Principal Investigators: S. Nicole Hastings, MD (Corresponding PI, Durham VA), Courtney Van Houtven, PhD (Durham VA), Kelli Allen, PhD (Durham VA) and Virginia Wang, PhD (Durham VA)
Principal Operational Partners: VA Office of Geriatrics and Extended Care (GEC), VA Caregiver Support Program, Physical Medicine and Rehabilitation Services, Office of VA Voluntary Services, and the VA Mid-Atlantic Healthcare Network.
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The overall goals of the Optimizing Function and Independence QUERI (Function QUERI) are to:
Functional status (e.g., an individual's ability to perform normal daily activities, fulfill usual roles, and maintain health and well-being) is an essential determinant of quality of life. Health-related functional impairments often lead to disability, which is a significant driver of health care utilization and costs.
The Optimizing Function and Independence QUERI aims to:
MyVA Goals: Build a collaborative, inclusive and results-oriented culture that inspires trust in order to improve the employee experience.
Function QUERI will conduct three distinct but related projects aimed at implementing evidence-based programs across the continuum of care for Veterans at risk for functional decline and loss of independence. These clinical programs address three high-priority gaps in clinical care identified by their national partners in the National Offices of Geriatrics and Extended Care, Physical Medicine and Rehabilitation Services, and the VA Caregiver Support Program. A major reason for clinical care gaps in this population is poor communication and coordination among the many interdisciplinary providers involved in their care. Adopting new programs requires buy-in and cooperation among many different service lines, and a one-size fits all approach is rarely effective. Function QUERI will utilize implementation strategies focused on promoting flexibility of clinical programs to fit local environments (Replicating Effective Programs) and enhancing the performance of provider teams (CONNECT).
Project 1: Targets prevention of disability related to immobility during hospitalization through a supervised walking program (STRIDE).
Project 2 (Quality Improvement): Focuses on improving function in patients with symptomatic knee osteoarthritis through expanded access to physical therapy in a group-based model (Group PT for Knee Osteoarthritis).
Project 3: Promotes functional ability and avoiding nursing home placement through caregiver training at the time of referral for home care services (HI-FIVES).