2008 — From Evidence to Implementation of New Clinical Procedures: VA's Response to Lung Cancer Screening

Jackson GL, Durham VA Medical Center HSR&D Center of Innovation; Kinsinger LS, VA National Center for Health Promotion and Disease Prevention; Monte RJ, Pittsburgh Veterans Engineering Resource Center; Provenzale D, Durham VA Medical Center HSR&D Center of Innovation; Atkins D, VA Health Services Research & Development; Woodward-Hagg H, VA Center for Applied Systems Engineering; Jain R, VA Office of Patient Care Services;

Workshop Objectives:
The National Lung Screening Trial (NLST) reported that screening patients at high risk for lung cancer with low-dose computed tomography (CT) led to a 16% mortality benefit compared to screening with chest radiography. However, there are important evidence gaps regarding the components of an effective screening program outside the research setting and the impact on clinical and organizational outcomes. Under leadership of the National Center for Health Promotion and Disease Prevention (NCP), the VA embarked on an 8-site comprehensive demonstration project designed to address these issues. After a period of proactive planning, screening actively began in the fall/winter of 2013. A partnership among VA clinical offices, individual VA medical centers, Health Services Research and Development (HSRandD), and Veterans Engineering Research Center (VERC) program planned the project, implemented screening, and measured implementation and program/intervention outcomes. HSRandD is conducting a mixed-methods (integration of quantitative and qualitative findings) implementation evaluation of the program with the goal of providing guidance to senior VA leadership on the processes of implementing LCS. This workshop will address how partners representing VA operations, engineering, and research/evaluation seek to understand implementation effectiveness, clinical and economic outcomes, and impact on patients in order to develop a patient-centered, evidence-based LCS program.

Activities:
The Chief Consultant for Preventive Medicine of the NCP will describe the process of developing collaboration among health system leaders, clinical departments, researchers, and engineers to establish, conduct, measure, and evaluate implementation of LCS. The role of the VERC in the development of patient tracking tools that integrate with CPRS and provide evaluation data will be discussed. This will be followed by a discussion of how a HSRandD led evaluation utilized a mixed-methods approach to evaluate differences in implementation of the program among facilities. Finally, discussants, including the national leaders of HSRandD, VERC program, and Office of Patient Care Services, will discuss the needs of senior system leaders who often must act in the face of limited information while addressing needs of multiple stakeholders.

Target Audience:
Those interested in how to combine perspectives to address VA's need to effectively implement new clinical advances.

Assumed Audience Familiarity with Topic:
None.