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Quality Enhancement Research Initiative

QUERI E-news
Winter 2023

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QUERI’s Unique Approach for Implementing VHA Priorities at the Frontline Level

Since 2019, QUERI has been a national leader in leveraging evidence to inform national programs and policies that affect Veteran health and ensure these programs work at the clinic level. Specifically, QUERI supports VA’s fulfillment of the Foundations for Evidence-based Policymaking Act (Evidence Act), which requires that U.S. Cabinet-level agencies use evidence and evaluation to justify their budgets and shape policies. QUERI funding opportunities provide support for VA investigators to work as equal partners with frontline providers, clinical managers, and health care leaders to scale-up, spread, and sustain effective practices across VA. QUERI funds more than 35 national evaluations, of which at least seven are featured in the FY23 VA Annual Evaluation Plan .

Systematic process to ensure QUERI funding addresses VA priorities and impacts Veteran health
Systematic process to ensure QUERI funding addresses 
VA priorities and impacts Veteran health

Through a national survey and qualitative discussions with multilevel leaders across VA, QUERI identifies emerging priorities and funds teams with the highest quality applications to address these priorities. For FY23, nine priorities were identified through this QUERI process. As shown in the table below, these priorities are highly aligned with current VHA goals.

FY23, nine priorities were identified through this QUERI process

Working closely with VHA leaders, QUERI has also resourced new teams across the country to help with the implementation and evaluation of VA priorities, including six cross-cutting national evaluations and rapid-response activities.

QUERI’s response to VHA national priorities includes Rapid Response Teams, which are teams supported through the QUERI Programs to implement and evaluate time-sensitive programs or policies to ensure they work at the frontline clinic level for Veterans.

QUERI Rapid Response Teams

QUERI addresses emerging VA priorities in a rapid manner through QUERI Program Rapid Response Teams (RRTs), which are interdisciplinary teams (e.g., implementation experts, data scientists, evaluators) that collaborate with VA clinical and policy partners to address a key implementation, evaluation, or training need. For example, when the COVID-19 pandemic brought an urgent need to develop and implement plans to vaccinate Veterans and employees against COVID-19, QUERI connected three RRTs – Bridge QUERI, Function QUERI, CARRIAGE QUERI – with VA’s National Center for Health Promotion and Disease Prevention (NCP) to inform the national rollout of COVID-19 vaccines. These three teams used both quantitative and qualitative methods to examine Veterans’ and VA employees’ views on COVID-19 vaccines, as well as their perceptions of VA initiatives to vaccinate Veterans and employees.

Based on findings from their evaluation, NCP and Bridge QUERI worked together to create a "3-Step Plan for Reaching COVID-19 Vaccine Acceptance." This plan was selected by the VHA Innovation Ecosystem as a Best Vaccine Practice to increase COVID-19 vaccine acceptance in VA and was shared widely with VISN and national VA leaders. Furthermore, this RRT has led to a broader collaboration to support NCP’s efforts on the White House Pandemic Innovation Task Force. At NCP’s request, Rani Elwy, PhD, who co-leads Bridge QUERI and its RRT, is serving as a member of the “Building Trust and Designing for Health Behavior Workgroup,” which reports to the White House Pandemic Innovation Task Force. Building on their prior work – and working with the Centers for Disease Control and Prevention and the Office of the Surgeon General, as well as key members of the Building Trust Workgroup – the Bridge QUERI RRT is helping to develop plans to build rapid response mechanisms into future pandemic efforts. They are also contributing to the development of optimal communication strategies to prepare for any future public health emergencies.

Bridge QUERI RRT has been instrumental in building awareness of the complexities of vaccine confidence and hesitance. —Michael Goldstein, MDAssociate Chief Consultant for Preventive Medicine, NCP

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