COIN Investigators & Staff
COIN Investigators
-
Heather Gilmartin, PhD, NP
- Title: Investigator,
Research Health Scientist
Clinical Assistant Professor, Department of Health Systems, Management and Policy, Colorado School of Public Health | Anschutz Medical Campus
Associate Director of Dissemination & Implementation, Colorado Clinical & Translational Science Institute (CCTSI) - Contact: Heather.Gilmartin@va.gov
- Location: Denver
- University of Colorado webpage
Colorado Clinical & Translational Science Institute (CCTSI)
Research Interests
Dr. Gilmartin’s research focus is on understanding and optimizing the culture of healthcare to enhance employee engagement and patient safety. She aims to achieve this by facilitating organizational learning through the implementation and dissemination of high reliability practices such as team training, mindfulness, joy in work, and relational coordination.
Dr. Gilmartin’s work is focused on the VA for it complements national priorities that aim to gain the trust of Veterans and enhance employee well-being through the consistent delivery of high-quality, safe, and equitable care and the creation of an organizational culture of learning.
The long-term impact of Dr. Gilmartin’s work will be the creation of a roadmap and tools to guide the creation of supportive learning environments in clinical teams and implement high reliability practices that consistently improve Veteran and employee health and well-being.
See Dr. Gilmartin's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials
The following images visualize Dr. Gilmartin's work. The word cloud is drawn from publication titles. The research collaboration map shows research relationships (click the image to enlarge):
| Publications | Grants |
|---|---|
| Clinical Research | Behavioral and Social Science |
| Prevention | Clinical Research |
| Health Services | |
| Behavioral and Social Science | |
| Infectious Diseases | |
| Rural Health | |
| Basic Behavioral and Social Science | |
| Clinical Trials and Supportive Activities | |
| Rare Diseases | |
| Patient Safety |
Grants & Funding
Relational Coordination in the Veterans Health Administration
This operational partnership led by Dr. Gilmartin at the Denver COIN will support VA researchers and operations who aim to assess, integrate, and translate relational and team-based interventions as part of funded research and operational projects.
Funder: Veterans Affairs
HSR&D website
Publications of note:
— A dissemination strategy to promote relational coordination in the veterans health administration: a case study
Building Supportive Learning Environments: Implementation Research in VA Cardiac Cath Labs
Role: PI
This project is relevant to all aspects of VA healthcare. It will develop and evaluate a training toolkit to assist healthcare teams in changing their culture toward learning to enhance Veteran care. This work will support the VA's transformation to a learning health system, so clinicians can see every patient encounter as a way to improve the next one.
By studying unit-level learning environments, we identify high-reliability practices supporting a learning culture and then use this knowledge to adapt a team training program to the culture and workflow of clinical units.
We will develop and test a training toolkit to empower teams to build their own learning culture and a rigorous mixed methods evaluation that leads to valid, generalizable lessons across healthcare settings. We expect this study to result in positive changes in learning environments, teamwork, and the highly-reliable use of evidence-based practices.
The findings will inform future studies to determine the impact of learning environments on Veteran outcomes.
Funder: Veterans Affairs
NIH website
Publications of note:
— Learning environments, reliability enhancing work practices, employee engagement, and safety climate in VA cardiac catheterization laboratories
— "Our Hands Are Tied Until Your Doctor Gets Here": Nursing Perspectives on Inter-hospital Transfers
— A pilot study to assess the learning environment and use of reliability enhancing work practices in VHA cardiac catheterization laboratories
Value-Based Care to Improve the Quadruple Aim for Veterans and Stakeholders
Role: Dissemination and Implementation Core: Relational Facilitation; PI: Catherine Battaglia
The Quadruple Aim Quality Enhancement Research Initiative (QUERI) aims to improve the care and experience for Veterans, clinician engagement, and reduce the cost of care. We will improve care coordination between Veterans Health Administration (VA) and community settings for Veterans using three evidence-based practices rooted in care coordination models to achieve consistently safe, efficient, and effective care for Veterans who are:
1) referred to home health care after discharge from VA,
2) receiving medication treatment for Opioid Use Disorders in the community, and
3) hospitalized or receiving emergency care in the community and return to VA or VA-assigned community PCP for ongoing care.
Veterans with complex medical and social needs will be case managed by a multidisciplinary team to ensure timely access to care and linkage to resources. The Quadruple Aim QUERI will improve health with optimal patient and clinician experience at a lower cost.
