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A Veteran and care provider engaging in Tai Chi on the left side of the photo. On the right side, text stating "VA did that? Veterans involved with VA's Whole Health system report a positive impact on their experience and engagement of their care and overall well-being."

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Well-being Signs Administrator Dashboard

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The Well-being Signs is a 3-question validated and reliable, quantitative scale that assesses how a Veteran is doing in their daily life activities and experiences in relation to their sense of purpose. The scale can be a powerful tool to transform traditional care into Whole Health care, but there is currently no way for clinicians to easily track well-being scores by specific clinic groups and patient demographics.
Users of the Well-being Signs Administrator Dashboard are able to evaluate Veteran well-being changes over time in utilization, clinic use, groups, individual, or demographics at the administrators' local VA healthcare facility. The Veteran and the Well-being Signs administrator utilize the Well-being Signs Administrator Dashboard evaluation outcomes to help connect the dots between healthcare recommendations and the Veteran's reason(s) to follow them in shared goal setting, fostering a Veteran's high sense of purpose.

This innovation is scaling widely with the support of national stakeholders. See more scaling innovations.

Origin:

July 2023, St. Cloud VA Medical Center

Adoptions:

23 successful, 20 in-progress

Awards and Recognition:

Office of Patient Centered Care and Cultural Transformation (OPCC&CT) formal endorsement and publication of the "Well-being Signs Administrator Dashboard: Installation Guide" on th ... Office of Patient Centered Care and Cultural Transformation (OPCC&CT) formal endorsement and publication of the "Well-being Signs Administrator Dashboard: Installation Guide" on the OPCC&CT Well-being Signs SharePoint site in April 2024 , OPCC&CT Invitation to present on six national Call to Practice calls to share the Well-being Signs Administrator Dashboard implementation resources nationally, April 2024-June 2024, VHA Shark Tank Winner

Partners:

Patient Centered Care and Cultural Transformation

Contact Team

Overview

Problem

What matters to Veterans, matters to the VA. Individuals with a a low sense of purpose have an increased risk of early death by 2.5x compared to individuals with a high sense of purpose (https://pubmed.ncbi.nlm.nih.gov/31125099/). The OPCC&CT developed Well-being Signs documentation templates in the Electronic Health Record (EHR) to allow administrators to i ... See more

Images

Survival Curves Illustrating the Association Between Life Purpose and Mortality demonstrating individuals with a higher sense of purpose have longer survival time.

Survival Curves Illustrating the Association Between Life Purpose and Mortality (https://pubmed.ncbi.nlm.nih.gov/31125099/: Alimujiang A, Wiensch A, Boss J, et al. Association Between Life Purpose and Mortality Among US Adults Older Than 50 Years. JAMA Netw Open. 2019;2(5):e194270. Published 2019 May 3. doi:10.1001/jamanetworkopen.2019.4270)

Videos

Well-being Signs Administrator Dashboard SharkTank 2024 Promotional Video

Links

Solution

To effectively evaluate and monitor Veteran Well-being Signs outcomes over time, the St. Cloud VA Healthcare System (VAHCS) Whole Health Team and VISN 23 Managerial Cost Accounting and Analytics (MCAA) Analysts developed the Well-being Signs Administrator Dashboard. The dashboard is a Power BI evaluation tool to the Well-being Signs and enables a user to eva ... See more

Images

The image outlines the how to administer the Well-being Signs.

"Well-being Signs Pocket Guide" for staff use, Office of Patient Centered and Cultural Transformation

Line graph demonstrating Well-being Signs outcomes over a three month period for Veterans with Pain in Health and Wellness Coaching. Veterans with pain Well-being Signs average score was 5.67 in July 2023 with average score of 7 in September 2023. Veterans with pain well-being improved by 23.46% from start of WH Coaching service in July 2023 to end of rating period in September 2023.

