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Reflection of Practicum Site

Lauren Littlejohn

Georgia Southern University

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Reflection of Practicum Site

Winston Salem State University's motto is "Enter to Learn, Depart to Serve." This motto

has guided me in my personal, professional, and academic journey. This motto keeps me

encouraged, and it helps me identify the why for pursuing doctorate education for me. For the

last five years, I have worked for the Department of Veteran Affairs in various roles, and each

one propelled me to get to the point of pursuing a doctorate in Public Health Leadership. Thus, I

decided the Atlanta VA Health Care System would be a great place to complete my preceptorship

for my degree.

Background of Practicum Site

Atlanta VA Health Care System (AVAHCS) is in Decatur, Ga. It is the largest VA facility

in the VA Southeast Network (VISN), which comprises facilities in the following states: Georgia,

Alabama, and South Carolina. The hospital is a tertiary medical center that includes 466 -bed

facility. The hospital has academic affiliations with Emory University, Morehouse School of

Medicine, Georgia State University, Georgia Southern University, etc. The hospital provides care

to over 115,000 veterans and has more than 1.44 million outpatient visits. The hospital employs

5,000 plus employees and has an operating budget of $794,275,770. In 2018, this hospital had

over 43,300 Emergency Room visits, 8,300 inpatient admissions, and more than 4,500 surgical

procedures. The hospital provides comprehensive health care services to include emergency

medicine, primary care, tertiary care, and long-term care in the areas of medicine, surgery,

mental health, physical medicine and rehabilitation, neurology, oncology, dentistry, geriatrics,

and extended care. AVAHCS has highly specialized services include open-heart surgery and

cancer therapies. Within the system, there are two Community Living Centers to serve metro

Atlanta (Eagle's Nest) and the Carrollton (Trinka Davis Veterans Village) areas with extended
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care rehabilitation, psychogeriatric, and general long-term care services. Mental Health Services

and Telemedicine services have expanded to almost every site of care within the Atlanta VAHCS.

Also, the facility serves as a prosthetics treatment center, fabricating and supplying mechanical

devices such as artificial limbs for patients within the states of Georgia, South Carolina, and

Alabama.

I was attracted to this practicum site since I wanted to be able to provide better healthcare

for those who have served. As an employee at the facility, I identified areas of growth that I

could provide assistance to that would improve the care for these patients and our employees.

With my advanced educational knowledge, I know that I could help the facility to improve our

organizational culture, which will improve care for our veterans. I sought out a mentor from

another department that was open to feedback and supported individual detail assignment that

would allow me to complete my practicum. Moreover, having previous federal government

experience from other facilities, I want to help the facility to change to become a High-

Reliability Organization.

Role

During the practicum rotation, I worked in the Education Service Line under the direction

of the Designated Learning Officer. My assistance was requested to redesign the facility's

leadership training program for employees. My role during the practicum was to serve as a

development coordinator for a training curriculum for leadership development for the facility.

The leadership program would introduce participants to healthcare leadership and teamwork

concepts through classroom instruction and practical exercises. The program is designed for

general schedule employees at target GS 5 through GS 9.

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Also, during my preceptorship, I completed a fact-finding assignment on allegation of

workplace harassment. I conducted 15 interviews with the complainant, witnesses, alleged

harassers, etc. I met with the Human Resources department to get clarification on rules and

policies. Additionally, I met with the Facility Workplace Manager on Harassment to gather

additional information for the case. I reviewed several Human Resource policies related to the

case and analyze guidance from the Equal Employment Office to determine if the allegations met

the definition of harassment. I reviewed the documentation submitted by the complainant that

dated back from March 2018 to the present. I completed a written report that summaries the issue

and concluded the finding of the case. I recommended actions that were pertinent to the case, and

the report was sent to the Medical Center Director for the next course of action.

Another assignment that I worked on was with the Deputy Chief of Staff to develop and

create an electronic Daily Management System (DMS). The use of visual management board is a

LEAN principle that the hospital would like to start using to improve the accountability of tasks

in hospitals, and the board serves as a communication tool. My department at the hospital

implemented the use of a DMS huddle each day in March. Since I helped to establish this

practice, the Deputy Chief of Staff requested the process to be used for her reporting service

lines. I created the DMS board and then taught 20 service chiefs how to use the website.

While working on the practicum, I helped plan a strategic leadership meeting to discuss

the Re-Opening plan for COVID for VA. I reviewed the 52-page document from the Veteran

Health Administration to develop PowerPoint presentations for service chiefs. Additionally, I

created an outline or quick notes summarizing the document for each provider. I then facilitated

a meeting with each service chief to discuss their plan and made sure the proposed plan met the

criteria in the guidance.

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I also served as Employee Engagement Committee member in which I worked on

developing the tentative draft of the charter for the committee. I created the membership

application and worked with the medical media department to get a flyer created for the

membership call. I then worked to create a recognition website for supervisors to use for

employees. The website created will be shared with employees at all eight facilities within VISN

seven.

