{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:05:23Z","timestamp":1789995923800,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":106,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006379","name":"Office of Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006379","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>Relational Playbook for Cardiology Teams<\/jats:italic>\n                      is a 6\u2010month, evidence\u2010based leadership development program designed to foster supportive learning environments within the Veterans Health Administration (VA). The Playbook features 50 leadership practices and resources, including readings, clinical examples, videos, and podcasts for flexible, asynchronous learning. Participants complete monthly independent study and implement 11 interventions during team meetings or one\u2010on\u2010one interactions. While rural healthcare settings may benefit from the Playbook, adaptations are needed to ensure acceptability, appropriateness, and feasibility. This study aimed to tailor the Playbook for rural hospital medicine using a theory\u2010informed multi\u2010method pre\u2010implementation approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical leaders in medicine, nursing, social work, and pharmacy were recruited from three rural VA hospitals. Facility\u2010level data were drawn from the 2023 VA Support Service Center Capital Assets database and the VA Hospital Medicine Survey. Observational data from site visits were collected using a structured template and analyzed through team\u2010based rapid qualitative content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>In 2024, we conducted three site visits at intermediate\u2010complexity VA hospitals serving rural Veterans. Clinical leaders at each site reported potential barriers to engagement, including leadership instability, physician burnout, and limited time for professional development. Tailoring strategies were recommended, including expanding recruitment to all clinical leaders, streamlining site visits, and using publicly available data to contextualize site\u2010specific challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A multi\u2010method pre\u2010implementation approach enabled effective adaptation of the Playbook, improving its relevance for rural settings. Early engagement and flexible implementation are key to successful adaptation. Future evaluation will assess impact on team dynamics and Veteran care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.70165","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:30:47Z","timestamp":1781584247000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tailoring the Relational Playbook for Cardiology Teams to the Rural Hospital Medicine Setting: A Multi\u2010Method Pre\u2010Implementation Evaluation"],"prefix":"10.1111","volume":"42","author":[{"given":"Heather M.","family":"Gilmartin","sequence":"first","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"},{"name":"Department of Health Systems Management and Policy, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Perry","sequence":"additional","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigid","family":"Connelly","sequence":"additional","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7640-9986","authenticated-orcid":false,"given":"Marguerite","family":"Daus","sequence":"additional","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Ladebue","sequence":"additional","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Hess","sequence":"additional","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianne","family":"Morgan","sequence":"additional","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"John P.","family":"Nolan","sequence":"additional","affiliation":[{"name":"Independent Researcher, Veteran Partner  El Dorado Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Sjoberg","sequence":"additional","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumya","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Melver L.","family":"Anderson","sequence":"additional","affiliation":[{"name":"VHA Hospital Medicine, Specialty Care Program Office, Veterans Health Administration  Washington, DC USA"},{"name":"Hospital Medicine Section, VA Eastern Colorado Healthcare System  Aurora Colorado USA"},{"name":"Division of Hospital Medicine University of Colorado Anschutz School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea","family":"Leonard","sequence":"additional","affiliation":[{"name":"Denver\/Seattle Center of Innovation for Veteran\u2010Centered and Value Driven Care VA Eastern Colorado Healthcare System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lrh2.10383"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558712448135"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0019793916642759"},{"key":"e_1_2_12_5_1","unstructured":"\u201cAddressing Health Worker Burnout: The U.S. Surgeon General's Advisory on Building a Thriving Health Workforce \u201d U.S. Surgeon General's Office. 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