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Building Research-Clinical Partnerships from the Ground Up: Frontline Perspectives on VA
Klap RS, Hamilton A, Oishi S, Carney D, Yano EM, Frayne S, Frayne SM. Building Research-Clinical Partnerships from the Ground Up: Frontline Perspectives on VA
Research. Poster session presented at: VA HSR&D Enhancing Partnerships for Research and Care of Women Veterans Conference; 2014 Jul 30; Arlington, VA.
The VA Women's Practice-Based Research Network (PBRN) was funded to facilitate inclusion of women Veterans in VA research and to provide an infrastructure for supporting multi-site research involving women. The PBRN adopted a hybrid top-down/bottom- up model where frontline clinicians/staff provide input on key research and quality improvement (QI) ideas. We interviewed clinicians/staff at the four original PBRN sites to compare and contrast their priorities and interests in relation to the published Women's Health research agenda, to better understand how to structure and accelerate future research partnered with frontline clinicians/staff.
An outcome of the 2010 VA Women's Health Services Research Conference, the VA HSRandD Women's Health Research Agenda designated six Strategic Priority Areas (SPAs): Access to care/rural health; primary care/prevention; mental health; post-deployment health; complex chronic conditions/aging/long term care; and reproductive health. We conducted semi-structured interviews of 49 frontline clinicians and staff at the four original PBRN sites in 2011-12. Responses to the following question were summarized and categorized: "Have you noticed any specific problems (either patient care or operations) that you feel need to be addressed with research and/or quality improvement efforts?"
VA clinicians/staff were interested in supporting research and QI efforts, and while research interests varied, they mapped well to the VA Women's Health Research Agenda SPAs. Many providers mentioned research topics related to the delivery of evidence-based care across the SPAs and seemed to appreciate how research could inform day-to-day practice. Some respondents suggested topics outside the agenda, including inappropriate use of the emergency room instead of primary care and the long-term implications of service-connected disability status for treatment outcomes.
Overall, there was concordance between the published women's health research agenda and clinician/staff research and QI suggestions.
Areas for potential growth that do not fit within the specific frame of the current agenda include suggestions for greater emphasis on operational needs related to improved efficiency and value, as well as unintended consequences of some VA policies and practices. Provider and staff input into research topics could help to facilitate uptake of evidence-based care.