COIN: Center of Innovation for Complex Chronic Healthcare (CINCCH); Hines, IL

Acting Director: Kevin Stroupe, PhD

Website: http://www.cmc3.research.va.gov/

About the COIN

CINCCH’s mission is to enhance quality of care, safety, and value for Veterans. A significant focus is on Veterans with disabilities, particularly Veterans with Spinal Cord Injuries and Disorders (SCI/D) and Traumatic Brain Injury (TBI), based on our long-standing work, collaborations, and expertise in these areas.

Research Focused Area includes three priorities:

1. Enhancement of patient registry and assessment of outcomes

To allow for longitudinal analyses of outcomes, there is a critical need for a comprehensive SCI/D registry that aggregates prior registries and includes epidemiologic data, health factors and outcomes that can be matched with other data, such as healthcare utilization records and cause of death. Research priorities include enhancement of a longitudinal registry of Veterans with SCI/D, assessment of outcomes including value associated with the SCI/D comprehensive annual evaluation examination, and definition and assessment of nurse-sensitive outcomes.

2. Provision of wheelchairs

Veterans with SCI/D and others with severe mobility impairments depend on state-of the-art wheelchairs and associated education and training; however, some Veterans receive less than optimal wheelchairs and lack adequate mobility skills, which compromises health, participation, and safety outcomes. Research priorities include implementation and evaluation of programs to support efficient and effective provision of wheelchairs to Veterans with complex needs.

3. Co-morbidities associated with SCI/D

CINCCH investigators continue to lead and participate in ongoing and planned research addressing multiple issues and aspects of care management for Veterans with SCI/D. These areas include infectious disease, fractures, pressure ulcers, pain management, and opioid use.

Other research and implementation efforts to enhance quality of care, safety, and value for Veterans include:

• Evaluating the effectiveness of treatment and outcomes for Veterans infected with resistant gram-negative organisms.
• Combating antimicrobial resistance through rapid implementation of available guidelines and evidence.
• Improving Veteran health by increasing dental stewardship of antibiotics and opioids.
• Examining the impact of the VA medication copayment redesign.
• Evaluating the use of patient-collected audio recorded encounters for provider audit feedback to reduce contextual errors.
• Evaluating provider learning modules to prevent venous thromboembolism after major cancer surgery.
• Developing and validating a novel measure to support a learning healthcare system.
• Examining provider use of pet therapy to improve compassion, burnout, and empathy.
• Encouraging patient-centered communication in clinical video telehealth visits.
• Evaluating implementation strategies to increase tele-rehabilitation.

Research to Impact for VeteRans (RIVRs)

The Research to Impact for VeteRans (RIVRs) program is a new HSR&D funding mechanism that gives researchers the opportunity to pursue a five-year impact goal. Each RIVR impact goal aligns with VA priority areas including VA legislative priorities (e.g., MISSION Act); cross-cutting ORD priorities (e.g. PTSD); other HSR&D defined clinical priorities (e.g. Health Equity); and HSR&D methodological priorities (e.g. Data Sciences, Implementation Sciences, Systems Engineering). Impact goals for RIVRS could include changes in VA policy or clinical guidelines, spread of operational processes across VISNs, scaling of an effective intervention to 2-3 additional sites, advancements in health services research methods, or any other impacts that have real-world effects on Veteran health and satisfaction.

Current RIVR project

Data to Improve Veterans’ Outcomes (DIVO) in SCI/D

Principal Investigator: Kevin Stroupe, PhD

Goals of this project include developing and improving the use of data, standardized across VHA Spinal Cord Injury and Disorders (SCI/D) Centers; enhancing the care and experience of Veterans with SCI/D; promoting a learning healthcare system; and supporting innovations in care through research. Investigators will accomplish this by enhancing an existing longitudinal registry of Veterans with SCI/D. Using health services research methods, including data and measurement science and mixed-methods approaches, investigators will incorporate routinely collected data as well as patient-reported data into the registry and use the registry to assess patients’ outcomes.

Partner Offices

Each COIN works closely with operational partners throughout the VA healthcare system. CINCCH's partners include:

• VA SCI/D National Program Office
• VHA National Center for Patient Safety
• Physical Medicine & Rehabilitation Program Office
• VA Office of Connected Care/Telehealth Services
• Great Lakes Health Care System, VISN 12
• VA Homeless Program Office
• Pharmacy Benefit Management

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Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.