"Wellbeing Signs Administrator Dashboard: Installation Guide" (St. Cloud VA HealthCare System and VISN 23 MCAA)

Results

Utilizing a Change Management approach, St. Cloud VAHCS integrated the Mission/Aspiration/Purpose (MAP) question (i.e., "What matters most to you in your life right now?" quantitative, open ended question), Well-being Signs, and "Introduction to Whole Health" class referral in Primary Care annual visits during the LPN annual nursing clinical reminders.

T
... See more

Images

A Provider on the right and Veteran on the left engaging in a Well-being Signs Shared Goal Setting Conversation

Provider and Veteran Well-being Signs Shared Goal Setting Conversation (Ashley Schmidt - Provider; James Newman - Veteran)

Graph showing Veterans with at least one whole visit with increased rate of Colorectal Cancer screenings than Veterans with no Whole Health visit(s).

Researches observed Veterans with at least one Whole Health visit completed more Colorectal Cancer screenings compared to Veterans with no documented Whole Health visits. (Zeliadt, Steven. "Clinical Quality Measures Before and After Whole Health." PowerPoint Presentation. 12 June 2024, Seattle-Denver HSR Center of Innovation).

Table demonstrating relation between whole health visit(s) and Clinical Quality Measures.

Researches observed Veterans with at least one Whole Health visit demonstrated multiple better Clinical Quality Measures compared to Veterans with no documented Whole Health visits. (Zeliadt, Steven. "Clinical Quality Measures Before and After Whole Health." PowerPoint Presentation. 12 June 2024, Seattle-Denver HSR Center of Innovation (COIN).

Veterans with at least one Whole Health Visit had a 1.32x higher odds of having talked with their healthcare team about specific health goals and 1.18x times higher odds of having been asked if there are barriers to taking care of their health over a six month period compared to Veterans who did not use Whole Health. (Zeliadt, Steven; Chen, Claire; Reed II, David; Etingen, Bella; Bolton, Rendell; Kloehn, Alex; Coggeshall, Scott; Bokhour, Barbara. "VA's National Implementation of Whole Health and Impact on Patient Experiences." PowerPoint Presentation. 12 June 2024, Seattle-Denver HSR Center of Innovation).

Veterans with at least one Whole Health Visit had a 1.32x higher odds of having talked with their healthcare team about specific health goals and 1.18x times higher odds of having been asked if there are barriers to taking care of their health over a six month period compared to Veterans who did not use Whole Health. (Zeliadt, Steven; Chen, Claire; Reed II, David; Etingen, Bella; Bolton, Rendell; Kloehn, Alex; Coggeshall, Scott; Bokhour, Barbara. "VA's National Implementation of Whole Health and Impact on Patient Experiences." PowerPoint Presentation. 12 June 2024, Seattle-Denver HSR Center of Innovation).

Links

Metrics

  • Utilizing the Well-being Signs Dashboard for further evaluation, during the Primary Care Well-being Signs integration pilot period from 12/18/2024-5/4/2024, on average, 8.5% of all Veterans with a score between 2-8 on the Well-being Signs accepted a referral to "Introduction to Whole Health" class. Total number of "Introduction to Whole Health" class referrals doubled each month of the pilot.
  • A Veteran experiencing a new diagnosis of Chronic Obstructive Pulmonary Disease (COPD) baseline Well-being Signs score with his Primary Care Provider was a 4 and rated "Regularly involved in things that are important to you" at a 3. After meeting with a Health and Wellness Coach and referred to Tai Chi, Yoga, and Nutrition, two months later the Veteran rated himself a 6 in "Regularly involved in things that are important to you" and the Veteran's overall Well-being Signs begins score began to increase (4.67 average score).
  • Veterans experiencing pain in Health and Wellness Coaching Well-being Signs average score was 5.67 in July 2023 and an average score of 7 in September 2023. Veterans experiencing pain well-being improved by 23.46% from start of Health and Wellness Coaching service in July 2023 to end of rating period in September 2023.

