QUERI – Quality Enhancement Research Initiative

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QUERI Impacts

By developing state-of-the-art methods that align organizational priorities with frontline staff engagement, QUERI drives adoption of effective practices that achieve improved outcomes within a sustainable cost, supporting VA’s transformation to a Learning Health System and High-Reliability Organization. Thus far, QUERI impacts include:

QUERI Impacts

Here are a few examples of the many ways in which QUERI impacts the health and care of Veterans:

  • Providers in VISNs 7, 16, 20, and 23 are deploying Telemedicine Outreach for PTSD – a program based on research conducted in VA that demonstrated the effectiveness of virtual team-based care for Veterans with PTSD who reside in rural settings. [Fortney et al., 2015]
  • Providers at VA medical centers in Colorado, Arkansas, and Tennessee are implementing the Primary-Care Integrated Pain Support (PIPS) to decrease risky opioid regimens and increase engagement with non-pharmacological treatments. This model is based on QUERI research that demonstrated the effectiveness of these collaborative, stepped-care models for pain where a non-physician works with a physician to deliver focused pain treatment depending on the patient’s needs, resulting in higher-quality pain care. [Kroenke et al., 2014]
  • VA has integrated more than 1,100 mental health Peer Specialists—Veterans with mental illness who are trained to use their experience to help other Veterans with mental illness—into VA clinical teams. This Peer Specialist model has been found to increase patient activation [Chinman et al., 2015] and are valued by Veteran patients and VA providers. [Hamilton et al., 2015]
  • VA Greater Los Angeles Healthcare System (GLA) Emergency Department (ED) providers are using the ED-Patient-Aligned Care Team (ED-PACT) Tool to communicate Veterans’ urgent or specific post-ED follow-up care needs to primary care teams, improving patient safety, efficiency and Veteran experience of care. To date, the ED-PACT Tool has been used to send more than 5,500 messages regarding Veterans’ care needs from GLA’s ED to primary care teams in 20 clinics. [Rubenstein et al., 2014]
  • The PREVENT Quality Improvement program implemented at the Nashville, Chicago, Salem, Orlando, and Palo Alto VAs improved outcomes related to trans-ischemic attacks (TIA) recurrence/mortality among Veterans and received national endorsement from ER/Neurology program offices. Link: http://vhaindwebsim.v11.med.va.gov/hub2/prevent/
  • STRIDE is a supervised walking program for hospitalized older adults designed to address the important clinical problem of immobility during hospitalization and its negative consequences, including hospital-associated disability. STRIDE has been implemented in eight VAMCs across the country. The Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), in Durham, NC, will study the roll-out of STRIDE at these sites, specifically examining the implementation process and patient functional outcomes. [Wang et al., 2018]