QUERI – Quality Enhancement Research Initiative

Optimizing Function and Independence QUERI

Durham, NC

View program fact sheet

Functional status – or a person’s ability to perform normal daily activities, fulfill usual roles, and maintain health and wellbeing – is an essential determinant of quality of life. Health-related functional impairments often lead to disability, which is a significant driver of healthcare use and costs. Currently, 12.4 million Veterans are age 65 or older, the age group at highest risk for developing a disability. Function QUERI was designed to improve Veteran function and independence by promoting the rapid translation of research findings into practice through implementation strategies that promote flexibility of clinical programs – and that enhance the performance of healthcare teams. Addressing high-priority gaps in clinical care identified by national partners, specific aims of Function QUERI include:

• Implementing and evaluating three distinct but related clinical programs:
• Adapting an innovative, team-based implementation intervention (CONNECT) to promote team readiness for use in a diverse mix of clinical settings and VA medical centers, and evaluating its impact across projects; and

Developing a Team Building and Readiness Toolkit for VA clinical programs to distill and disseminate findings from Function QUERI implementation activities.

Expected Impacts

Patient and Service-Level Outcomes

• STRIDE STRIDE—a supervised, inpatient walking program — is expected to decrease the length of hospital stays as well as decrease discharges to nursing homes, and to improve physical function and quality of life for Veterans.
• iHI-FIVES—a caregiver skills training program—is expected to increase days in the community, improve satisfaction with VA healthcare, decrease caregiver burden, and decrease caregiver depressive symptoms.

And Group Physical Therapy is expected to improve knee physical function, and increase satisfaction with group-based physical therapy.

Tools and Toolkits

Function QUERI will produce a Team Building and Readiness Toolkit for multidisciplinary teams to implement clinical programs using REP and CONNECT strategies.

Principal Investigators: Courtney Van Houtven, PhD, Kelli Allen, PhD, and Virginia Wang, PhD.

Operations Partners: VA Office of Geriatrics and Extended Care; VA Caregiver Support Program, VA Physical Medicine and Rehabilitation Services, Office of VA Voluntary Services, VA Mid-Atlantic Healthcare Network (VISN 6)