Funder: Veterans Affairs
NIH website
Mindful Hand Hygiene to Reduce Infections Among Veterans While Enhancing Provider Well-Being
Role: Mindfulness Advisory; PIs: Todd Greene and Sanjay Saint
This study will test whether a hand hygiene-based mindfulness intervention can improve provider hand hygiene adherence, improve provider well-being, and enhance Veteran outcomes.
Given the importance of hand hygiene adherence and increasing provider burnout and stress levels, this work aligns with the Department of Veterans Affairs (VA) priorities and will enhance Veteran safety.
Our findings will shed light on preventing infections more effectively through a novel mindfulness intervention focused on increasing hand hygiene adherence and provider well-being.
Funder: Veterans Affairs
NIH website
Pragmatic trial to increase quality of care in State Veterans Homes: Improving safety using an evidence-based, frontline staff huddling practice
Role: Relational Coordination Advisor; PIs: Christine Hartman and Lynn Snow
Veterans comprise 93% of all State Veterans Home nursing home (SVH) residents. Frontline staff, such as nursing assistants, provide hands-on care for these Veterans.
This study capitalizes on the expertise of frontline staff. It uses interdisciplinary frontline staff huddles for identifying and implementing evidence-based fall prevention interventions.
The study will investigate the program's effectiveness in reducing falls, evaluate program implementation, and assess program sustainability. Veterans living in and staff working in the participating SVHs will benefit. It will also help the SVH system by providing information on how this program can be spread and sustained across the system when applied to fall prevention and other vital issues.
Funder: Veterans Affairs
NIH website
Improving the Measurement of Surgical Site Infection (SSI) Risk Stratification and Outcome Detection: Implementing strategies to improve detection of and risk stratification for surgical site infections
Role: Site Director
Funder: Agency for Healthcare Research & Quality Action Research Network
The Role of Organizational Context on Adherence to Healthcare-associated Infection (HAI) Bundle Practices and HAI Outcomes
Role: Fellow
Funder: Veterans Affairs
Nationwide Evaluation of the MyVA Access program
Role: Qualitative Methodologist; PI: Michael Ho
Funder: Veterans Affairs
Optimizing the Nurse Work Environment to Improve Patient Outcomes
Role: PI
Funder: Veterans Affairs
Building Supportive Learning Environments: Implementation Research in VA Cardiac Cath Labs
Role: PI
Funder: Veterans Affairs
Relational Coordination in Care Coordination
Role: PI
Funder: Veterans Affairs - Shark Tank Innovation Project
Enhancing Patient Safety through Cognition & Communication: The "M-Safety Lab"
Role: Mindfulness Advisory: PI: Sunjay Saint
Funder: Agency for Healthcare Research and Quality
Evaluation of Rural SimLEARN Project
Role: Evaluation Lead
Funder: Veterans Affairs, Office of Rural Health
Improving Transitions of Care for Rural Veterans Referred to Tertiary Medical Centers
Role: PI
Funder: Veterans Affairs, Office of Rural Health
Recent Publications
2023
Gilmartin HM, Saint S, Ratz D, Chrouser K, Fowler KE, Greene MT. The influence of hospital leadership support on burnout, psychological safety, and safety climate for US infection preventionists during the coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol. 2023 Sep 13:1-6. doi: 10.1017/ice.2023.184. Epub ahead of print. PMID: 37702064
Kon S, Fisher S, Ngo N, Craig R, Gunter C, Bessesen M, Gilmartin H. Utilization of a novel humble inquiry interview approach in assessing implementation barriers to a Nurse-Driven Clostridioides difficile test order set. Am J Infect Control. 2023 May 29:S0196-6553(23)00385-1. doi: 10.1016/j.ajic.2023.05.012. Epub ahead of print. PMID: 37257565
Learn more about this publication on Dimensions
Kelley L, Broadfoot K, McCreight M, Wills A, Leonard C, Connelly B, Gilmartin H, Burke RE. Implementation and Evaluation of a Training Curriculum for Experienced Nurses in Care Coordination: The VA Rural Transitions Nurse Training Program. J Nurs Care Qual. 2023 Feb 27. doi: 10.1097/NCQ.0000000000000698. Epub ahead of print.
PMID: 36857291.