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

There are no unsuccessful adoptions for this innovation.

Multimedia

Videos

Administration of the Well-being Signs in Primary Care: MSA Check - in to LPN to Provider

Implementation

Timeline

  • 1 week
    If not already completed, install Well-being Signs Electronic Health Record (EHR) documentation templates.
  • 1 Week
    Identify Program Analyst with required skill (see installation guide) to install Well-being Signs Administrator Dashboard (2 hour max time needed to install).
  • 1-2 Weeks
    If not already occurring, identify care team(s) to integrate Well-being Signs into care conversations and implement Well-being Signs documentation workflow. Provide education on how to administer the Well-being Signs. Provide Well-being Signs Administrator Dashboard access to care team(s) as evaluation resource to inform care.
  • 2 weeks+
    Care team(s) begin to collect Well-being Signs scores.
  • 4 weeks+
    Users of the Well-being Signs Administrator Dashboard may begin to utilize data for evaluation.

Departments

  • Veteran experience
  • Mental health care
  • Social work
  • Amputation care
  • Audiology and speech
  • Bariatric surgery
  • Cancer care
  • Dermatology
  • Diabetes
  • Endocrinology
  • Extended care and rehabilitation
  • Gastroenterology
  • Gynecology
  • Hematology/Oncology
  • Radiology
  • Chaplaincy
  • Psychiatry
  • Sleep medicine
  • Smoking and tobacco cessation
  • Maternity
  • LGBTQ+ Veteran care
  • Cardiology
  • Cardiovascular surgery
  • Geriatrics
  • Chiropractic
  • Colon and rectal surgery
  • Complementary and alternative medicine
  • Caregiver support
  • Podiatry
  • Coronary care unit
  • Critical care
  • Spinal cord injuries and disorders
  • Adaptive sports
  • Addiction and substance abuse treatment
  • Advice nurse
  • Allergy, asthma and immunology
  • Discharge planning
  • Hospital medicine
  • Nursing services
  • Psychology
  • Telehealth
  • Internal medicine
  • Intimate partner violence
  • Low vision and blind rehabilitation
  • Military sexual trauma
  • Minority Veteran care
  • MOVE! weight management
  • Nephrology, renal and kidney
  • Neurosurgery
  • Ophthalmology
  • Optometry
  • Orthopedics
  • Otolaryngology
  • Outpatient surgery
  • Pain management
  • Palliative and hospice care
  • Physical medicine and rehabilitation
  • Physical therapy, occupational therapy and kinesiothology
  • Plastic and reconstructive surgery
  • Polytrauma and traumatic brain injury
  • Primary care
  • PTSD treatment
  • Pulmonary medicine
  • Radiation oncology
  • Recreation and creative arts therapy
  • Rehabilitation and prosthetics
  • Returning service member care
  • Rheumatology
  • Social services
  • Suicide prevention
  • Surgery
  • Surgical oncology
  • Thoracic surgery
  • Transplant surgery
  • Vascular surgery
  • Vocational rehabilitation and employment programs
  • Wheelchair and mobility
  • Whole health
  • Women Veteran care
  • Wound care and ostomy
  • Neurology
  • Nutrition, food, and dietary
  • HIV/hepatitis
  • Homeless Veteran care

Core Resources

Resource type Resource description
PEOPLE
  • Program Analyst (installation of dashboard, one time - 2 hours), Well-being Signs Administrator Lead (support installation of dashboard and care team(s) integration of measure, 2-4 hours for 4 weeks), Care team Well-being Signs administrators (support identifying workflow integration, one time education on how to administer measure, one time – 2 hours), care teams ongoing administration of Well-being Signs measure 1-2 minutes integrated into already occurring informed care conversations
PROCESSES
  • 15 minute educator on Well-being Signs administration, documentation, and evaluation resources
TOOLS
  • Program Analyst access to vhacdwdwhsql33.vha.med.va.gov, working knowledge of SQL series, familiarity with creating and running stored procedures, and knowledge of Power BI or Report Builder and ability to create online reports
  • Well-being Signs Electronic Health Record (EHR) Documentation Templates Installation Guide
  • Well-being Signs Administrator Dashboard Installation Guide
  • Well-being Signs Administrator Pocket Card
  • Well-being Signs Fillable Handout

