSI launch (October 2020-June 2022). We conducted directed qualitative content analysis of 41 periodic reflections (brief guided discussions with templated notes) completed with implementation team members. Evaluation team members (EF, SF, AK) independently coded for implementation strategies used, following the Expert Recommendations for Implementing Change (ERIC) taxonomy; in response to emerging themes, a second round of coding further explored concepts informed by organizational literature (i.e., transformational leadership, characteristics of work relationships).

Results:
To date, VSI has established 17 active partnerships with public and private agencies and enrolled more than 800 service members. During pre- and early implementation periods, the VSI team utilized 27 ERIC implementation strategies, including: linking to pre-existing networks and services and fostering new networks and relationships; developing educational, legal and procedural documents to clarify roles and responsibilities and standardize delivery of core program components; innovating information technology solutions; and engaging in continuous data monitoring and feedback to partners. Efforts by the Veterans Health Administration (VHA) National Center for Healthcare Advancement and Partnerships (HAP) to establish the Veteran Sponsor Partnership Network proved critical in ensuring centralized expertise, resource development, and policy guidance to support partnership development and implementation. Additional features of the VSI approach included addressing shared concerns, ensuring relationships were mutually beneficial, providing clear communication of goals and expectations, and, amid the disruptions of the COVID pandemic, traveling for on-site visits and in-person meetings, thus facilitating trust supported by rich and timely communication.

Implications:
This in-depth case study describes how VSI, in close collaboration with HAP, has achieved notable success in forging active partnerships during a challenging period. VSI’s partnership-building efforts have leveraged a variety of implementation strategies, particularly around strengthening stakeholder interrelationships and formalizing procedures to support clear communication and roles. The VSI approach to partnership building has been further characterized by aspects of transformational leadership (e.g., communicating a shared vision, inspiring innovation) and high-quality work relationships (e.g., rich communication, inclusion, and trust).

Impacts:
Partnership building is a critical element of innovation spread and sustainment, yet strategies for building effective partnerships remain underexplored. Identifying necessary components of successful partnership-building can accelerate the impact of innovation and implementation across VA.