Learn more about this publication on Dimensions
2022
Williams PH, Gilmartin HM, Leonard C, McCarthy MS, Kelley L, Grunwald GK, Jones CD, Whittington MD. The Influence of the Rural Transitions Nurse Program for Veterans on Healthcare Utilization Costs. J Gen Intern Med. 2022 Aug 30. doi: 10.1007/s11606-022-07401-y. Epub ahead of print. PMID: . PMID: 36042072
Learn more about this publication on Dimensions
Leonard C, Connelly B, Kwan B, Albright K, Gilmartin H. Addressing leadership communication, parenting demands and mental health challenges: a mixed-methods case study of clinical and translational scientists during COVID-19BMJ Leader Published Online First: 21 July 2022. doi: 10.1136/leader-2021-000523
Learn more about this publication on Dimensions
Sjoberg H, Kenney RR, Morgan B, Connelly B, Jones CD, Ali HN, Battaglia C, Gilmartin HM. Adaptations to relational facilitation for two national care coordination programs during COVID-19. Front Health Serv. 2022 Jul 22;2:952272. doi: 10.3389/frhs.2022.952272. PMCID: PMC10012763. PMID: 36925807
Learn more about this publication on Dimensions
Gilmartin HM, Hess E, Mueller C, Connelly B, Plomondon ME, Waldo SW, Battaglia C. Learning environments, reliability enhancing work practices, employee engagement, and safety climate in VA cardiac catheterization laboratories. Health Serv Res. 2022 Apr;57(2):385-391. doi: 10.1111/1475-6773.13907. PMID: 35297037
Learn more about this publication on Dimensions
Gilmartin, HM, Warsavage, T, Hines, A, Leonard, C, Kelley, L, Wills, A, Gaskin, D, Ujano-De Motta, L, Connelly, B, Plomondon, M, Yang, F, Kaboli, P, Burke, RE, Jones, CD. Effectiveness of the rural transitions nurse program for veterans: A multicenter implementation study. J Hosp Med. 2022; 17: 149- 157. doi:10.1002/jhm.12802
Learn more about this publication on Dimensions
Nunnery MA, Gilmartin H, McCarthy M, Motta LU, Wills A, Kelley L, Jones CD, Leonard C. Sustainment stories: a qualitative analysis of barriers to sustainment of the National Rural Transitions of Care Nurse Program. BMC Health Serv Res. 2022 Jan 28;22(1):119. doi: 10.1186/s12913-021-07420-1. PMID: 35090448
Learn more about this publication on Dimensions
Yu A, Jordan SR, Gilmartin H, Mueller SK, Holliman BD, Jones CD. "Our Hands Are Tied Until Your Doctor Gets Here": Nursing Perspectives on Inter-hospital Transfers. J Gen Intern Med. 2022 Jan 6:1–8. doi: 10.1007/s11606-021-07276-5. Epub ahead of print. PMCID: PMC8735724. PMID: 34993869
Learn more about this publication on Dimensions
2021
Leonard C, Connelly B, Albright K, Gilmartin H. "This is an opportunity for leadership to lead, but leadership has disappeared": A qualitative case study of clinical and translational scientists during COVID-19. Res Sq [Preprint]. 2021 Mar 16:rs.3.rs-310774. doi: 10.21203/rs.3.rs-310774/v1. PMCID: PMC7987101. PMID: 33758832
Learn more about this publication on Dimensions
Connelly B, Leonard C, Gaskin D, Warsavage T, Gilmartin H. Increasing enrolment in a national VA transitions of care programme: a pre-post evaluation of a data dashboard and nudge-based intervention. BMJ Health Care Inform. 2021 Nov;28(1):e100416. doi: 10.1136/bmjhci-2021-100416. PMCID: PMC8587340. PMID: 34764197
Connelly B, Battaglia C, Gilmartin HM. A dissemination strategy to promote relational coordination in the veterans health administration: a case study. BMC Health Serv Res. 2021 Sep 27;21(1):1018. doi: 10.1186/s12913-021-07009-8. PMID: 34579712
McCarthy MS, Ujano-De Motta LL, Nunnery MA, Gilmartin H, Kelley L, Wills A, Leonard C, Jones CD, Rabin BA. Understanding adaptations in the Veteran Health Administration's Transitions Nurse Program: refining methodology and pragmatic implications for scale-up. Implement Sci. 2021 Jul 13;16(1):71. doi: 10.1186/s13012-021-01126-y. PMCID: PMC8276503. PMID: 34256763
Gilmartin HM, Plomondon ME, Mueller C, Connelly B, Battaglia C, Waldo SW, Doll J. The Impacts of COVID-19 on Veterans Affairs Catheterization Laboratory Staff During the First Months of the US Response. J Cardiovasc Nurs. 2021 May 19. doi: 10.1097/JCN.0000000000000828. Epub ahead of print. PMID: 34016839
