QUERI – Quality Enhancement Research Initiative

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Action-Oriented Evaluation of Inter-Professional Learning Efforts in the CoEPCE and IAPACT Environments

Portland, OR

Overview:

As team-based care becomes a cornerstone of emerging norms in primary care delivery, health care professionals from diverse fields need clinical training that prepares them to work in collaborative, interdisciplinary teams. To that end, VA supports the development of innovative tools for workplace-based learning in Inter-professional Education and Collaborative Practice (ICECP). This initiative's overarching goal is to collaborate with VA's Centers of Excellence in Primary Care Education (CoEPCE) and the CoEPCE Coordinating Center in a comprehensive evaluation of IPEC innovations and their dissemination, implementation, and sustainment in Inter-Professional Academic Patient Aligned Care Team (IA-PACT) settings within the VA healthcare system. This Initiative will work to evaluate the dissemination, implementation, and adoption of inter-professional educational training within VA primary care clinics that also provide ongoing training of health professionals.

Objectives:

The goal of the evaluation is to provide rapid insights into the characteristics of tools and configurations of clinic dynamics that best promote sustained and widespread use of effective learning techniques. Investigators also will examine the effectiveness of developed strategies and tools for promoting core values of inter-professional education, as well as budget and quality impacts associated with their use in the IA-PACT setting. The evaluation will advance knowledge on strategies for implementation and sustainability of effective education innovations in the primary care context. Specific aims include:

  • Refine and implement a collaborative realist evaluation plan, with a focus on four distinct but inter-related fields of enquiry—
    • Understand the mechanisms that drive the delivery of core IPECP content;
    • Assess quality and costs outcomes associated with product use;
    • Examine dissemination by CoEPCEs, and implementation of products by IAPACTS and other users; and
    • Evaluate interactions between IPECP innovations and different outcomes of interest.
  • Guided by action evaluation principles, identify the factors associated with success in either quality impacts or implementation/dissemination/sustainment, and share these findings with stakeholders to facilitate IA-PACT practice transformation.
  • Provide ongoing technical advice to the CoEPCEs, as needed, to develop appropriate plans for independent, site-specific evaluation projects.

Methodology:

This Initiative will be guided by an action-oriented, realist evaluation approach that will build in mechanisms for formatively reporting findings back to the Centers and the Coordinating Center, in order to maximize the impact of findings on ongoing implementation efforts. The evaluation process will be a mixed-methods study, using qualitative data collected through site visits, surveys, and interviews with participants in the Centers of Excellence and IA-PACT teams. Investigators also will utilize data on costs and quality measures associated with the adoption of enhanced inter-professional learning tools and strategies. The first phase will focus on a comprehensive strategy to evaluate the success of the dissemination, implementation, and adoption of tools and strategies developed by the Centers for use more broadly in the IA-PACT setting. The second phase of the Initiative will focus on the collection and analysis of data from each of the participating Centers.

Operations Partner:

VA's Office of Academic Affiliations (OAA) fulfills one of the four statutory missions of the VA—"to educate for VA and for the Nation." Partnerships with U.S. academic institutions allow the VA to spread knowledge that enhances healthcare for Veterans, in addition to constantly adapting curricula as the American healthcare system evolves. The OAA has assisted in the education of hundreds of thousands of clinicians and strives to collaborate with academic institutions to create environments that enhance the health and care of Veterans.

Principal Investigator: Anais Tuepker, PhD, MPH; contact at Anais.Tuepker@va.gov .