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From Respiratory Therapist to Change Manager: Enhancing Veterans Healthcare through Process Improvement and the PACT Act

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Karla Enderle, BS RRT

Working as a Registered Respiratory Therapist in the Veterans Healthcare Administration (VA) has been a deeply rewarding experience. Throughout my career, I have had the privilege of serving our nation’s veterans and witnessing the positive impact of quality healthcare on their lives. I want to share my journey from respiratory therapy to becoming involved in process improvement and quality management and becoming a change manager for the implementation of the PACT Act in the VA. This is an example of the transformative power a Respiratory Therapist can have in improving veterans’ healthcare.

As a Registered Respiratory Therapist in VHA, my primary role is to provide specialized care to veterans with respiratory conditions. I was hired as the first “hybrid therapist” at my facility, my responsibilities included all aspects of respiratory care, both inpatient and outpatient specialty care along with diagnostics. I was trained not only to provide acute, emergent, and critical care, specific to Veteran healthcare, but also to assist with a variety of outpatient tests and procedures. This hands-on experience allowed me to develop a deep understanding of the challenges faced by our nation’s Veterans and the importance of delivering the high-quality care they’ve earned and so deserve.

 Recognizing the need for continuous improvement in healthcare delivery, I became increasingly interested in process improvement and quality management. I actively sought opportunities to contribute to these areas within the VA.  It’s through my work with the Systems Redesign & Quality Management Teams that I was offered the opportunity to participate in training for the newly developed VHA/PROSCI Change Management Certification. Through my involvement in quality improvement projects, I gained valuable insights into identifying inefficiencies, streamlining workflows, and enhancing patient outcomes. These experiences only ignited and further fueled my passion for driving positive change in healthcare systems, also leading me to being working on my master’s in healthcare administration (MHA), earlier this year.

 As I delved deeper into process improvement and quality management, I achieved significant professional milestones. In December 2022, I received a job detail to help lead the change management charge while updating VHA’s electronic health record system. I successfully led initiatives to standardize protocols, implement evidence-based practices, and enhance patient safety measures. Collaborating with interdisciplinary teams, we facilitated the development of quality improvement plans and conducted audits to ensure compliance with regulatory standards. These accomplishments not only improved patient care but also fostered a culture of continuous improvement within the VA, with a primary focus on engaging & empowering frontline staff in these improvement initiatives. This opportunity also helped to confirm my passion for making mass scale, system wide improvements, and helped me feel more confident about my recent decision to begin my MHA.

 Shortly after completing my PROSCI Change Management Certification, I was chosen by the Acting Medical Center Director (MCD) to lead implementation of the new PACT Act initiative. My dedication to continual process improvement and quality management, paired with my respiratory background made me the obvious choice, specifically because PACT Act includes multiple respiratory diseases as “presumptive conditions.” With this implementation, based on area and date of deployment, the specified pulmonary diseases are automatically presumed to be caused from the toxic exposures in the specified area, during the specified time period. The Promise to Address Comprehensive Toxics (PACT) Act is transformative initiative aimed to enhance access, coordination, and quality of care for Veterans. As the PACT Act Change Manager, my responsibilities include leading cross-functional teams, developing implementation strategies, data tracking, and ensuring seamless transitions to the new care model. This role has allowed me to combine my clinical expertise with my passion for driving systemic change.

Being a change manager for the PACT Act implementation has been a career-defining experience. Witnessing the positive impact on veterans’ lives and the satisfaction of healthcare providers has reinforced my commitment to improving healthcare systems. Looking ahead, I aspire to continue advocating for veterans’ needs, driving innovation, and fostering a culture of continuous improvement within the VA.

 Transitioning from a registered respiratory therapist to a change manager in the VA has been a transformative journey. My involvement in process improvement and quality management paved the way for my role in implementing the PACT Act. Through these experiences, I have witnessed firsthand the power of effective change management in enhancing Veterans’ healthcare. I remain committed to driving positive change, improving patient outcomes, and ensuring that our Veterans receive the highest quality of care, as they so deserve.

About the Author:

Karla Enderle, BS RRT
PACT Act Change Manager
Registered Respiratory Therapist
Veterans Healthcare System of the Ozarks

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