Gilmartin H, Smathers S, Reese SM. Infection preventionist retention and professional development strategies: Insights from a national survey. Am J Infect Control. 2021 Jul;49(7):960-962. doi: 10.1016/j.ajic.2021.04.083. Epub 2021 May 4. PMID: 33961951
Gilmartin HM, Hess E, Mueller C, Plomondon ME, Waldo SW, Battaglia C. A pilot study to assess the learning environment and use of reliability enhancing work practices in VHA cardiac catheterization laboratories. Learn Health Syst. 2020 Apr 8;5(2):e10227. doi: 10.1002/lrh2.10227. PMCID: PMC8051348. PMID: 33889736
Leonard C, Gilmartin H, McCreight M, Kelley L, Mayberry A, Burke RE. Training registered nurses to conduct pre-implementation assessment to inform program scale-up: an example from the rural Transitions Nurse Program. Implement Sci Commun. 2021 Mar 8;2(1):28. doi: 10.1186/s43058-021-00127-8. PMCID: PMC7938579. PMID: 33685521
Mody L, Akinboyo IC, Babcock HM, Bischoff WE, Cheng VC, Chiotos K, Claeys KC, Coffey KC, Diekema DJ, Donskey CJ, Ellingson KD, Gilmartin HM, Gohil SK, Harris AD, Keller SC, Klein EY, Krein SL, Kwon JH, Lauring AS, Livorsi DJ, Lofgren ET, Merrill K, Milstone A, Monsees EA, Morgan DJ, Perri LP, Pfeiffer CD, Rock C, Saint S, Sickbert-Bennett E, Skelton F, Suda KJ, Talbot TR, Vaughn VM, Weber DJ, Wiemken TL, Yassin MH, Ziegler MJ, Anderson DJ; SHEA Research Committee. COVID-19 Research Agenda for Healthcare Epidemiology. Infect Control Hosp Epidemiol. 2021 Jan 25:1-81. doi: 10.1017/ice.2021.25. Epub ahead of print. PMID: 33487199
2020
Gilmartin HM, Connelly B, Hebbe A, Battaglia C, Kwan BM. Assessing the impact of remote work during COVID-19 on clinical and translational scientists and staff in Colorado. J Clin Transl Sci. 2020 Dec 21;5(1):e71. doi: 10.1017/cts.2020.570. PMCID: PMC8027555. PMID: 34192046
Gilmartin HM, Battaglia C, Warsavage T, Connelly B, Burke RE. Practices to support relational coordination in care transitions: Observations from the VA rural Transitions Nurse Program. Health Care Manage Rev. 2020 Nov 11. doi: 10.1097/HMR.0000000000000300. Epub ahead of print. PMID: 33181554
McCarthy MS, Stonecipher JJ, Gilmartin H, El-Hajj D, Battaglia C. An interdisciplinary postdoctoral fellowship model: Opportunities for nurse PhDs. J Nurs Educ Pract. 2020;10(2):10.5430/jnep.v10n2p33. doi: 10.5430/jnep.v10n2p33. PMCID: PMC7590921. PMID: 33117466
Keach JW, Stanislawski MA, Barón AE, Plomondon ME, Langner P, Amin A, Gilmartin HM, Waldo S, Maddox TM. Variation in contrast-associated acute kidney injury prophylaxis for percutaneous coronary intervention: insights from the Veterans Affairs Clinical Assessment, Reporting, and Tracking (CART) program. BMC Nephrol. 2020 Apr 28;21(1):150. doi: 10.1186/s12882-020-01802-z. PMCID: PMC7189455. PMID: 32345254
Connelly B, Ujano-De Motta LL, Leonard C, Mayberry A, Kelley L, Gaskin D, Gilmartin HM. Mapping the reach of a rural Transitions Nurse Program for veterans with geographic information systems. Implement Sci Commun. 2020 Mar 19;1:36. doi: 10.1186/s43058-020-00026-4. eCollection 2020. PMID: 32885193
Gilmartin HM, Liu VX, Burke RE. Web Exclusive. Annals for Hospitalists Inpatient Notes - The Role of Hospitalists in the Creation of Learning Healthcare Systems. Ann Intern Med. 2020 Jan 21;172(2):HO2-HO3. doi: 10.7326/M19-3873. PMID: 31958842
Inventions, Intellectual Property and Patents
The Relational Playbook for Cardiology Teams
Registered invention with VA Technology Transfer Program. VA ID 2022-474. October 1, 2022.
Media (Video, Podcast, Other)
VA HSR&D Podcast
Investigator Insights: Building Resiliency, Quality, and Retention into VA’s Cardiac Cath Labs
Topic: Quality Improvemnt
Date: 04/29/2022
Heather Gilmartin, PhD, NP, investigator and nurse scientist at the Denver/Seattle Center of Innovation in Denver, Colorado discusses her HSR&D Career Development Award program work, which is focused on building supportive learning environments VA’s cardiac catheter labs.
