“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 February 8-10 in Baltimore, MD. 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 were able to come together in person for the first time since the pandemic began. Competitively selected from more than 800 submitted abstracts, the meeting featured: 4 plenary papers, 204 additional papers presented as part of themed sessions, 10 workshops, 4 Veteran Engagement Forums, 151 posters, and 16 Veteran/Caregiver hosted posters on healthcare issues of vital importance to Veterans and the VA healthcare system. Topics in this comprehensive agenda included but were not limited to health equity and social determinants of health, long-term care and aging, virtual care and telehealth, mental health, suicide prevention, COVID-19, primary care, and women’s health.
“Three of the greatest things about HSR&D, for me, was the incredible support I received early in my career, including intramural research funding. And being at this meeting after four years of not seeing people has reaffirmed what a great and special community we have, particularly for junior people. The second is that we have direct engagement with clinical leaders, which helps ensure that the work we’re doing is responsive to their needs – and when we generate it, we can talk to them directly, which increases the value of the work we’re doing. And third is the EHR data we have access to, which is greater than any other health system in the country. This enables all kinds of research that no one else can do.” —Matt Maciejewski, PhD, HSR&D Research Career Scientist and national meeting attendee
The HSR&D/QUERI National Meeting kicked off with a mini-conference for HSR&D Career Development Awardees (CDAs), which was expertly planned by co-chairs Utibe Essien, MD, MPH; Lucinda Leung, MD; and April Mohanty, PhD, MPH. With a focus on building diversity among HSR&D’s early-career researchers, CDAs participated in targeted discussions on topics including career advancement, recruitment from under-represented groups (i.e., LGBTQ+ Veterans, women Veterans, minoritized Veterans), and career planning and mentorship.
Dr. Atkins opened the first plenary session with a brief summary of HSR&D’s recent impacts on Veterans’ health and care in areas that include several advances in our understanding of COVID-19, its variants, available treatments, and outcomes (i.e., increased risk of cardiovascular conditions among Veterans up to one year following infection). HSR&D investigators also found that alignment with VA’s patient-centered mission and community-based culture served as important factors in job satisfaction, despite burnout from the pandemic. This was accomplished due to the steady growth of HSR&D under Dr. Atkins’s leadership. HSR&D currently has 463 ongoing projects, 870 active investigators, and 94 clinical office partnerships.
Amy Kilbourne, PhD, MPH, Director of QUERI, addressed attendees on the importance of implementation science and QUERI’s extraordinary growth over the past 25 years. Currently, QUERI partners with more than 70 VISNs and VA national program office leaders and has disseminated over 200 research-informed strategies and products to more than 26,000 VA healthcare providers. In addition, QUERI trains VA’s healthcare workforce in implementation, quality improvement, and evaluation best practices. For example, QUERI researchers facilitated the national dissemination of the Caring Letters Campaign, which reached more than 200,000 Veterans at risk of suicide. QUERI investigators were also instrumental in promoting use of the STORM electronic decision support tool to improve opioid medication management, resulting in a >20% reduction in mortality from opioid use disorder.
HSR&D was honored to have both Carolyn Clancy, MD, Assistant Under Secretary for Health for Discovery, Education, and Affiliate Networks (DEAN) and VA’s Chief Research and Development Officer, Rachel Ramoni, DMD, ScD, attend the first plenary session. In a panel facilitated by Elizabeth Yano, PhD, MSPH, Director of HSR&D’s Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), Drs. Clancy and Ramoni answered questions previously submitted by attendees. In response to a question about the underlying goals of the upcoming VA research realignment, Dr. Ramoni spoke about “the need and opportunity to work together in an integrated way,” and “exploring ways to enhance communication and collaboration,” while Dr. Clancy emphasized the importance of getting partners engaged up front. Dr. Clancy highlighted the Researchers and Evaluators in Residence (REiR) program as an example of VA leveraging HSR&D researchers, who are already embedded in the VA system, to better inform VA programs and policies that will improve care for Veterans.
Drs. Ramoni, Yano, Clancy, and Atkins.
Due to the inability of holding in-person meetings during the pandemic, HSR&D celebrated our last three recipients of the Under Secretary’s Award for Outstanding Achievement in Health Services Research at the 2023 meeting. This award is the highest honor for a VA health services researcher. For their exceptional careers and continued dedication to improving the health and care of Veterans, HSR&D was proud to present the Under Secretary’s Award for Outstanding Achievement in Health Services Research to the following researchers. VA Under Secretary for Health, Shereef Elnahal, MD, MBA, acknowledged and congratulated 2021 awardee Keith Humphreys, PhD, 2020 Awardee Donna Washington, MD, MPH, FACP, and 2019 Awardee Matthew Samore, MD.
