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      VA Video Telehealth and Training Programs During the COVID-19 Response

      , Ph.D., BC-FNP, BC-ANP , 1 , , MSN, APRN-BC 2 , , MN, RN 3 , , RN, MSN 4

      Telehealth and Medicine Today

      Partners in Digital Health

      COVID-19 PANDEMIC, Surgery, Telehealth, VA, Vetean’s Administration, Video

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          Abstract

          Objective

          The U.S. Department of Veterans Affairs has a robust telehealth program supported by a training infrastructure for VA clinicians and staff. In fiscal 2019, over 909,000 VA patients received a portion of their VA care through telehealth, and over 60% of VA’s primary and mental health care providers participated in one or more Clinical Video Telehealth (CVT) appointments to a patient’s home.

          In March 2020, during the initial spread of COVID-19, Veterans Health Administration leadership issued guidance for providers to transition from in-person care to virtual modalities for routine care not requiring a physical encounter. VA’s comprehensive training infrastructure helped providers quickly become capable of delivering CVT care to meet the needs of their patients, and the VA Office of Connected Care Quality and Training (QT) Division adjusted the program as providers’ needs evolved.

          Design

          As clinical staff faced new and increasing demands to respond to needs during the pandemic, the QT Division streamlined existing training programs to deliver essential content and enable providers to acquire necessary telehealth skills more quickly. This included reducing the number of core courses required to become telehealth-capable from four to two by introducing an integrated course. The QT Division reorganized and edited content from other accredited courses to convey key topics. To shorten courses for providers with full schedules, the QT Division removed accreditation from some courses, such as the COVID-19 VA Video Connect for Providers course.

          Results

          The QT Division’s pandemic response resulted in over 80,000 new course completions in the first month and over 20% more primary care and mental health providers conducting CVT visits in the first five months. During this period, the number of CVT appointments increased by over 1,000%.

          Conclusion

          VA’s telehealth training infrastructure, implemented by the QT Division, enabled VA to enter the COVID-19 public health emergency fully prepared for the rapid growth in telehealth care. As CVT became increasingly important during the COVID-19 response, the QT Division made necessary curriculum adjustments to meet provider and patient needs.

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          Most cited references 10

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          Team-training in healthcare: a narrative synthesis of the literature

          Background Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings. Methods A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes. Results Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice. Conclusions Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes.
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            Nurses’ professional competency and organizational commitment: Is it important for human resource management?

            Background Professional competency is a fundamental concept in nursing, which has a direct relationship with quality improvement of patient care and public health. Organizational commitment as a kind of affective attachment or sense of loyalty to the organization is an effective factor for professional competency. Objective This study was conducted to evaluate the nurses´ professional competency and their organizational commitment as well as the relationship between these two concepts. Methods and materials This descriptive-analytic study was conducted at the hospitals affiliated with a University of Medical Sciences, in the southeast of Iran in 2016. The sample included 230 nurses who were selected using stratified random sampling. Data were gathered by three questionnaires including socio-demographic information, competency inventory for registered nurse (CIRN) and Allen Meyer's organizational commitment. Results Results showed that professional competency (Mean±SD: 2.82±0.53, range: 1.56–4.00) and organizational commitment (Mean±SD: 72.80±4.95, range: 58–81) of the nurses were at moderate levels. There was no statistically significant correlation between professional competency and organizational commitment (ρ = 0.02; p = 0.74). There were significant differences in professional competency based on marital status (p = 0.03) and work experience (p<0.001). Conclusion The results highlighted that the nurses needed to be more competent and committed to their organizations. Developing professional competency and organizational commitment is vital, but not easy. This study suggests that human resource managers should pursue appropriate strategies to enhance the professional competency and organizational commitment of their nursing staff. It is necessary to conduct more comprehensive studies for exploring the status and gaps in the human resource management of healthcare in different cultures and contexts.
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              Improving Patient Outcomes: Effectively Training Healthcare Staff in Psychological Practice Skills: A Mixed Systematic Literature Review

               Katherine Garzonis (corresponding) ,  Eryn Mann,  Aleksandra Wyrzykowska (2015)
              Training is an important part of modern European healthcare services and is often cited as a way to improve care quality. To date, various training methods have been used to impart skills relevant to psychological practice in a variety of mental health professionals. However, patient outcomes are rarely used in evaluating the effectiveness of the different training methods used, making it difficult to assess true utility. In the present review, we consider methods of training that can effectively impact trainee and patient outcomes. To do so, PubMed, PsycNET, Scopus, CENTRAL and ERIC were searched for studies on training of healthcare staff in psychological practice approaches. In total, 24 studies were identified (16 quantitative and 8 qualitative). For the most part, group, individual, and web-based training was used. A variety of health professionals were trained in skills including ‘communication’, ‘diagnosis’, and ‘referral’ to name but a few. In the majority of studies staff skill level improved. These findings hold implications for the design, implementation, and evaluation of training for mental healthcare staff.
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                Author and article information

                Journal
                TMT
                Telehealth and Medicine Today
                Partners in Digital Health
                2471-6960
                04 February 2021
                2021
                : 6
                Affiliations
                [1 ]Director, VA Office of Connected Care Quality and Training Division, U.S. Department of Veterans Affairs, Office of Connected Care, Quality and Training Division
                [2 ]Telehealth Training Team Lead, VA Office of Connected Care Quality and Training Division, U.S. Department of Veterans Affairs, Office of Connected Care, Quality and Training Division
                [3 ]National Quality Lead, VA Office of Connected Care Quality and Training Division, U.S. Department of Veterans Affairs, Office of Connected Care, Quality and Training Division
                [4 ]Quality Manager, VA Office of Connected Care Quality and Training Division, U.S. Department of Veterans Affairs, Office of Connected Care, Quality and Training Division
                Author notes
                Corresponding Author: Johnston L. Rhonda, Email: rhonda.johnston@ 123456va.gov
                Article
                241
                10.30953/tmt.v6.241
                © 2021 Johnston L. Rhonda

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, adapt, enhance this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                Categories
                Training Tools for Health Professionals & Patients

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