I would identify what barriers are preventing the veterans from receiving their treatment, as well as assess the capacity for change within the VA organization. I would identify the financial organizational implications and may come about, as well as the benefits too. Once phase 1 and phase 2 have been identified, then the rest of the remaining phases will more easily come together. Financial Implications Financial implications associated with the implementation of this improvement strategy may appear to be greater initially out of pocket due to the expenses associated with purchasing the equipment such as the treatment van or bus, pain medications and non-pharmacologic treatments, and computer equipment with wireless mobile internet. There also may be additional fees associated with extending insurance coverage to the mobile pain treatment vehicle, so that the healthcare providers are covered during their practice. Nursing budgets would also need to be adjusted to accommodate for staffing the mobile treatment vehicle. The benefits of treating veterans and managing their pain offsite of the VA hospital will have a positive monetary impact to the organization. Veterans would have decreased number of emergency department visits and a decreased in the number of hospital admissions. This would ultimately lead to a savings to the hospital’s bottom line.

Organizational Leadership 11 Method of Evaluation When evaluating the effectiveness of my improvement strategy, I would use a specifically tailored modified Gantt Chart. The evaluation process would start during the implementation phase and last throughout the evaluation phase. During the implementation of the plan, a modified Gantt Chart would be created with specific control points that help identify if the strategy is progressing according to the plan, as well as milestones indicating what and when specific areas of the strategy are projected to occur. It will be identified during the implementation portion of the improvement strategy that critical control points are being met, such as staying within the budget, total number of homeless veterans treated at the mobile pain treatment vehicle, and how often the veterans return for their next scheduled treatment. The results from this data will then be compared against the number of homeless veterans who used the emergency department for pain management or were admitted to the hospital for substance abuse or IV/IM drug use infections during the same time as the mobile pain treatment vehicle trials. This will identify whether this is a direct correlation between the improvement strategy and improved patient outcomes. Also, the financial impact may be assessed by averaging out the cost associated with each emergency department visit or hospital admission for homeless veterans with pain control, substance abuse, or infection related diagnoses or chief complaints, and comparing it to the cost of the mobile pain treatment improvement strategy.