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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.
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
Recent Updates
Overview
Problem
Images
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
- "A growing body of literature suggests that having a strong sense of purpose in life leads to improvements in both physical and mental health and enhances overall quality of life. There are interventions available to influence life purpose; thus, understanding the association of life purpose with mortality is critical." Association Between Life Purpose and Mortality Among US Adults Older Than 50 Years
Solution
Images
"Well-being Signs Pocket Guide" for staff use, Office of Patient Centered and Cultural Transformation
"Wellbeing Signs Administrator Dashboard: Installation Guide" (St. Cloud VA HealthCare System and VISN 23 MCAA)
Results
T ... 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.
The LPN records the information on the intake sheet and provides the information to the Provider. The Veteran and Provider explore what matters most to the Veteran and barriers in their well-being (informed by the MAP question and Well-being Signs) fully integrating the Veteran responses into a standard clinical care, shared goal setting conversation. The Veteran and Provider are then empowered and equipped to make relevant and impactful referrals that support the Veteran's high sense of purpose and well-being.
Initially, Primary Care pilot teams volunteered to be a part of the project. Throughout the pilot, the St. Cloud project management/Change Management team provided a Change Management approach by building Awareness, Desire, Knowledge, Ability, and Reinforcement (ADKAR) at each project milestone to support the Primary Care pilot team members efforts and integration of the measure. Due to the Primary Care pilot team members' success, as of May 2024, the pilot transitioned to standard care for all Primary Care annuals across all St. Cloud VAHCS Patient Aligned Care Teams (PACT).
-A quote from a St. Cloud VAHCS Provider-
“I just wanted to say I did a repeat of the WBS today and the patient had an improvement from 1.67 to 5.33! (St. Cloud VAHCS Whole Health System Manager asked, "What happened since you last you saw him for the measure to go up?") “He did physical therapy, got him in with pain psychology, some topicals…it was nice for him to be able to speak to it even though he still has pain, that he can look at things in a more positive view now, seeing more joy!!”
Individual St. Cloud VAHCS case studies evaluated with the Well-being Signs Administrator Dashboard, resulted in Veterans further connecting with additional clinical and well-being based services after meeting with their Primary Care Provider during their annual visit. Dashboard evaluation further demonstrated improved Well-being Signs secondary scores when measured at the referred services over time.
Researchers, utilizing a national sample size of any Veteran across all VA Healthcare Systems with at least one or more Whole Health visits, demonstrated observational results with improved Clinical Quality Measures (Zeliadt, Steven. "Clinical Quality Measures Before and After Whole Health." PowerPoint Presentation. 12 June 2024, Seattle-Denver HSR Center of Innovation) and improved Veteran Survey of Health Experiences of Patients (SHEP) results (Zeliadt, Steven. "Clinical Quality Measures Before and After Whole Health." PowerPoint Presentation. 12 June 2024, Seattle-Denver HSR Center of Innovation) compared to Veterans with no Whole Health visits.
St. Cloud VAHCS care teams utilize the Well-being Signs as a conversation starter about further Whole Health approaches to care. This first Whole Health interaction between the care team and Veteran, may be the initial conversation that could further support national, observational Whole Health outcomes (i.e., positive changes in Veterans' Clinical Quality Measures and Veteran experience with at least one or more Whole Health visits) at any VA healthcare system. With the Wellbeing Signs Administrator Dashboard, the user is able to sustainably track the impact of Veteran Whole Health visits on well-being wherever and whenever measured in the healthcare system. The user is then able to compliment Veteran Clinical Quality Measures and Veteran experience measures alongside well-being, a Whole Health approach to data collection and evaluation. See more
Images
Provider and Veteran Well-being Signs Shared Goal Setting Conversation (Ashley Schmidt - Provider; James Newman - Veteran)
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).
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).
Links
- Well-being Signs Implementation Resource videos with recorded role-play administrations of the Well-being Signs in care settings Well-being Signs Video Vignettes -
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)
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
- Adaptive sports
- Addiction and substance abuse treatment
- Advice nurse
- Allergy, asthma and immunology
- Amputation care
- Audiology and speech
- Bariatric surgery
- Cancer care
- Cardiology
- Cardiovascular surgery
- Caregiver support
- Chaplaincy
- Chiropractic
- Colon and rectal surgery
- Complementary and alternative medicine
- Coronary care unit
- Critical care
- Diabetes
- Dermatology
- Discharge planning
- Endocrinology
- Extended care and rehabilitation
- Gastroenterology
- Geriatrics
- Gynecology
- Hematology/Oncology
- HIV/hepatitis
- Homeless Veteran care
- Hospital medicine
- Internal medicine
- Intimate partner violence
- LGBTQ+ Veteran care
- Low vision and blind rehabilitation
- Maternity
- Mental health care
- Military sexual trauma
- Minority Veteran care
- MOVE! weight management
- Nephrology, renal and kidney
- Neurology
- Neurosurgery
- Nursing services
- Nutrition, food, and dietary
- 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
- Podiatry
- Polytrauma and traumatic brain injury
- Primary care
- Psychiatry
- Psychology
- PTSD treatment
- Pulmonary medicine
- Radiation oncology
- Radiology
- Recreation and creative arts therapy
- Rehabilitation and prosthetics
- Returning service member care
- Rheumatology
- Sleep medicine
- Smoking and tobacco cessation
- Social services
- Social work
- Spinal cord injuries and disorders
- Suicide prevention
- Surgery
- Surgical oncology
- Telehealth
- Thoracic surgery
- Transplant surgery
- Vascular surgery
- Veteran experience
- Vocational rehabilitation and employment programs
- Wheelchair and mobility
- Whole health
- Women Veteran care
- Wound care and ostomy
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
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TOOLS |
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Files
- Well-being Signs Administrator Dashboard: Installation Guide V2. June 2024 provide users with a quick guide and select examples on how to filter and sort data for evaluation, informing Veteran care for frontline staff and program managers, required analyst skill for installation, and installation coding to replicate the dashboard across local healthcare facilities or VISNs - Well-being Signs Administrator Dashboard: Installation Guide V2. June 2024
- The pocket card outlines for staff on how to administer the Well-being Signs - Well-being Signs Pocket Card
- FAQ on Well-beings administration, purpose, and scope - Well-being Signs Fact Sheet
- Well-being Signs EHR Documentation Installation Guide allows utilization of Well-being Signs in documentation - Well-being Signs EHR Documentation Installation Guide
- Well-being Signs fillable document to collect Veteran responses, optional use - Well-being Signs Fillable Handout
Links
- Full catalogue of all Well-being Signs resources - OPCC&CT Well-being Signs SharePoint (Internal VA Website)
Contact
Comment
Comments and replies are disabled for retired innovations and non-VA users.
Email joia.byrnestellez@va.gov with questions about this innovation.
About
Origin story
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
I cannot wait to see what happens here in Orlando with this innovation! We are so excited to innovate with your team!
We are so excited to partner with you and your team!
I am excited to see what happens with this project! Good luck!