National Suicide Prevention 2.0 Clinical Telehealth program: Virtual evidence-based implementation and change management in Veteran Affairs

Body of Abstract:

Background: As part of the U.S. Department of Veteran Affairs’ (VA) public health strategy for suicide prevention, the Suicide Prevention 2.0 Clinical Telehealth Program (SP 2.0 Clinical) is a VA nationwide fully virtual initiative driving systems change and implementing evidence-based psychotherapy for suicide prevention for veterans. The program specifically reaches Veterans with a recent history of suicidal self-directed violence behaviors. Evidence-based treatments and interventions, based on the 2019 Clinical Practice Guidelines for the Assessment and Management of Patients at Risk for Suicide, include Cognitive Behavioral Therapy for Suicide Prevention (CBT-SP), Problem Solving Therapy for Suicide Prevention (PST-SP), Dialectical Behavior Therapy (DBT) and the Safety Planning Intervention (SPI).

Aims: (1) Describe an enterprise-wide fully virtual evidence-based clinical suicide prevention program (2) Explain Prosci’s ADKAR change management model (3) Identify SP 2.0 Clinical change management strategies (4) Evaluate success of SP 2.0 Clinical’s implementation approach (5) Explore change management strategies with workshop participants and share lessons learned across implementation techniques.

Methods: The SP 2.0 Clinical program implementation was informed by Prosci’s ADKAR change management model (Hiatt, 2006) and used a variety of change management strategies to achieve the 5 tangible and concrete outcomes necessary to drive lasting change: Awareness, Desire, Knowledge, Ability, and Reinforcement.

During this workshop, we will (1) present the ADKAR model and how it informed our overall implementation approach, (2) discuss techniques used and lessons learned for organizational change during four years of implementation, (3) highlight how we used data to both drive further systems change and demonstrate successful systems change, and (4) facilitate break-out discussions based on audience member’s perceived stage of change (i.e., what element of ADKAR is most relevant to their work). Audience members will develop action steps for change management activities tailored to the current status of their change process advancing their suicide prevention-related change efforts

(e.g., if increasing awareness is the goal, then focus on communication).

Results: The SP 2.0 Clinical initiative has driven successful suicide prevention-related organizational change, as evidenced by being operational in all 18 regions of Veteran Affairs Health Care Systems, with over 24,000 referrals received, over 8,500 intakes conducted, and high rates of subsequent treatment engagement (82%). Tailoring change management strategies to the phase of systems change was essential to successful implementation.

Conclusions: This project integrates change management and evidence-based care for suicide prevention. We demonstrate the breadth of strategies tailored for implementing a nationwide fully virtual suicide prevention initiative, using evidence-based change management strategies to put practice guidelines into action to improve veteran access to care. At the conclusion of this program, the participant should be able to (1) describe the implementation and outcomes of VA’s Suicide Prevention 2.0 Clinical Telehealth program in Veteran Affairs (VA) (2) describe the ADKAR model and what change management techniques are appropriate for driving each outcome of Awareness, Desire, Knowledge, Ability, and Reinforcement, (3) apply evidence-based change management techniques to their own personal suicide prevention-related change management efforts and (4) create action plans tailored to build the next relevant ADKAR element in the participant’s change process.

Learning Objectives:

• Describe the implementation and outcomes of VA’s Suicide Prevention 2.0 Clinical Telehealth program in Veteran Affairs (VA)
• Describe the ADKAR model and what change management techniques are appropriate for driving each outcome of Awareness, Desire, Knowledge, Ability, and Reinforcement.
• Apply evidence-based change management techniques to their own personal suicide prevention-related change management efforts.
• Create action plans tailored to build the next relevant ADKAR element in the participant’s change process.