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QUERI recently funded several new Partnered Evaluation Initiatives (PEIs), which involve primary funding from an operations partner in order to conduct specific evaluations of initiatives with potential high impact on VA national policy. The new PEIs include:
- Complementary Integrative Health Evaluation Center
Complementary and integrative health (CIH) such as acupuncture, mindfulness meditation, and yoga are emerging as safe, non-pharmacologic options to improve health with few side effects. CIH is a national priority for VA, as it is the focus of a Congressional Act that directs VA to "...expand the scope of VA's research and education on, and delivery and integration of, complementary and alternative medicine services." CIH also is specifically included in the 2015 MyVA Integrated Plan (MIP), VA's Blueprint for Excellence, and the Office of Patient Care Services PACT Pain Roadmap. While CIH is reportedly provided in most VA medical facilities, it is usually in very limited capacity due to significant implementation barriers. Moreover, current CIH research is almost exclusively on non-Veterans and does not involve patient-reported outcomes. Therefore the new QUERI Complementary Integrative Health Evaluation Center, located in Los Angeles, CA, aims to improve Veterans' health and experiences of care through increased availability and use of evidence-based CIH, such as yoga, tai chi, mindfulness medication, and acupuncture. Investigators will work with partners from VA's Office of Patient-Centered Care and Cultural Transformation (OPCC&CT).
- Diffusion of Excellence Evaluation
The Spreading Healthcare Access, Activities, Research and Knowledge (SHAARK) Partnered Evaluation Center (PEC) is designed to provide rapid and frequent feedback to VA Diffusion of Excellence (DEI) partners by: 1) addressing factors aimed at increasing participation in the DEI; 2) helping increase organizational readiness for change within VA facilities to successfully implement promising practices; and 3) addressing key contextual factors that are associated with successful implementation of gold-status practices at VA healthcare facilities. An anticipated evaluation outcome is the increased ability of DEI partners to provide effective "personalized implementation" (organizational-level and person-level human centered design) of promising practices. Key partners for this evaluation are the Office of Strategic Integration (OSI), which works with stakeholders to improve organizational efficiency and the successful implementation of health and business programs, and Office of the Assistant Deputy Under Secretary for Health for Quality, Safety and Value in cooperation with the VA Center for Innovation (VACI).
- Evaluation of Implementation of a National Point-of-care Ultrasound Training Program
Point-of-care ultrasonography (POCUS) has been shown to reduce procedure-related complications from invasive bedside procedures, reduce time to diagnosis, and reduce ancillary testing, which can reduce patient radiation exposure and healthcare costs. Despite its potential advantages, POCUS has not been universally adopted in healthcare due to limited numbers of providers trained in its use. VA's Simulation Learning, Education and Research Network (SimLEARN) and Specialty Care Centers of Innovation have launched a collaborative initiative to develop a national POCUS training program. Based in San Antonio, TX, the new QUERI Point-of-Care Ultrasound Training Program PEI will teach frontline VA providers diagnostic and procedural applications of POCUS. Investigators also will evaluate the effectiveness of a POCUS training course on provider skill acquisition and retention, frequency of use, and will identify barriers/facilitators to POCUS use at participating VA facilities.
- Evaluating Evidence-Based Quality Improvement of Comprehensive Women's Healthcare in Low-Performing VA Facilities
Women Veterans continue to be among the fastest growing segments of new users of VA healthcare; however, their needs and current numerical minority have, at times, presented challenges to ensuring uniform delivery of gender-sensitive comprehensive care. VA researchers have been testing evidence-based quality improvement (EBQI) strategies for accelerating the tailoring of VA's patient-centered medical home model (Patient-Aligned Care Teams or PACTs) to the needs of women Veterans. Early successes prompted VA Women's Health Services (WHS) to adapt the EBQI approach to help broadly strengthen the women's health programs in lower-performing VA facilities in FY2017. Based in Los Angeles, the new QUERI Women's Healthcare PEI will evaluate barriers and facilitators to achieving the delivery of comprehensive healthcare for women Veterans in low-performing VA facilities. Investigators also will evaluate the effectiveness of EBQI in supporting low-performing VA facilities. VA Women's Health Services in the Office of Patient Care Services (PCS) oversees services for women Veterans in VA, and is the primary partner for the evaluation and EBQI implementation.