QUERI – Quality Enhancement Research Initiative

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Partnered Evaluation of the Clinic Management Training Program/Center for Access Policy Evaluation and Research (CAPER)

Boston, MA

Overview

Access to care remains a top priority for the VA after concerns peaked in 2014 due to a widely publicized crisis in confidence regarding access to VA healthcare. In response, Congress passed the Veterans' Access Choice and Accountability Act (VACAA), which significantly reorganized the delivery of VA healthcare by allowing Veterans to go outside VA for healthcare, as well as implementing the clinic management training program. This program implements a team of clinicians, administrative leads, analysts, and schedulers to monitor and expand outpatient access. In collaboration with VA Clinical Operations, investigators in the Center for Access Policy, Evaluation and Research (CAPER) QUERI Partnered Evaluation Initiative will rigorously evaluate clinic operations. CAPER QUERI investigators will:

  • Evaluate the data tools used to measure access,
  • Assess clinic practice management policies,
  • Examine staffing capacity across clinic operations, and
  • Identify the impact of novel virtual health interventions focused on increasing access.

Objectives:

The Center for Access Policy, Evaluation and Research (CAPER) will achieve these goals through the following objectives:

  • Standardize and augment data tools and analytics to monitor access and identify gaps in analytical support
  • Examine the overall impact of clinic practice management on data metrics
  • Determine whether there is adequate capacity in staffing resources including scheduling, primary and specialty care
  • Evaluate whether novel virtual health interventions increase specialty care capacity

Methodology

In close collaboration with the operation partners, CAPER QUERI analyzes nationwide administrative data to validate access metrics such as wait times or access to telephone care. Variation over time and space in the implementation of key scheduling policies will be utilized to examine the impact of these policies on validated metrics. Finally, a randomized program evaluation of virtual health technology will assess the causal relationship between the implementation of mobile health solutions and access to care.

Operations Partner:

The Office of Veterans Access to Care, under the Deputy Under Secretary for Operations and Management, oversees key functions of clinical operations. These functions include improving outpatient clinic access, monitoring clinical consults, telephone contact and management, determining and implementing scheduling policies, and leading the acquisition of scheduling information technology. The Office of Connected Care expands access for Veterans beyond the traditional outpatient visit by developing virtual health technologies.

Principal Investigator: Julia Prentice, PhD; contact at Julia.Prentice@va.gov .