» Table of Contents

Director's Letter

Melissa Braganza, MPH

This winter, we kicked off our five-year HSR/QUERI strategic planning process, where we are gathering feedback from multilevel VA leaders, Veterans, providers, investigators and staff, research offices, and external partners. Strategic planning is critical to what we do in QUERI. Last cycle’s FY2021-2025 QUERI strategic planning led to the development of more rapid mechanisms for evaluation support (e.g., QUERI Rapid Response Teams, Evidence-based Policy Evaluation Centers), a greater emphasis on designing more practical methods and tools for operational partners (e.g., adaptive evaluation designs, implementation playbooks, economic evaluations and sustainment plans), the launch of new mentoring and training opportunities in implementation, evaluation, and quality improvement methods (e.g., QUERI Mentoring Cores, Advancing Diversity in Implementation Leadership initiative), and the expansion of our QUERI annual priority-setting process to inform research priorities and Evidence Act evaluations. We are excited to see what new initiatives arise from this year’s strategic planning process.

Speaking of our annual priority-setting process, this past Fall marks the seventh year in which we have gathered priorities from local, regional, and national leaders to help us identify new opportunities where QUERI interdisciplinary teams can work with operations leaders to help move the needle on quality of care and support VHA performance plan goals. These priorities, which are highlighted in this issue of QUERI News, are aligned with current VA priorities, Agency Priority Goals, and VHA’s Long Range Plan. Many of these priorities—such as workforce recruitment and retention, health care access, community care, suicide prevention—will look familiar, as they make the list year after year. Yet, in the last couple of years, priorities around military exposures and homelessness have emerged. Several QUERI partnered evaluations that have been launched to help address these priorities are featured in this issue.

In concert with these evaluation and quality improvement initiatives addressing short-term VA program and policy needs, we are also building out longer-term infrastructure to be able to more quickly respond to future emerging VA and legislative priorities. Through additional DEAN support, we are funding two new interdisciplinary teams, comprised of QUERI investigators and operations partners, to build learning health systems focused on geriatrics and homelessness. These teams are creating learning communities and building data infrastructure that can help lay the foundation for future evidence generation and evaluation activities. Much of this work will involve partnering with VA’s Office of Research & Development (ORD), Health Systems Research (HSR), clinical operations and policy leaders, and HSR/QUERI investigators to build and operationalize these learning health systems that can help drive sustained, systemwide care improvements through science, policy, and practice change. With this in mind, we are combining our HSR and QUERI strategic planning process to gather priorities, ideas, and insights in both the research and quality improvement areas to help us to better align research, implementation, evaluation, and quality improvement efforts as part of a learning health system. This issue highlights one example of how research, QUERI, and operations aligned to address a VA priority from what began as an HSR randomized clinical trial to the scale-up and spread of a caregiver training support program, Caregivers First, through support from QUERI, the VA Caregiver Support Program, and Diffusion of Excellence. As the learning health system continues to evolve, this example of seamless alignment between research and operations to address VA priorities is what we hope to achieve through building out these additional data and learning community components of a learning health system.

Melissa Braganza, MPH
Acting Director, Quality Enhancement Research Initiative