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Amy Kilbourne, PhD, MPH, Director of QUERI

Director's Letter

Aligning QUERI Efforts with VHA and Veterans' Needs

Getting back to standard time, what a difference an hour makes. Now it’s dark starting and ending work (at least in Michigan), and it still can mess with the circadian rhythm.

Speaking of which, QUERI recently asked several local, regional, and national providers and leaders about “what keeps them up at night,” in what they do to serve Veterans and the providers who care for them. This issue highlights some of their key responses.

For the past four years QUERI has asked VA local, regional, and national clinical operational leaders this question. This yearly process is used to help QUERI respond to emerging national trends as well as to support VISN leaders in moving the needle on quality of care. Most recently, this valuable feedback will be used to inform VA’s required yearly evaluation plans for the Evidence Act. Impacts of several of these initiatives are featured in this issue. In addition, we are delighted to announce new QUERI Advancing Diversity in Implementation Leadership (ADIL) awardees, who will build upon the multi-level partnerships fostered by our QUERI centers to enable implementation, evaluation, and quality improvement (QI) leadership for those representing the diversity of the Veterans we serve.

Many of the priorities – such as access, community care, virtual care, delayed care due to COVID, and suicide prevention – still make the list year after year. But as the VA learning health system evolves, leadership priorities are getting more specific in their asks. For example, community care coordination has been a priority for the past couple of years, but now VHA leaders have specified a more systematic set of learning health system goals of improving the data infrastructure and process by which Veterans access VA and community care over time. Also, we need to understand and improve policies that address VA workforce shortages, especially in rural areas, and mitigate them using new models of service delivery. Much of this work will require partnerships with VA’s Office of Research & Development (ORD), Health Services Research & Development (HSR&D), as well as VHA clinical operations and QUERI investigators to link the science with the application to improve health. On the horizon, QUERI – through its role to help VA fulfill core components of the Evidence Act – will launch centers to address these big-ticket national policy and program questions, and will use implementation science to ensure solutions work at the clinic level.

Finally, I am continually reminded that some of the best insight comes from the people we work with. At a July Community Advisory Board meeting of Michigan frontline providers and consumers of mental health services, I had the opportunity to hear different perspectives on the question “what keeps you up at night?” One woman from the Detroit area enthusiastically noted “fireworks!” So despite all that is going on, there exist reminders that some of our most lasting memories come from our celebration with neighbors and the people we serve.

Amy Kilbourne, PhD, MPH
Director, Quality Enhancement Research Initiative

Melissa Braganza, MPH
QUERI Program Manager