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HSR&D and QUERI National Meeting 2023

“Advancing Health Equity through Research, Implementation Science, Diversity, and Inclusion” was the theme of the 2023 VA Health Services Research and Development Service (HSR&D) and Quality Enhancement Research Initiative (QUERI) National Meeting that was held in Baltimore, MD this past February. This year’s theme emphasized VA’s commitment to improving the quality, safety, and equity of healthcare for Veterans – and empowering its healthcare workforce through innovations in informatics, implementation science, and Veteran engagement. Meeting participants included more than 550 researchers, VA operational partners, clinical leaders, Veterans, and caregivers who came together in person for the first time since the pandemic began.

Importance of Implementation Science

Amy Kilbourne, PhD, MPH, Director of QUERI, addressed national meeting attendees on the importance of implementation science and QUERI’s extraordinary growth over the past 25 years. Since 2016, QUERI has partnered with more than 100 VISNs and VA national program office leaders and has disseminated over 200 research-informed strategies and products to more than 27,000 VA healthcare providers and staff. For example, QUERI investigators evaluated the national implementation of Caring Letters, which has reached over 200,000 Veterans at risk of suicide. QUERI investigators were also instrumental in demonstrating how mandated case reviews on opioid analgesic-prescribed patients at high risk of overdose/suicide was associated with >20% reduction in all-cause mortality. In addition, QUERI trains VA’s healthcare workforce in implementation, quality improvement, and evaluation best practices.

Recipients of the Under Secretary’s Award

Due to the inability of holding in-person meetings during the pandemic, HSR&D celebrated the last three recipients of the Under Secretary’s Award for Outstanding Achievement in Health Services Research at the 2023 meeting. Meeting attendees celebrated 2021 Awardee Keith Humphreys, PhD and 2019 Awardee Matthew Samore, MD. In addition, they honored 2020 Awardee Donna Washington, MD, MPH, FACP, who has devoted her career to addressing the healthcare needs of vulnerable and underserved populations, particularly racial/ethnic minority and women Veterans. A general internist and a core investigator with HSR&D’s Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), Dr. Washington also leads the Health Equity QUERI Center, which partners with VA’s Office of Health Equity (OHE) to examine health, healthcare quality, experiences, and outcomes of vulnerable Veteran populations across the VA healthcare system.

QUERI Presentations

QUERI investigators presented their work on an array of topics. Below are just a few brief examples of their outstanding presentations.

• Rapid Qualitative Approach to Support Evaluation and Tailoring in the Housing Transitions QUERI: Erica Fletcher, PhD, spoke about Housing Transitions QUERI—a VA-funded initiative to implement Critical Time Intervention (CTI), an evidence-based case management practice supporting housing transitions for Veterans who experience homelessness, across 32 community-based agencies nationwide who partner with VA. This implementation-effectiveness trial compares two implementation strategies: Replicating Effective Programs [REP] and REP enhanced with external facilitation. Dr. Fletcher described pre-implementation qualitative findings in CTI formative evaluation, implementation planning, and tailoring.

• Effect of Implementation Facilitation on Initiation and Retention on Medications for Opioid Use Disorder: Anne Black, PhD, spoke to meeting attendees about the QUERI-funded Consortium to Disseminate and Understand Implementation of Opioid Use Disorder Treatment (CONDUIT) and its aim to unite six inter-related pilot Partnered Implementation Initiative projects to improve access to medications for opioid use disorder (MOUD), as well as alternative therapies for pain for Veterans with opioid use disorder in more than 50 VA healthcare facilities spanning 6 VISNs.

• Incorporating a Health Equity Focus into Implementation and Evaluation of Evidence-Based Practices for High-Risk Patients: Michelle Wong, PhD, spoke about the High-RIsk VETeran (RIVET) QUERI Program, which compared two strategies to implement evidence-based practices for high-risk, complex patients in primary care. RIVET QUERI aimed to incorporate domains from emerging health-equity focused implementation frameworks into a tailored logic model that will guide RIVET Program evaluation.

• Basic Training in Military and Veteran Cultural Humility: Brandolyn White, MPH, discussed the Dynamic Diffusion Network (DDN) QUERI Program, which is partnering with Veterans to strengthen efforts to improve the delivery of VA healthcare services to Veterans. She spoke about results from a DDN QUERI workshop that seeks to 1) provide an overview of the U.S. military, its customs, and culture; 2) share understanding of the U.S. military culture to remove barriers, aid in rapport, and offer common language when engaging with Veterans; 3) describe caveats in communicating with Veterans; 4) describe the most frequent disabilities encountered in combat Veterans (e.g., PTSD/TBI); and 5) offer resources to improve outreach to Veterans.

For more information, please visit the 2023 HSR&D/QUERI National Meeting site.