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RRT Highlights: Behavioral Health QUERI

Rapid Response Team (RRT) evaluations conducted by QUERI Program Centers are a key mechanism to provide support to operations partners on issues that require immediate evaluation, implementation, or quality improvement support. Behavioral Health QUERI is one such Program Center that has conducted impactful work utilizing the RRT mechanism. This Program Center, led by Sara Landes, PhD, and Chris Miller, PhD, is focused on advancing the implementation of quality mental health care provided to Veterans, especially those at highest risk for suicide. Their key partners in this work are the Office of Mental Health (OMH) and the Office of Suicide Prevention (OSP). While RRTs were a new addition to QUERI Program Centers funded in 2020, Behavioral Health QUERI has a history of supporting operational partners in implementation and conducting evaluations. ¹

Behavioral Health QUERI’s Rapid Response Team is led by Monica Matthieu, PhD, LCSW, who is an expert in suicide intervention implementation. Each Behavioral Health QUERI RRT project includes additional faculty and staff (e.g., project coordinators, qualitative interviewers, and qualitative and quantitative analysts) based on their expertise, availability, and interest. This model allows for tailoring of Behavioral Health QUERI resources to best respond to partners’ needs while providing opportunities for staff and faculty (including mentees) to gain experience in highly partnered work.

Behavioral Health QUERI works closely with operational partners to identify whether work proposed by partners fits the RRT mechanism in scope and timeline (i.e., RRTs are expected to fit within a 3 to 6-month duration) as well as focus area. Behavioral Health QUERI is able to provide support to partners in identifying whether a project may fit better as an “additional” QUERI project rather than an RRT. When projects are appropriate for the RRT mechanism, they are reviewed by QUERI and assigned to a QUERI Program Center, such as Behavioral Health QUERI.

Given the short timelines of RRT projects, Behavioral Health QUERI also created a comprehensive RRT project checklist to both orient partners to the process and support staff in making sure all requirements were met. For example, the checklist includes items related to completing the Memorandum of Understanding (MOU), presenting to the Behavioral Health QUERI Stakeholder Council, developing evaluation materials, obtaining necessary clearance for materials, and following VA requirements for surveys and interviews.

OMH, OSP, and the Veterans Crisis Line (VCL) have been Behavioral Health QUERI’s primary RRT customers. As noted above, Behavioral Health QUERI investigators have a long history of working with OMH, OSP, and VCL leadership. For example, Dr. Landes worked with OSP in her evaluation of the implementation of REACH VET, a clinical initiative that uses predictive modeling and medical record data to identify Veterans at highest risk for suicide. ² In another example of partnering with OMH, Dr. Miller led an RRT project that involved providing training and consultation to Transformational Coaches, who in turn helped medical centers adopt a team-based model for delivering outpatient mental health services, in concert with OMH. Based on Dr. Matthieu’s previous experience with writing Congressional reports on implementation and evaluation findings from mandated pilot projects, a number of additional QUERI or unaffiliated projects beyond RRT projects have been commissioned by our OMH and OSP partners.

As a result of the expertise of Behavioral Health QUERI investigators and staff, RRT projects have included a range of skills, from developing evaluation and implementation plans, conducting pilot evaluations, designing and conducting surveys and multi-year projects to satisfy Congressional mandates, and providing additional implementation, technical, and data analytic support. The table below outlines RRT projects.

Behavioral Health QUERI RRT Projects

RRT projects have culminated in reports to clinical operations partners and Congress. In addition, evaluation findings have been more widely disseminated in conference presentations and publications. Behavioral Health QUERI is an example of a Program Center with a long-standing respect for mutually beneficial partnerships that has utilized RRTs to support operations partners in impacting Veteran health.

^[1] Research & Services Partnerships: Lessons Learned Through a National Partnership Between Clinical Leaders and Researchers. (Psychiatric Services)

^[2] https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.20230277