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VA Leadership Perceptions of Quality Enhancement Research Initiative (QUERI) Role in Disseminating Evidence-Based Practices

Smith JL, Ritchie M, Owen RR. VA Leadership Perceptions of Quality Enhancement Research Initiative (QUERI) Role in Disseminating Evidence-Based Practices. Paper presented at: AcademyHealth Annual Research Meeting; 2008 Jun 8; Washington, DC.


Research Objective: The VA Quality Enhancement Research Initiative (QUERI) was developed to speed implementation of research findings into clinical practice for high-risk, high-burden diseases. Over the past 9 years, QUERI has increased its emphasis on developing enduring partnerships between clinical leaders and researchers to identify and implement evidence-based interventions that address high priority system needs. As part of a project to spread evidence-based collaborative care for depression regionally to new VA networks/facilities, the research team interviewed organizational leaders to examine their perspectives about roles for QUERI in transitioning clinical innovations from research into routine clinical practice. Study Design: Qualitative - Semi-structured qualitative interviews were conducted with a purposive sample of current or former VA Central Office leaders and key staff. The interview protocol included questions asking about partnerships between clinical leaders and researchers, processes for integrating new clinical programs into the VA structure, and how to maintain support for such programs over time. Verbatim transcripts were entered into Atlas.ti software to facilitate content analysis for identification of core themes and representative quotes. Population Studied: Purposive sample of 26 current or former VA Central Office leaders and key staff who either (a) could influence adoption/implementation of collaborative care for depression in the VA system, or (b) had experience with similar initiatives to implement new clinical programs in the VA. Principal Findings: Informants suggested that QUERI investigators: develop relationships and communication channels with VA leaders for information-sharing, collaborate with VA organizations to accomplish specific tasks/goals for quality improvement, offer content expertise and technical/consultative services on implementation, and market QUERI and QUERI products to VA leaders to increase awareness and stimulate demand for QUERI innovations. For QUERI leaders in VA Central Office, informants suggested they support QUERI investigators by assisting them in establishing and maintaining connections with VA clinical leaders, facilitate career development for implementation researchers, and self-evaluate whether the QUERI program is meeting its overarching goals. Conclusions: VA leaders have distinct perceptions regarding the role of QUERI in disseminating and implementing clinical innovations across the system. QUERI investigators should consider these perceptions in establishing partnerships with clinical leaders for such dissemination efforts. Implications for Policy, Delivery or Practice: Study results may benefit QUERI investigators and other implementation researchers in improving and evaluating strategic partnerships with organizational leaders in efforts to implement evidence-based practices. Findings may also help inform strategic and policy planning for the overall VA QUERI program. Primary Funding Source: VA HSRandD

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