My Life, My Story: Advancing the Veteran Experience
Veterans have compelling and deeply moving stories to tell — stories that may shed greater light on their overall health status. In addition to honoring their military service, these stories give voice to each Veteran's unique life experience, often yielding clinical information that might otherwise go undetected. By helping Veterans connect their stories with their VA health care providers and inpatient and primary care teams, My Life My Story supports more effective patient-centered care.
The program is part of VA's Diffusion of Excellence initiative, which discovers practices implemented locally at VA medical centers nationwide and determines the if they could be implement at other VA care locations. Among the practices identified are several cohorts of Gold Status Projects — the best of the best. My Life, My Story, was developed at the William S. Middleton Memorial Veterans Hospital in Madison, Wisconsin, and is "one of a dozen Gold Status projects currently diffusing across VA and having an impact on Veterans' care and experience," said Dr. Ryan Vega, Diffusion of Excellence lead. "VA is fortunate to have incredibly innovative and compassionate staff who are deeply committed to our Nation's Veterans. My Life, My Story is a perfect example of how we are continuing to advance the Veteran experience and solidify VA as the greatest health care system."
The program began in Madison's mental health service in 2013 with a grant written by Drs. Dean Krahn and Eileen Ahearn. Since then, the facility has completed 1,500 interviews and produced 1,000-word, first-person narratives for each one.
In this program, VA staff and trained VA volunteers conduct interviews with Veteran patients and write brief stories about the Veterans' lives. "The interviews are open-ended," says Ringler. "We have topics to touch on, but no set list of questions. Veterans are free to talk about what they want. I always begin interviews by saying, 'What do you want your care team to know about you as a person?'"
In addition to fostering a deeper relationship between a Veteran and his/her care team, sharing the stories can change a Veteran's treatment plan. Hypothetically, a mental health provider caring for a Veteran with depression may link the patient's condition to his or her military service. By reading the Veteran's story, however, the clinician may learn that the patient was also the primary caregiver for his or her parents, and that both had recently passed away. This information can change the way the care team looks at the sources of the Veteran's depression and may ultimately change their treatment plan.
According to Thor Ringler, a writer/editor at the Madison VA and the Gold Status Fellow for the practice, 16 VA facilities are now using My Life, My Story.
"The program touches a lot of different people, both within and outside VA," he explains. "Its heart is making connections between people and using stories to do so."
My Life, My Story was started to help VA health care providers better understand their patients and provide them with insights and information that might not otherwise manifest through single visits. If the Veteran chooses to participate in the program, their story becomes part of their medical record. Ringler soon learned that giving them copies of the finished product provided a way for Veterans to share their life stories with their friends and families.
In a recent Madison VA facility survey, the program drew an "overwhelmingly positive" response from VA providers as to whether reading these stories was a good use of clinical time and whether they would help improve clinical care. Some clinicians use the stories to establish rapport with their patients; others use them to help develop treatment plans.
Madison is actively diffusing the project throughout VHA. "Being selected as a Gold Status practice has been a big help in that," says Ringler. "We've received great support from different offices within VA. Our goal is to spread 'My Life, My Story' to any VA facility that would like to have it, and to support them in getting it up and running. We offer three two-day workshops a year here in Madison."
In 2018, the project will be recommended for implementation nationwide by VA's Office of Veterans Experience.
Outside of the workshops, Ringler provides interested facilities with additional help. "We have training guides, videos and toolkits we make available. It's just a matter of finding a champion for the project."
"I believe stories are important," says Ringler, "and there's a need to make these stories available. As the program spreads, it tells Veterans and their families they matter to VA — and there's more to it than just their health."