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FORUM - Translating research into quality health care for Veterans


In This Issue

Director's Letter

Director's Letter
by Seth A. Eisen, M.D., M.Sc.

HSR&D is uniquely positioned to facilitate the implementation of evidence-based research into policy and clinical practice. This is the core of HSR&D's mission. Engagement of stakeholders (i.e., field and VA Central Office [VACO], operations and managers, patient care staff, and Veterans), as appropriate, early in the research process is key to the success of this mission....

Commentary

Research and Prevention of Health Care-Associated Infections
by Gary A. Roselle, M.D., VHA National Director, Infectious Diseases Program, VA Central Office and Chief, Medical Service, Cincinnati VA Medical Center

Health care-associated infections (HAIs) cause significant illness in the United States, with an estimated 1.7 million cases and 99,000 deaths in 2002. Traditionally, clinicians have assumed that some HAIs are inevitable. In recent years, two important factors have driven a change in attitude from "HAIs are inevitable" to "HAI prevention is imperative" ...

Response to Commentary

Crucial Opportunities for Addressing HAIs
by Bradley N. Doebbeling, M.D., M.Sc., Senior Investigator, VA HSR&D Center on Implementing Evidence-Based Practice, Indianapolis, Indiana

Hospitals that have tackled HAIs as an organizational change challenge—rather than continuing to delegate HAIs to the infection control program—are those that have seen dramatic reductions in MRSA and other HAIs and dramatic improvements in quality in other domains...

Research Highlights

Reducing MRSA Health Care-Associated Infections
by Rajiv Jain, M.D., Director, VHA MRSA Prevention Program, and Acting Chief Consultant for Medical-Surgical Services in the Office of Patient Care Services, and Martin E. Evans, M.D., Associate Director, VHA MRSA Prevention Program

Data from the VHA MRSA Prevention Initiative from inception of the program to the present are currently being analyzed. Preliminary results suggest significant changes in MRSA HAI rates in the ICU and non-ICU setting as well as significant decreases in MRSA transmission among patients during their hospital stay...


Tackling Hand-Hygiene Compliance: An Organizational Approach
by Carol VanDeusen Lukas, Ed.D., Center for Organization, Leadership and Management Research, VA Boston Healthcare System, Boston, Massachusetts, and Robert A. Petzel, M.D., VA Under Secretary for Health

In an effort to improve hand-hygiene compliance, the Center for Organization, Leadership and Management Research (COLMR) worked closely with VISN 23 on a recently completed, three-year intervention based on the premise that although hand hygiene is an individual act, achieving high rates of compliance requires interdependent organizational action....


Preventing Catheter-Associated Urinary Tract Infection in U.S.
by Sarah L. Krein, Ph.D., R.N., and Sanjay Saint, M.D., M.P.H., HSR&D Center for Clinical Management Research, Ann Arbor, Michigan

Improving patient safety and quality of care requires moving beyond simply disseminating scientific evidence. Nevertheless, identifying and implementing effective strategies to ensure the use of proven practices in real-world clinical settings remains challenging...


Creating Systems to Improve ICU Outcomes: Reducing Central Line-Associated Bloodstream Infections and Ventilator Pneumonia in VA ICUs
by Marta L. Render, M.D., Chief, VA Inpatient Evaluation Center, Cincinnati, Ohio, Rachael Hasselbeck, M.S.N., Director, Implementation, VA Inpatient Evaluation Center, Cincinnati, Ohio, and Peter Almenoff, M.D., Assistant Deputy Under Secretary for Quality and Safety, VA Office of Quality and Safety, Kansas City, Missouri

The VA Inpatient Evaluation Center (IPEC) provides infrastructure to improve outcomes in hospitalized Veterans. IPEC uses information technology to measure variation in outcomes and evidence-based practices, provides benchmarked feedback to both senior and middle-level managers, and creates learning tools for implementation...


Goldstein Receives 2010 Under Secretary's Award for Outstanding Achievement

For more than 18 years as a VA health services researcher, Dr. Goldstein has brought scientific distinction to the VA Palo Alto Healthcare System through her contributions to health services research, and has clearly exemplified the three major criteria for this award...


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