UMMS Affiliation

Department of Population and Quantitative Health Sciences

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Alternative and Complementary Medicine | Health Services Administration | Health Services Research | Integrative Medicine | Military and Veterans Studies | Virus Diseases


Background: The US Veterans Health Administration (VA) is transforming its healthcare system to create a Whole Health System (WHS) of care. Akin to such reorganization efforts as creating patient-centered medical homes and primary care behavioral health integration, the WHS goes beyond by transforming the entire system to one that takes a proactive approach to support patient and employee health and wellness. The SARS-CoV-2 pandemic disrupted the VA's healthcare system and added stress for staff and patients, creating an exogenous shock for this transformation towards a WHS.

Objective: We examined the relationship between VA's WHS transformation and the pandemic to understand if transformation was sustained during crisis and contributed to VA's response.

Methods: Qualitative interviews were conducted as part of a multi-year study of WHS transformation. A single multi-person interview was conducted with 61 WHS leaders at 18 VA Medical Centers, examining WH transformation and use during the pandemic. Data were analyzed using rapid directed content analysis.

Results: While the pandemic initially slowed transformation efforts, sites intentionally embraced a WH approach to support patients and employees during this crisis. Efforts included conducting patient wellness calls, and, for patients and employees, promoting complementary and integrative health therapies, self-care, and WH concepts to combat stress and support wellbeing. A surge in virtual technology use facilitated innovative delivery of complementary and integrative therapies and promoted continued use of WH activities.

Conclusion: The pandemic called attention to the need for healthcare systems to address the wellbeing of both patients and providers to sustain high quality care delivery. At a time of crisis, VA sites sustained WH transformation efforts, recognizing WH as one strategy to support patients and employees. This response indicates cultural transformation is taking hold, with WH serving as a promising approach for promoting wellbeing among patients and employees alike.


SARS-CoV-2 pandemic, complementary and integrative health, health system transformation, health worker wellbeing, military veterans

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Copyright © The Author(s) 2021. Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (

DOI of Published Version



Dryden EM, Bolton RE, Bokhour BG, Wu J, Dvorin K, Phillips L, Hyde JK. Leaning Into Whole Health: Sustaining System Transformation While Supporting Patients and Employees During COVID-19. Glob Adv Health Med. 2021 May 26;10:21649561211021047. doi: 10.1177/21649561211021047. PMID: 34104578; PMCID: PMC8168024. Link to article on publisher's site

Journal/Book/Conference Title

Global advances in health and medicine

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Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License