Files

Links

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

VA User (Whole Health Clinical Director) Innovation adopter posted

I cannot wait to see what happens here in Orlando with this innovation! We are so excited to innovate with your team!

1
VA User (Health Systems Specialist, IHCC) posted

I am excited to see what happens with this project! Good luck!

1

Email

Email with questions about this innovation.

About

Origin story

The St. Cloud VA Healthcare System (VAHCS) Whole Health Department began utilizing the Well-being Signs measure in the Fall of 2021 as an integrated measure for the facility's Health and Wellness Coaching program and included the Well-being Signs measure as part of the Whole Health Department's Key Performance Indicators (KPIs). The initial version of the We ... The St. Cloud VA Healthcare System (VAHCS) Whole Health Department began utilizing the Well-being Signs measure in the Fall of 2021 as an integrated measure for the facility's Health and Wellness Coaching program and included the Well-being Signs measure as part of the Whole Health Department's Key Performance Indicators (KPIs). The initial version of the Well-being Signs allowed a user to pull a raw data spreadsheet for independent evaluation. St. Cloud VAHCS was an early pilot site for the Well-being Signs research and development. When version two of the measure was launched in January 2023, the previous report became void. To be able to continue to report data on the Well-being Signs KPI, the Whole Health System Manager reached out to the VISN 23 Managerial Cost Accounting Analytics (MCAA) team for collaboration. This collaboration resulted in the Wellbeing Signs Administrator Dashboard first version by June 2023 and most current version by June 2024 with improved updates from user feedback. The Office of Patient Centered Care and Cultural Transformation (OPCC&CT) recognized the value of the Well-being Signs Administrator Dashboard and provided mentorship and feedback as the dashboard was piloted from August 2023 to April 2024. By April 2024, OPCC&CT formally endorsed and published the "Well-being Signs Administrator Dashboard: Installation Guide" on their Well-being Signs SharePoint site. The national office invited the St. Cloud team to present at six national OPCC&CT Community of Practice calls to share and promote the dashboard resources. As a result, multiple facility leads and VISN analysts reached out to the St. Cloud team and began work towards installing the Well-being Signs Dashboard. Currently, 10 sites have fully installed the dashboard and are utilizing the resource for regular evaluation. 32 additional VA facilities are in progress to install a copy of the Well-being Signs Administrator Dashboard, including all facility access in VISN 10, VISN 12, and VISN 15.

Original team

Joia Byrnes Tellez

St. Cloud VAHCS Whole Health System Manager

Ashley Schmidt

St. Cloud VAHCS Whole Health Clinical Director

Jennifer Ferguson

VISN 23 MCAA Program Analyst

Carisa Voightman

VISN 23 MCAA Program Analyst

Crystal Thesing

St. Cloud VAHCS Primary Care Chief Nurse

Dettleff Olson

St. Cloud VAHCS Primary Care Medical Director

Breta Monroe

St. Cloud VAHCS Associate Director of Patient Care Services and Nurse Executive

Javed Tunio

St. Cloud VAHCS Chief of Staff

Jessica Hennessey

OPCC&CT VISN 23 Field Implementation Team Consultant

Grace W. Yan

OPCC&CT Lead- Innovations & Resource Development (Whole Health System Development)

Jennifer Henderson

VISN 23 Whole Health Network Sponsor

Irad Gillett

OPCC&CT Health Systems Specialist - Data Analyst

Jackie Stevenson

St. Cloud VAHCS Public Affairs Specialist