VISN 8 Whole Health Integration Qualitative Evaluation: A QUERI Rapid Response Project

Gilmartin HM, Nunnery MA, Ball SL, Hale A, Fehling KB, Sayre G, Stevenson LD. VISN 8 Whole Health Integration Qualitative Evaluation: A QUERI Rapid Response Project. Aurora, Colorado: VA Collaborative Evaluation Center (VACE) and Quadruple Aim QUERI; 2022 Jan 5. 13 p.

This rapid response evaluation of Whole Health Integration into Primary Care and Mental Health within VISN 8 utilizing qualitative interviews with VA employees (referred to as participants in this report) elicited rich, on-the-ground feedback on implementation successes and challenges. Importantly, employees who attended employee Whole Health wellness courses or trainings to teach Whole Health skills to Veterans reported positive experiences with Whole Health for themselves and the Veterans they serve. Improved well-being and ability to positively cope with stress were widely reported by employees exposed to the Whole Health trainings to better prepare them to serve Veterans. The unique timing of the Whole Health VISN-wide rollout during a high-stress pandemic offers VA staff ways to increase their resiliency. Interviewees described the importance of system-wide support to facilitate Whole Health practice uptake. Leadership support is crucial; supporting training for staff to not only use Whole Health skills themselves, but also to integrate Whole Health coaches into their service, promote messaging to Veterans about the benefits of Whole Health, and facilitate clinician buy-in and transition from an illness- focused model to a preventative care Whole Health model. An important facilitator for the uptake of Whole Health services is integration into existing services. Participants reported that Mental Health and Specialty Services were somewhat resistant to embracing Whole Health, seeing Whole Health as a competitor to what is currently being offered within a service. They reported the importance of emphasizing how Whole Health can assist these services, bridging the gaps for Veterans in between their specialty care visits. Respondents noted that introducing consistent messaging helps Veterans understand that Whole Health offers them more options to achieve their health care goals and needs. Participants shared that marketing Whole Health to Veterans as a Veteran-Centric model that revolves around their health goals will be beneficial to the uptake of Whole Health utilization. Participants reported several challenges in the midst of the Whole Health rollout in VISN 8. Commonly reported issues included a lack of basic resources for Whole Health clinicians such the lack of a dedicated private space, the temporary nature of the positions leading to turnover, coding challenges, and the COVID pandemic. This report offers solutions and suggestions from providers and staff on the ground to address these challenges.