A VA Research Career. One Nurse’s Journey
October 20, 2021
View the recording
Access Passcode: Password*1
Brainwriting Premortem How-To Video
15 December 2021
Read the manuscript for free on PubMed Central, Brainwriting Premortem: A Novel Focus Group Method to Engage Stakeholders and Identify Preimplementation Barriers
Download the 7 page PDF: Brainwriting Premortem Protocol
Webinar: Speaking Up for Patient Safety: It’s Complicated
by Heather Gilmartin, PhD, NP, CIC
Seminar date: 12/14/2021
Description: Dr. Gilmartin will describe the speaking up and psychological safety literature related to patient safety practices in diverse healthcare settings and recent studies that investigated the relationship between psychological safety and reporting nonadherence to a safety checklist, infection prevention processes, and COVID-19 preparation and response. Intended Audience: Front-line clinicians, facility leaders and researchers interested in learning about the speaking up and psychological safety literature and tools to improve team dynamics to enhance patient safety.
Find the PDF handout and transcript
What We Are Learning About Relational Coordination Interventions in Healthcare
by Heba Naim Ali, MD, MS, PhDc ; Heather Gilmartin, PhD, NP, CIC ; Jody Hoffer Gittell, PhD
Seminar date: 11/15/2021
Description: VA researchers are increasingly using relational coordination – communicating and relating for the purpose of task integration – as a theory and method for understanding performance improvement and organizational change. In this seminar, Dr. Gittell will share the latest findings about outcomes of relational coordination – quality, efficiency, employee well-being, learning and innovation; and the latest findings about the interventions that strengthen it – hiring and training for teamwork, shared protocols and information systems, shared accountability and rewards, boundary spanner roles, and more. Intended Audience: Researchers and staff in the VA looking for concrete steps and interventions to optimize team performance or introduce organizational change.
Find the PDF handout and transcript
Podcast: Role of Mentorship Program for New Investigators
6 July 2018
Dr. Heather Gilmartin, investigator and nurse scientist at the Denver/Seattle Center of Innovation in Denver, Colorado, talks with her colleague Dr. Cathy Battaglia, Director of the Denver Research and Education Mentor Program about the Denver HSR&D Post-doctoral Fellowship program and the role of mentorship in developing the next generation of HSR&D investigators.
Listen to Role of Mentorship Program for New Investigators (12:18)
Podcast: Pain Management and Opioid Safety
4 May 2018
Dr. Heather Gilmartin, nurse scientist at the Denver/Seattle Center of Innovation in Denver, Colorado, talks with her colleague, Dr. Joe Frank, primary care physician at the Denver VA and health services researcher at the Denver/Seattle Center of Innovation, about his work in the area of pain management and opioid safety.
Listen to Pain Management and Opioid Safety (10:54)
Podcast: Rural Transition Nurse Program
16 March 2018
Dr. Heather Gilmartin talks with Dr. Bob Burke and Lynette Kelley, FNP, from the HSR&D Center of Innovation for Veteran-Centered and Value-Driven Care in Denver, CO, and Seattle, WA. They will be sharing their insights on the Rural Transition Nurse Program.
Listen to Rural Transition Nurse Program (22:47)
Explainer Video: Relationship Between Psychological Safety and Reporting Non-adherence to a Safety Checklist
2 February 2018
Watch patient safety checklists explainer video
Patient safety checklists are ubiquitous in health care. Nurses bear significant responsibility for ensuring checklist adherence. To report nonadherence to a checklist and stop an unsafe procedure, a workplace climate of psychological safety is needed. The author analyzed organizational data to examine the relationship between psychological safety and reports of nonadherence to the central line bundle checklist. Results showed varied perceptions of psychological safety but no relationship with nonadherence. You will enjoy watching this innovative video and will learn a lot from it (and be sure to also read the article).
Explainer Video: Brief Mindfulness Practices for Healthcare Providers - A Systematic Literature Review
October 2017
Some common themes identified in reviewing the published literature on how mindfulness practices can impact healthcare delivery and patient safety and care. Read the paper
Visual Abstracts
Slidedocs
A slidedoc is a document created using presentation software, where visuals and words unite to illustrate one clear point per page. They’re meant to be printed or distributed instead of presented. The result is a medium that can be read more quickly than a document. The slidedoc can include a link to a full report or publication for the interested reader.
COVID Slidedoc
15 January 2021 - Dr. Heather Gilmartin and colleagues studied the impact of COVID-19 on VA cardiac cath lab staff. The full report is available upon request.
Contact Dr. Gilmartin at heather.gilmartin@va.gov with questions.