An HSR&D Senior Research Career Scientist and investigator with HSR&D’s Center for Innovation to Implementation (Ci2i), Dr. Humphreys conducts research on treatments for substance use and psychiatric disorders. Over his career, he has shed light on several key issues to enhance VA healthcare, including applying practice guidelines in everyday clinical practice; how self-help groups for addiction disorders can improve treatment outcomes and reduce healthcare costs; and how innovative research methods can aid in assessing outcomes. A general internist and a core investigator with CSHIIP, Dr. Washington leads the Health Equity QUERI Center. She has devoted her career to addressing the healthcare needs of vulnerable and underserved populations, particularly racial/ethnic minority and women Veterans. For example, in collaboration with VA’s Office of Health Equity, she was a chief architect of VA’s first ever National Veterans Health Equity Report. Director of HSR&D’s Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, Dr. Samore’s novel research has resulted in major improvements to Veterans’ healthcare, including advances in electronic health record (EHR) data to improve the measurement of prescribing practices and patient outcomes, and system-wide shifts in VA’s approach to antibiotic prescribing and antibiotic stewardship.
Drs. Humphreys, Samore, Washington, Elnahal, and Atkins.
A keynote address was given by Robert Otto Valdez, PhD, MHSA, Director of the Agency for Healthcare Research and Quality (AHRQ), who began his career as the lead child health researcher for the historic RAND Health Insurance Experiment (HIE). Internationally recognized as an expert in health services research, the U.S. healthcare system, and health policy analysis, he has led numerous global healthcare initiatives with the Pan American Health Organization and the University of California. Guest Speaker, Gbenga Ogedegbe, MD, MPH, Founding Director of the Institute for Excellence in Health Equity, NYU Langone Health, is a leading NIH-funded scientist in health equity research. Having been born in Nigeria, Dr. Ogedegbe spoke about his own experience with structural racism and how it can affect healthcare systems. Another Guest Speaker was Senior Policy Researcher at the RAND Corporation, Kayla Williams. A Veteran – and recipient of the 2013 White House Woman Veteran Champion of Change award – Ms. Williams’ work focuses on optimizing policies and programs to support Veterans and military personnel.
“It’s a privilege, in my view, to work for VA. Both as a nurse and a scientist, what has always attracted me to stay with VA for more than 30+ years is that it’s a wonderful community to work in – very collaborative and supportive. And, of course, it’s an important way of giving back to an important community of Veterans, who rely on VA for their healthcare. Seeing that we can make a difference.“ —Denise Hynes, PhD, MPH, RN, HSR&D Research Career Scientist and national meeting attendee
Veterans played an active part in this year’s national meeting, submitting abstracts for posters and oral presentations, with Ray Facundo, MSW, serving as a conference co-chair and Veteran representative on the planning committee. There were several Veteran Forums that covered topics such as conducting impactful research with under-represented Veteran patient populations, effectively and safely treating pain with opioids, and grassroots Veteran engagement to inform VA policy. There also was a workshop on Veteran Engagement titled “Basic Training in Military and Veteran Cultural Humility” that sought to create a shared understanding of the U.S. military culture and offer a common language for healthcare providers when speaking with Veterans. Moreover, Veterans participated in poster sessions on Veteran and Caregiver Engagement that covered topics such as “Advance Care Planning and Healthcare Equity” and “Leveraging Veterans’ Experience for Research.”
Veteran Mark Flower, poster presenter.
“I’ve worked in VA for a long time. I never thought I’d stay. The benefits are the Veterans and working with a patient population who is amazing and well-deserved—and to be part of helping that community… I’ve been very moved by it. I didn’t come into VA with that thought, sadly, but I’m a big convert. And I really can’t say enough about the VA researchers I get to work with.” —Jennifer Funderburk, PhD, HSR&D research psychologist and national meeting attendee
Plenary sessions and selected oral paper sessions are available via the HSR&D/QUERI National Meeting Live Stream Archive at any time. Soon, you will also be able to enjoy podcasts and videos from the meeting that feature more than 30 researchers speaking on an array of topics, ranging from health equity to COVID-19 to suicide prevention.
“Working within VA/HSR&D gives the researchers the ability and opportunity to translate their research findings into broader implementation into the VA healthcare system. And that can have significant impacts on VA policy, clinical practice, and can even directly affect Veterans’ health outcomes. I was an HSR&D Career Development Awardee (CDA), and this gave me an excellent opportunity to train in implementation science, which is an essential skill to translate research findings into adoption and implementation.” —Guneet Jasuja, PhD, MPH, investigator and epidemiologist, HSR&D’s Center for Healthcare Organization, and Implementation Research (CHOIR), and national meeting attendee
HSR&D gives special thanks to the National Meeting Planning Committee and this year’s host Centers of Innovation – the Center for Health Equity Research and Promotion (CHERP) in Philadelphia and Pittsburgh, PA; the Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP) in Los Angeles, CA; and the Charleston Health Equity and Rural Outreach Innovation Center (HEROIC) in Charleston, SC for all of their hard work in developing and carrying out such a highly successful meeting!