Description: We led an independent evaluation to determine the feasibility and advisability of the realignment and reorganization of suicide prevention coordinators (SPCs) within VA’s Office of Mental Health and Suicide Prevention (OMHSP) and the creation of a SPC Program Office (PO) as mandated by Section 506 of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019. Our evaluation team conducted: (1) an assessment of the feasibility and advisability of creating a suicide prevention coordinator program office to oversee and monitor SPCs and suicide prevention case managers (SPCMs) across all medical centers of the Department; (2) reviewed of current staffing ratios for SPCs and SPCMs in comparison with current staffing ratios for mental health providers within each medical center of the Department; and (3) provided a description of the duties and responsibilities for SPCs across the Department to better define, delineate, and standardize qualifications, performance goals, performance duties, and performance outcomes for SPCs and SPCMs.
Project Management. We performed to our comprehensive Project Management Plan, led by our Program Manager. Our agile management toolkit and engagement approach combine industry best-practice standards from the Project Management Body of Knowledge (PMBOK) tailored to VA policies and processes. Our Program Manager liaised with VA clients and our Evaluation Team while maintaining the work breakdown structure, issue log, lessons learned, and project schedule while ensuring the project is within budget. We also created and maintained Weekly Status Reports and Monthly Progress Reports. The evaluation team met daily to keep abreast of all work activities, resolve problems and develop mitigation strategies for potential challenges. Meetings were held with the client twice weekly to ensure VA is updated on all evaluation tasks and to resolve issues requiring clarification and/or necessary approvals.
Survey Design. The evaluation team employed a mixed-methods approach for data collection. Our evaluation team developed semi-structured interview questions (i.e., core and role-specific) which will be posed to key VA Stakeholders. The purpose of the interviews was to understand their perspectives on the current state of SPC and SPCM roles, and of the prospective operational impact on local facility functions posed by each proposed option. The other main purpose was to understand their perspectives on the advantages and disadvantages of the two propositions, namely the realignment and reorganization of SPCs within OMHSP and the creation of a national SPC program office. All data and recordings of the interviews were securely stored and managed behind a protected firewall. We will transcribe each interview and shared the data with the government. Quantitative data were also collected using a questionnaire developed by our evaluation team. We prepared the sampling plan, which ensured that one Veterans Affairs Medical Center (VAMC) is included from each of VA’s 18 Veterans Integrated Service Networks (VISN). VAMC complexity level and locations (i.e., urban-rural classification) were also considered as part of the sampling process.
Data Analysis, Results, and Reporting. Our evaluation team conducted a thematic content analysis of data from the semi-structured stakeholder interviews using NVivo to summarize themes that best capture support and dissent for the current versus proposed future state, including key operational impacts on SPPs, projected impacts on the Quadruple Aim outcomes, and legal/regulatory implications. We will use SPSS to analyze quantitative data. The quantitative measures focused on various aspects of the SPC role such as discipline, certification, national licensure and the VAMC staffing ratios. Descriptive, bi-variate and multi-variate analyses were performed. A Final Report was submitted to VA in October 2021. Study findings were submitted as part of the Secretary of VA’s Annual Report to Congress.