A healthy learning organization is a place where employees want to serve, and Veterans want to receive services. A learning organization is essentially a transfer of knowledge where everyone learns differently, and we focus on people, process, and performance.

Let’s look at what is a Learning Organization and review the six essential questions for changes to the next HRO newsletter.

• What is a Learning Organization?
  • A learning organization is an organization skilled at creating, retaining, and transferring knowledge through sharing lessons learned and innovations
• Why is a Learning Organization important?
  • It creates a culture where asking questions, creative problem solving and sharing of lessons learned is the norm
  • This allows us to remain agile and dynamic in the world of healthcare delivery, where we know things can change daily
• How can you promote a Learning Organization?
  • Share Safety Stories and key takeaways with your teams
  • Identify various style of learning and create processes to support them
  • Utilize systematic problem-solving tools such as the 5 Why’s and PDSA cycles
  • Practice data-driven decision making
  • Why start from square one every time? Share lessons learned with others to transfer knowledge

What’s next on our HRO Journey in promoting a Learning Organization?

1. What is changing?

• The content and the formatting of the Quarterly HRO Newsletter to transfer knowledge for a variety of learning styles
• Each of the 3 pillars of HRO (Leadership Commitment, Culture of Safety & Continuous Process Improvement) will included content on:
  • People (connecting opportunities to strengthen our AES results and building upon the people piece of our work)
  • Process (sharing any Promising Practices or standard work documents that are being developed by our facilities)
  • Performance (sharing progress on key metrics from the VISN 22 Strategic Plan, the Medical Center Director’s Executive Career Field (ECF) Performance Plan or other key areas)

2. Why is it changing?

• As we accelerate our HRO Journey in VISN 22, it’s imperative to broaden our approach to be more inclusive of various styles of learning as well as building transparency into all of the great work being done at our facilities

3. Why is it changing now?

• As we began our new fiscal year, we asked for feedback into our various platforms of communication and what opportunities we had to improve them
• That feedback was considered and incorporated into our FY23 changes

4. What is not changing?

• Monthly Desert Pacific Post
• Monthly V22 HRO Community of Practice resources email
• Weekly V22 Communication Report

5. What are the risks of not changing?

• We will miss capturing, engaging, educating, and recognizing the staff and the great changes and work they are doing

6. What are the benefits of changing?

• Creating a larger community of a learning organization to help us accelerate our HRO Journey forward
• Sharing of Promising Practices from facilities so others can adapt as needed
• Recognizing opportunities that may not have worked so others can avoid the same mistakes

You help to influence work experiences and inform leaders where we want to prioritize change. We’re looking for your voice, your feedback. Please click HERE to take our short questionnaire.

Thank you for demonstrating a Commitment to Zero Harm in a Culture of Excellence/Safety by continuing the conversation around a learning organization and change management and helping make a positive change in VISN 22.  Your continuous engagement strengthens our organization, and we appreciate you!   

VISN 22 Story: Interview with the Northern Arizona VA Health Care System HRO Lead- Bill Rhoades

Tell us about yourself? What is your background? 

I have been with the VA since 2015. I started as a Vocational Rehabilitation Specialist in the CWT Program. In 2018, I joined the Education Department as the Training Specialist and joined the Organizational Excellence Service Line in May 2021. I am a 22-year Navy Veteran and Mustang, advancing to Senior Chief Petty Officer and promoted to Chief Warrant Officer. In this part of my life, my hobbies and interests include doing whatever my wife wants done at the house (painting, hanging things on walls, making roll out shelves in the cabinets, etc.). I also enjoy walking and walk 4 to 5 miles at least three times a week (no running for me with prosthetic knees😊).

How long have you been the HRO Lead?

I have been the HRO Lead since November 18 when Robin Maddox left for retirement, but I also assisted Robin in her role as HRO Lead since January 2022.

How is the NAVAHCS making high reliability a part of its culture?

NAVAHCS is making HRO part of the culture in every monthly meeting, Town Hall, and Daily enterprise Huddle. HRO was the main focus at our recent Strategic Planning Retreat. At NAVAHCS we not only say HRO, we openly discuss Psychological Safety and what it means to all staff and strive to achieve it in all workgroups, we openly discuss and encourage clear communication and its importance to our mission and patient safety, we openly discuss continual improvement and what it means to learn from our mistakes. Simply, we are keeping the conversation going and being consistent with our messaging.

How is high reliability embedded into your leadership rounding, safety values, and continuous process improvement?

