QUERI – Quality Enhancement Research Initiative

Go to the HSRD website

Designing for Dissemination and Implementation Training Hub

Denver, CO

Corresponding Principal Investigator: Cathy Battaglia, PhD, RN, (Catherine.Battaglia@va.gov ) is also Fellowship Director at HSR&D’s Center of Innovation for Veteran-Centered and Value-Driven Care in Denver, CO.


With the passing of recent legislation (i.e., Choice Act, MISSION Act), Veterans have more options for healthcare providers and systems. However, with these options comes the potential for treatment fragmentation, information loss, pharmacological duplication or drug interaction, and deterioration of patient experiences. Within the VA healthcare system, coordination of care between providers is a high priority, as many Veterans suffer from numerous comorbid conditions and seek treatment from multiple providers. In addition, there is enormous pressure to accelerate the translation of evidence-based findings into practice. To address these concerns, investigators with the Designing for Dissemination and Implementation (D4D&I) Training Hub will train VA practitioners, researchers, and operational leaders and staff to use a multifaceted implementation strategy to increase the impact, effectiveness, widespread adoption, and maintenance of evidence-based care coordination programs across clinical settings, patient populations, and throughout the continuum of care.


The D4D&I Training Hub will:

  • Train participants to use the four discrete methods of the D4D&I strategy.
  • Implement a virtual learning collaborative (VLC) to facilitate peer-to-peer learning by providing participants with a forum for sharing experiences.
  • Evaluate the D4D&I Training Hub strategy using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework. This evaluation will encompass participant learning and satisfaction with the training, professional growth with the VLC, cost of implementing the training hub, and downstream program outcomes and products.

More specifically, the D4D&I Training Hub will use evidence-based experiential and e-learning educational strategies for adult learning. Each training cohort will participate in a 24-week program. The use of an e-learning platform increases accessibility, scale, and spread across the VA. Participants will learn how to conduct implementation science-guided assessments, engage stakeholders, adapt their care coordination program based on data and feedback, and program evaluation.

Expected Impacts

The D4D&I implementation strategy targets the adoption, implementation, sustainment, and scale-up and spread of a program. It will increase the knowledge and skills of VA practitioners, researchers, and operational leaders/staff who are ready to disseminate and implement their evidence-based care coordination programs across the VA. The D4D&I Training Hub expects to train 50-60 participants – and that the spread and scale-up of the D4D&I training program across the VA will positively impact clinical performance and Veteran care.

Operations Partners: Diffusion of Excellence and Innovation Gold Status Fellows program, the Offices of Nursing Service (ONS), Rural Health (ORH), Community Care, Academic Affiliations, and various Field Advisory Committees.