# Evaluation of a National VA Organizational Structure Redesign

> **NIH VA I50** · OLIN TEAGUE VETERANS CENTER · 2021 · —

## Abstract

Justification: Our operational partner, the Office of the Assistant Deputy Under Secretary for Health
for Clinical Operations (10NC), requested a QUERI partnered evaluation of a redesign of the national
clinical services organizational structure, called Integrated Clinical Communities (ICC).
Gaps Addressed: Prior to this proposal, QUERI start-up funds were used to conduct interviews with
VHACO and VISN leaders in order to articulate the logic model underlying the ICC reorganization, and
identify validated survey measures that can be used to evaluate the ICC implementation at the VAMC
and VISN levels of analysis. However, our interviews revealed that the VAMC-level logic model was not
as well developed as the VISN-level and VHACO-level logic model. This is due in part to a decision to
not mandate a specific reorganization at the VAMC level of analysis based on lessons learned in the
1990s service line reorganization. Thus, there are likely to be a wide range of VAMC-level
implementations of the ICCs. At the VHACO level of analysis, the ICC implementation is potentially
threatened by overlapping roles and responsibilities between the ICC leads and the existing VHACO
program offices.
Innovativeness: The opportunity to improve policy development and implementation in VHA occurs
rarely. The last large-scale organizational redesign was the VISN reorganization conducted twenty
years ago. Our team includes an evaluator of the prior VISN reorganization. The proposed evaluation
will provide the timely feedback needed to guide 10NC regarding how to ensure that this work improves
care for Veterans.
Specific Aims: The proposed 18-month program evaluation has two specific aims: (1) Field, evaluate
and elaborate the ICC survey, and (2) determine how the VHACO ICC implementation achieves the
expectations of the logic model.
Project Methods: The proposed evaluation will use observational methods. A quantitative survey
developed with QUERI start-up funds will measure the intermediate outcomes for each of the six ICCs
at the facility level and VISN level. Aim 1 will use qualitative interviews to better understand the logic
model for the VAMC-level implementation. Aim 2 will use qualitative interviews to evaluate how the ICC
implementation at the VHACO-level achieves the expectations of the ICC logic model.

## Key facts

- **NIH application ID:** 10188100
- **Project number:** 1I50HX003166-01A1
- **Recipient organization:** OLIN TEAGUE VETERANS CENTER
- **Principal Investigator:** Justin K. Benzer
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-10-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10188100

## Citation

> US National Institutes of Health, RePORTER application 10188100, Evaluation of a National VA Organizational Structure Redesign (1I50HX003166-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10188100. Licensed CC0.

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