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Completed

NCT Number: NCT03280225

REACH VET Implementation Program Evaluation

The VA's Office of Mental Health and Suicide Prevention implemented an new program to increase suicide prevention outreach for Veterans at highest risk for suicide. Using a statistical model, REACH VET, short for Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment, uses information from Veterans' health records to identify those who are at a higher risk for suicide, hospitalization, illness, or other negative outcomes. Once a Veteran is identified, his or her VA mental health or primary care provider reaches out to check on the Veteran's well-being and review their treatment plan to determine if enhanced care is needed. The goal of the current study was to evaluate the implementation of this program. The objectives of this evaluation were to evaluate how well this program is put into place using an implementation strategy called virtual external facilitation, and to collect data about the cost of the program and the strategy.

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Key information

Conditions

Suicide Behavior Behavioral Symptoms Self-Injurious Behavior

Sex eligibility

All sexes

Study type

Observational

Primary location

Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR, North Little Rock, Arkansas, United States

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About this study

The VA's Office of Mental Health and Suicide Prevention is implemented an innovative new program to increase suicide prevention outreach and target Veterans at highest risk for suicide. Using a new predictive model, REACH VET, short for Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment, analyzes existing data from Veterans' health records to identify those who are at a statistically elevated risk for suicide, hospitalization, illness, or other adverse outcomes. Once a Veteran is identified, their VA mental health or primary care provider reaches out to check on the Veteran's well-being and review their condition(s) and treatment plans to determine if enhanced care is needed.

The goal of the proposed study is to evaluate the implementation of REACH VET. The objectives of this evaluation are to:

  • evaluate the implementation of REACH VET using virtual external facilitation, and
  • collect preliminary data about the cost and cost offsets.

The current evaluation will examine the impact of a virtual external facilitation strategy on the implementation of REACH VET in 28 medical facilities across 7 Veteran Integrated Service Networks (VISNs) in a stepped wedge design. Primary implementation outcomes include metrics of REACH VET implementation: coordinator assignment, provider assignment, care evaluation, and attempted outreach. Qualitative interviews will be conducted with implementation facilitators, Suicide Prevention Coordinator(s), clinical leadership, and providers to identify barriers and facilitators to implementation of REACH VET and the experience of facilitation. Secondary data will be collected on the cost of the intervention and the cost of implementation strategy.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • VA employee at a facility receiving virtual external facilitation
  • Involved in REACH VET implementation

Exclusion criteria

  • Not a VA employee
  • Not employed at a facility receiving virtual external facilitation
  • Not involved in REACH VET implementation

Treatment and study plan

External facilitation

Other

Facilitation is an evidence-based implementation strategy to support sites that have difficulty implementing innovative programs. Facilitation is a multi-faceted "process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship (Powell et al., 2015)." Facilitation has been used nationally across VA to implement a number of different clinical interventions. The current project will examine this minimally intensive version of implementation facilitation, virtual external facilitation.

Other names: Virtual external facilitation, facilitation, implementation facilitation

Primary outcomes

  1. Coordinator Assigned Post-Implementation

    Time frame: 6 months after implementation was completed

    The average percentage of eligible Veterans across all 23 participating sites having a coordinator assigned within 2 weeks of the monthly REACH VET report being released during the 6 month post-implementation period.

  2. Provider Assigned Post-Implementation

    Time frame: 6 month period following implementation

    The average percentage of eligible Veterans across all 23 participating sites having a provider assigned within 2 weeks of the monthly REACH VET report being released during the 6 month post-implementation period .

  3. Care Evaluation Performed Post-Implementation

    Time frame: 6 month period following implementation

    The average percentage of eligible Veterans across all 23 participating sites receiving a care evaluation within 2 weeks of the monthly REACH VET report being released during the 6 month post-implementation period.

  4. Attempted Outreach Post-Implementation

    Time frame: 6 month period following implementation

    The average percentage of eligible Veterans across all 23 participating sites where outreach was attempted within 2 weeks of the monthly REACH VET report being released during the 6 month post-implementation period.

Secondary outcomes

  1. Organizational Readiness for Change Survey

    Time frame: 1 month

    Eligible staff at participating VA facilities were solicited to complete a modified version of the Texas Christian University Organizational Readiness for Change - Staff (TCU ORC-S). We abbreviated the original instrument to 62 items and modified text for contextual relevance. Responses were collected from 22 sites across five Veteran Integrated Service Networks (VISN). The responses were scored on ten scales: Program Needs (10 - 50 higher is preferred), Training Needs (10 - 50 higher is preferred), Pressure for Change (10 - 50 higher is preferred), Staffing (10 - 50 higher is preferred), Mission (10 - 50 higher is preferred), Cohesion (10 - 50 higher is preferred), Autonomy (10 - 50 higher is preferred), Communication (10 - 50 higher is preferred), Stress (10 - 50 lower is preferred) and Change (10 - 50 lower is preferred).

Sponsors and collaborators

Lead sponsor

VA Office of Research and Development

Fed

Registry information

Official study title

Risk Stratified Enhancements to Clinical Care: Targeting Care for Patients Identified Through Predictive Modeling as Being at High Risk for Suicide, With the Office of Mental Health Operations

Acronym: REACH VET

Important dates

Study start
2017
Primary completion
2020
Study completion
2020
First posted
Sep 12, 2017
Registry last updated
Jan 25, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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