Challenges

The biggest challenge that I faced during my practicum would be the learning of federal

policy and procedures. Several assignments and tasks required me to research VHA directives

and policies for understanding before the assignment could be completed. For example, the fact-

finding assignment is an informal process that serves as a resource of information for performing

a thorough and unbiased investigation. The fact-finding address critical issues and reach finding,

conclusions, or recommendation that are supported by evidence. If fact-finding is done correctly,

the process could improve the operation of the health care system, morale of employees, and

image. I required me to read and analyze the definitions of Work Harassment by the Equal

Employment Opportunity Commission. The assignment required me to examine and review all

allegations to determine if harassment occurred objectively. The process was very tedious and

required me to review all supporting documentation for evidence of harassment. This case

required a review of data from several sources: timesheet reports, memorandums from the

Human Resource office, emails from supervisors, various other documents submitted by the

complainant. The assignment took a lot of time because I had to determine what information was

important, and I had to justify each finding.

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Another challenge could be the fact that the practicum took place during the national

pandemic, COVID. There were assignments that I wanted to get exposure to; however, due to the

pandemic, the opportunity was not available or not of high importance. For example, I was

requested to serve as the point of contact for the All Employee Survey (AES)to help to update

the facility number of employees for each service line. After updating the data, I would be

responsible for assisting with the AES survey and helping the facility in obtaining a 60%

response rate. The AES starts in June of each year; however, due to COVID, the survey start date

will be August. This decision to move the period for the survey back will affect Performance

Appraisal and Senior Executive's annual reviews.

Accomplishment.

During this eight week rotation, I have accomplished several things that I am proud of.

Firstly, the implications of the Fact-Finding report have led employees in one department to get a

better work environment since the service chief being reassigned. Additionally, other department

changes lead to new leadership for the staff. Additionally, the recognition tool developed will

improve the facilities employee's morale due to getting recognition from the supervisor. Lastly, I

feel that this new leadership program will be instrumental in developing several employees.

Strengths.

While completing my practicum, I had the opportunity to participate in the Strengths-

Based Leadership: Creating Workplaces that Work training by Region IV Public Health Training

Center. I had the opportunity to take the Clifton Strengths assessment and receive descriptions of

my top five strengths. Then, the top five strengths were discussed in depth during the workshop

through the lens of leadership and creating workplace culture. My top strengths were Relator,

Achiever, Responsibility, Analytical, and Developer. From the training, I learned how each of my
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strengths influence my behavior. For example, the strength as achiever, explains my drive and

determination. I believe this strength motivates me to continue to do better because I want to

achieve something. My desire to achieve is the power supply that causes me to set the pace and

define the levels of productivity for my work group. I believe this strength was one of the

reasons I was given the opportunity to complete a fact-finding assignment that dealt with

allegations of high-ranking staff member in the organization.

Moreover, my strength of responsibility forces me to take psychological ownership for

anything I commit to, and whether large or small, I feel emotionally bound to follow it through

to completion. Each one of those two strengths are something that others have identified in me. I

believe my strength for being analytical is a skill set that helps me in my role as Performance

Improvement Coordinator and as nurse. My desire to understand how certain patterns affect one

another is a skill that has helped me in my career because I search to find the root cause. Lastly,

my strength of being a developer is something that motivates me to help other. I see the potential

in others, and this motivates me to help my team members to grow.

I believe having self-awareness of my strengths will help me be a better-informed leader.

I know how to use my strengths to build a strengths-based workplace culture and I know how to

influence and motivate others. I believe this practicum experience has given me the opportunity

to evaluate my own interest related to healthcare policy and I have learned more about

compliance with regards to VHA directives.

After Graduation.

This experience will help me be more successful in my next job opportunity. I was

exposed to a different skill set outside of nursing practice and I know that experience will help

me when I decide to apply for another position outside of nursing. I was able to gain exposure in
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helping with reassignment of workload for staff and this skill would benefit me since I’m in non-

supervisory role and I do not normally assign or identify workload for others. I also was able to

participate in investigation that helped me to learn more VHA directives for management

officials. As a non-supervisory, I’m not offered the opportunity to know more about management

and this experience has helped me. The curriculum at Georgia Southern University focused on

providing leadership training to equip complex problem solvers with skills in efficient utilization

of resources, analyzing health needs in the community, policy development and implementation

and partnership building. And this training has impacted my professional and personal

development. I was able to gain the skillset on how to evaluate strategic planning processes using

quality, cost benefit, and performance improvement analyses. I also had knowledge on policy

and program implementation to develop a plan to implement a policy or program, including

goals, outcomes and process objectives, staffing plans, budget and implementation steps. This

degree has provided me with the training I need to develop skills in program-building

implementation that may improve the organization to make progress in the healthcare of our

veteran population.

Professional Goals.

My goal in the next five-ten years will be to move up in quality management role within

the Department of Veteran Affairs. I do not foresee me leaving federal government since I love

the work that I do and I feel as if my work is important for veterans. I do however want to have a

more activity role in health policy and implementation within the agency. I believe I will be able

to assist in the expansion of telehealth within VA system. With COVID crisis, the hospital is

examining current practices of face to face visit. COVID has forced the facility to perform more

telehealth visits. My additional knowledge from Georgia Southern will help me be an ideal
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candidate as personnel with knowledge on implementation and dissemination in VA. I know this

doctoral degree will help me in my current role in expansion of telehealth to improving access to

care and ensuring quality metrics are comparable.