Supporting the Veterans Health Administration’s Office of Nursing Services Strategic Plan

Introduction

The Office of Nursing Services (ONS) provides leadership, guidance and strategic direction for the Veterans Health Administration (VHA) on issues related to nursing practice, education, research and workforce for clinical programs and health care delivery sites across the continuum of care for Veterans. ONS created a 10-year Nursing Workforce Strategic Plan that encompasses its four goals, strategies, key performance indicators, milestones and timelines. The four goals focus on recruiting and retaining the nation’s top nurses, specifically through optimizing nursing practice; strengthening the nursing workforce; reimagining lifelong learning and career development; and inspiring an industry-leading culture. VHA partnered with Artemis ARC to operationalize the strategic plan and establish a blueprint for a broader organization-wide transformation by developing solutions to the most pressing challenges.

Challenge

Maintaining world class, Veteran-centered care through a strong, fully staffed nursing workforce

VHA faces a shortage of nurses due to attrition, competition from the private sector and the COVID-19 pandemic. As the nation’s largest employer of nurses, VA needs highly qualified nursing personnel to staff nearly 1,300 health care facilities, including 171 medical centers and 1,113 outpatient sites serving 9 million Veterans each year. The Nursing Workforce Strategic Plan is designed to meet the nursing workforce needs of today while planning for and strengthening the workforce needs of tomorrow so that Veterans continue to receive the excellent health care and support they deserve. The work will allow VHA to remain an employer of choice for nurses while also ensuring an innovative, best-in-class nursing workforce.

Solutions

Developing a framework for VHA to operationalize the Nursing Workforce Strategic Plan

ONS is partnering with Artemis to design and execute evidence-based, comprehensive strategies and approaches for realizing the vision laid out in the Nursing Workforce Strategic Plan. The framework for the plan includes the relationship between the overarching goals and tactical strategies for implementation, along with VHA’s organizational, functional perspectives of capacity, internal processes and customers/outcomes.

Providing project management support and organizational structure to carry out the Nursing Workforce Strategic Plan

Implementing VHA’s vision requires central planning support and coordination.

As such, Artemis is supporting a central Project Management Office, developing an overarching project management plan, creating internal processes on behalf of ONS, supporting SharePoint organizational efforts and producing leadership briefing materials for executive-level stakeholders, such as the VA Acting Under Secretary of Health. Artemis provides full project management support to ONS using effective management practices, including Jira for work management and Microsoft Teams for client communication, to implement the strategic plan’s workstreams.

Supporting 12 workstreams tasked with workforce strategies that align with the strategic plan’s goals

We are helping 12 multidisciplinary workstreams identify milestones, timelines, owners and clear next steps to implement strategic actions that align with the goals of the strategic plan. Additionally, Artemis is conducting nursing environmental scans and other research to ensure ONS uses appropriate, evidence-based approaches and innovative care models to operationalize the strategic plan. The team is collecting best practices critical to nursing leadership structure and incorporating this information into each workstream’s milestones. We also provide support for several pilot programs aimed at testing the effectiveness of the strategic plan’s strategies. Some topics the pilots will test for include alternative scheduling for nursing shifts, a standard staffing model tool for support services to meet patient care demands in ambulatory care settings, an alternative model of care, the use of technology (such as wearables and smart devices) to maximize Veteran access to care, an electronic reference system and a standardized toolkit to support publication of evidence-based practice implementation.

Delivering communications and product development support

Artemis is supporting the workstreams in developing noteworthy, evidence-based products. These products are all aimed at helping nurses in the field and include resource guides, toolkits, trainings and comprehensive reports. Additionally, thorough literature reviews, environmental scans, white papers, data sets and other resource documents have been created to provide context for the strategic plan activities. To support leadership briefings and meetings, Artemis prepares briefing materials, talking points, eye-catching graphics, and other communications tools to ensure awareness of the strategic plan and the resources and products created from it.

Results

Achieving the four goals of the ONS strategic plan

• A comprehensive Project Management Workbook for the overarching contract and for each of the 12 workstreams to ensure organization and alignment on timelines, priorities, owners and risks
• Multiple resource documents, to include white papers, current state analyses, environmental scans, literature reviews, etc.
• Key performance indicators for the overarching strategic plan, along with workstream specific outcome measures to begin tracking progress in future fiscal years
• Based on the current work of operationalizing the strategic plan, the anticipated outcome to nurses in the field include:
  • Standardized nurse leadership roles and staffing models
  • Practice at the top of nursing licensure
  • Reduced time-to-hire and gaps in staffing
  • Movement across nursing specialties
  • Improved mentorship opportunities
  • Protected time for learning, education and career development
  • Improved professional development opportunities and pathways
  • Enhanced psychological safety
  • Optimized nurse experience
  • Shared decision making