In support of the Department of Veterans Affairs’s (VA) Fourth Mission to improve the nation’s preparedness for clinical response to national emergencies, the Veterans Health Administration (VHA) Emergency Management Coordination Cell (EMCC) prepared a structured, comprehensive training program to address the emergent changing education needs of its staff providing care for veterans.
With other major health organizations sharing various, complex guidance and information daily, much of it contradictory and evolving, it was imperative that subject matter experts and VHA leadership vet education, information, and resources. The EMCC created a Clinical Coordination Cell (CCC) with multiple functions including clinical care recommendations, policy review, and training development. The CCC took the lead in collecting and evaluating this knowledge base and best practices and instituted a standardized process (see flowcharts 1 and 2) to evaluate, develop, and deploy training and resources to VHA clinical employees while also making this critical material available to the public.
The Employee Education System (EES), VHA’s program office responsible for employee education and training, worked directly with the CCC to vet, approve, and create education and training critical for clinical employees to deal with the COVID-19 pandemic and related issues. EES developed role-based training solutions to address the real issues arising in the field for COVID-related care, including realigning trained administrative staff to more clinical functions, and moving clinical staff to new roles to support emergency departments and intensive care units, nursing home care, and infectious disease control. EES and CCC also implemented an ongoing review process for updating materials with the most current scientific and clinical evidence.
Part of these efforts included creation of the VA COVID-19 training website. This website is a public-facing site that provides free COVID-19-related training and resources, offered through the VA and other authoritative external sources, without the need for staff to log in to the VA network or a specific user account. With a computer, tablet, or smartphone, users can reach this site from anywhere in the world. This site provides clinical crisis skills training or upskilling in critical topics for staff being assigned to intensive care units, wards, emergency departments, and community living centers as well as comprehensive training materials for mental health and state veteran homes. The site has received more than 31,000 unique page views from across the world and continues to grow.
EES and CCC also innovated new channels to identify and distribute current and promising practices to optimize COVID-19 clinical care. One channel was the development of Clinical Strong Practices (CSPs) in which the group collaborated with innovations ecosystem teams to produce clear, easily used materials for promising practices. A total of seven CSPs on topics such as COVID-19 airway management and comparisons of use for different masks in various healthcare and community settings were created. An additional channel was the development of the COVID-19 in 20 Live Virtual Training series based on sharing information “from the field, for the field.” After more than 40 shows and 180,000 views, the program continues to reach VHA staff twice weekly with featured guests including frontline clinical staff in VHA facilities and those deployed to Fourth Mission taskings, national experts, and VHA facility, VISN, and central office leaders.
To ease the burden of mandatory and other required training, VHA also implemented a 120-day moratorium on non-COVID-19-related mandatory or required training. Training administrators were delegated authority to make determinations on local mission-critical training requirements to ensure patient and employee safety. For those not directly involved in COVID-19 operations, they were encouraged to continue training as planned but with due dates extended. Learning leaders were also expected to reduce the training burden associated with onboarding new VHA clinical augmentation staff responding to the pandemic.
With these processes and platforms in place, EES then worked with VHA leadership, program office communicators, public affairs officers, and other key personnel to inform employees of the available training and resources resulting in more than 14,000 course completions and 12,000 learning hours acquired by VHA staff on COVID-19-related content.
After VHA’s education and training for COVID-19 was deployed, EES, in partnership with the Office of Community Care and Office of Rural Health, continued to further support VA’s Fourth Mission by providing a COVID-19 health policy, education, standard operating procedures, information, and resources for all public health care providers to access. These VHA offices have developed a centralized webpage to provide all this information to the public in an easily accessible format and are now working to communicate the availability of this information to all public health care providers.