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Quality Enhancement Research Initiative

QUERI E-news
Fall 2023

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Congratulations to Newly Funded QUERI Partnered Evaluation Initiatives and Advancing Diversity in Leadership Awardees!

Two Partnered Evaluation Initiatives and two Advance Diversity in Implementation Leadership projects kicked off this past Spring.

Partnered Evaluation Initiatives

QUERI Partnered Evaluation Initiatives (PEIs), which are co-funded by the operations partner, evaluate programs or policies that are aligned with national VA priorities and have the potential for high impact on care provided to Veterans. QUERI recently funded a new evaluation partnering with VISN 21 to enhance heart failure care, and a national evaluation addressing VA’s suicide prevention priority.

  • The Implementation Evaluation of PACT Pharmacy Management of Heart Failure in VISN 21 The Implementation Evaluation of PACT Pharmacy Management of Heart Failure in VISN 21 is led by Paul Heidenreich, MD, a core investigator with HSR’s Center for Innovation to Implementation (Ci2i) and Chief of Medicine at VA Palo Alto Healthcare. The HEART PHARMD partners with VISN 21 (Sierra Pacific Network) to evaluate the implementation intervention of an evidence-based practice of heart failure management by pharmacists in Patient Care Aligned Teams (PACTs). HEART PHARMD will work to enhance VA’s quality of heart failure care while improving access to care at VA medical centers and community-based outpatient clinics. Another key goal is to reduce disparities and improve health equity in guideline-recommended medication use for heart failure.
  • Evaluation of the Centralized Caring Letters Suicide Prevention Intervention after Removal of an Electronic Health Record Flag (HRF) for Suicide Risk led by Mark Reger, PhD, Chief of Psychology Services at VA Puget Sound Healthcare. The Evaluation of a Centralized Caring Letters (CL) Suicide Prevention Intervention will examine the use of nationally centralized Caring Letters vs both a historical cohort in which no letters were mailed, and the previous approach of using local Suicide Prevention Coordinators. Additionally, this PEI will evaluate the impact of adding an implementation strategy, including an assessment of whether centralizing HRF caring letters increases reach and implementation fidelity. The Suicide Prevention Program is taking steps to standardize and centralize Caring Letters after clinically-guided inactivation of a High Risk for Suicide Patient Record Flag (HRS-PRF). Centralized HRF caring letters is expected to reach about 30,000 VA patients with HRS-PRF inactivations per year.

Advancing Diversity in Implementation Leadership

The purpose of the QUERI initiative to Advance Diversity in Implementation Leadership (ADIL) is to promote implementation, quality improvement (QI), and evaluation leadership opportunities for individuals who reflect the diversity of the Veterans VA serves. ADILs are open to candidates who are investigators, staff, or students currently affiliated with a QUERI center—and are from populations that reflect the diversity of the Veterans VA serves. QUERI recently funded two ADILs to address VA’s priorities of supporting Veteran caregivers and enhancing Veterans’ experience of care, particularly for homeless-experienced Veterans.

  • Disparities in Respite Service Use among Veteran Caregivers led by Melissa Harris, PhD, with mentoring from Courtney Van Houtven, PhD, who leads QUERI’s VA Caregiver Support Program PEI and is a core investigator with HSR’s Durham Center of Innovation to ADAPT in Durham, NC. This ADIL will characterize disparities in the use of respite service among Veteran caregivers and explore Veteran caregivers’ perceptions regarding barriers and facilitators to using respite services with the goal of identifying strategies to optimize respite care service and address complex factors driving disparities.
  • Enhancing Critical Time Intervention (CTI) for homeless-experienced Veterans led by Talia Panadero, BA, with mentoring from Sonya Gabrielian, MD, who co-leads Housing Transitions QUERI and is a researcher with HSR’s Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP) in Los Angeles, CA. This ADIL will examine Veteran factors (e.g., demographics, social supports) and care experiences that may impact CTI implementation. It also aims to enhance implementation supports (e.g., case manager training, external facilitation resources) to reflect identified Veteran experiences.

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