HRO is embedded in leader rounding in a number of ways. First, we do not use any standard questions for rounding. We ask leaders to be themselves and start each conversation with “hi, how is it going” and let the conversation evolve from there. Leaders are scheduled to report back on rounding each Thursday and we ask them to present information such as any challenges to rounding, any quick identified during rounding that have been resolved, any big hit, what have we learned and what is our staff telling us.

HRO is embedded in our safety values by promoting and performing a monthly Safety Forum that all staff are invited to attend with themes and topics such as Psychological Safety, JPSR, Just Culture, and the topics are driven by what is happening now and what safety information is important to discuss with staff.

HRO is embedded in our continuous process improvement in how we manage change, how we report things that are changing such as successes and positive change from our AES action plans.

What high reliability best practices have you implemented?

We have a safety story presented to the enterprise Huddle each Wednesday and a schedule has been developed to identify what department presents on what date.

We have included this same practice for leader rounding reporting to the enterprise Huddle each Thursday with the same scheduling. Leader Rounding reporting began today 12/15/22 with Specialty and Diagnostics reporting. AES Action Plan updates are provided at each monthly Employee Town Hall. In 2023, instead of just me presenting the updates, I will have staff from individual workgroups report on their action plan changes and successes.

Welcome VISN 22 Quality Management Officer- Dr. Yvonne Ginez-Gonzales

Please join me in welcoming Dr. Yvonne Ginez-Gonzales as the VISN 22 Quality Management Officer effective December 4, 2022!

She is a VA CASE Green Belt Certified Process Improvement Specialist and VHA Prosci Change Practitioner.

Prior to this appointment, Dr. Ginez-Gonzales served as the Chief of Quality, Safety, and Value Service at the VA Long Beach Healthcare System where she led a multidisciplinary team of 41 staff to execute quality programs for the entire healthcare system with a focus on identifying and minimizing risks, improving clinical and business processes, and enhancing the patient experience. 

Programs under her supervision included Systems Redesign and Improvement / High Reliability Department, Patient Safety Department, Accreditation Department, Infection Prevention and Control Department, Peer Review, and Risk Management.  She served as the primary point of contact for all external (TJC, CARF (PM&R, SCI, BRC, and Behavioral Health), and Ascellon – SCI and CLC, GAO, AABB, OMI, NRC, and NHPP) and internal (OIG CHIP, Network Special Purpose Visits, OMHO, Fact Finding and AIB, RCA and HFMEA) regulatory and accreditation visits to the facility with oversite of the evidence of standard compliance plans of corrections completed and closed timely. 

She served as the leading expert and primary advisor to the Medical Center Director and Executive Leadership Team on the deployment and implementation of the organization’s Lean Management System, Health Care System Performance, and Enterprise Risk Management Program.  She serves as a preceptor of MSN and DNP students, including Emerging Leaders, and HHA students. 

She started her nursing career in 1997 as a Licensed Vocational Nurse in various clinical settings before obtaining her Registered Nurse License and progressing to receive her Doctor of Nursing Practice from California State University, Fullerton in May 2015.  Dr. Ginez-Gonzales served as a Sergeant in the U.S. Army Reserves, 349th General Hospital (HUM), for thirteen years.

She is married, a proud mom of 2 college students (Nicolas and Chloe). She enjoys spending time with family, bingeing Netflix shows, Star Wars series fan, and doing puzzles.

Call to action from the VISN 22 Patient Safety Officer- Brittany L. Cato

My charge to you, Let’s grow together!

VISN 22 All Employee Survey (AES) -Patient Safety Culture Results are linked HERE – “The largest opportunity is room for improvement”.

Even though, since 2019, VISN 2022 improved in all four composites (Error Transparency & Risk Mitigation, Supervisor Communication & Trust, Risk Identification & Just Culture and Teamwork Cohesion & Engagement), there is always room to learn, grow and improve.

The Culture of Safety survey identified that only 60.54% of respondents “are given feedback about changes put into placed based upon event reports” and only 60.76% of respondents identified “mistakes have led to positive changes here”. If we dig a little deeper, Supervisory Communication & Trust composite measure had the lowest change from previous 2021 survey. As you can see, we definitely have room to improve.

My charge to you, “lets grow together”. Participate in patient safety activities, anticipate risk, and grow in Just Culture. VISN 22 is committed to living a just culture.

HOT TIPS (TOPICS IN PATIENT SAFETY)

To maximize our first pillar leadership commitment and assist with Supervisor Communication & Trust we are going on a VISN tour for a Culture of Safety Roadshow. The Roadshow is intended to be a tiered approach utilizing:

• Q&A panel approach (using questions submitted by leadership and front-line staff)
• Just Culture skills teaching
• Transparent discussion from high performing areas

SEE YOU ON THE ROAD!!!