QUERI – Quality Enhancement Research Initiative

Go to the HSRD website

Evidence-Based Quality Improvement Implementation Strategy Learning Network Hub

Los Angeles, CA

Principal Investigator: Alison Hamilton, PhD, MPH;  Alison.Hamilton@va.gov

Co-Principal Investigator: Elizabeth Yano, PhD, MSPH; elizabeth.yano@va.gov


The objective of the Evidence-Based Quality Improvement (EBQI) Implementation Strategy Learning Network Hub Site (“EBQI Hub”) is to equip stakeholders in various VA roles (policymakers, operations managers, frontline providers and staff, and researchers) with the training and resources needed to apply EBQI. In doing so, the EBQI Hub will support increased implementation, scale-up, spread, and sustainability of effective practices, with the goal of strengthening VA as a Learning Healthcare System.


Over the course of three years, the EBQI Hub team will provide virtual EBQI training nationally to at least 300 participants using:

  • Distance-learning technology, including four 90-minute live webinar modules;
  • an EBQI SharePoint site with both training materials and EBQI tools; and
  • a telephone and online-based help desk staffed by the expert Hub team.

The EBQI Hub also will provide guided mentorship to at least 12 trainees and/or teams, including Diffusion of Excellence Initiative Gold Status Fellows, who have applied for six months of mentorship for a clearly specified innovation. The Diffusion of Excellence Initiative was created to identify and disseminate innovative practices, as well as to standardize those that promote positive outcomes for all Veterans using the VA healthcare system.


As an implementation strategy, EBQI aims to improve implementation of evidence-based practices and programs in delivery systems by ensuring that QI initiatives benefit from the best scientific evidence, as well as from clinical operations leadership, data, and technical support. EBQI leverages scarce researcher resources by enabling a small research team to support improvement among much larger numbers of clinical QI partners. There are four key EBQI principles:

  • Research-clinical partnerships;
  • EBQI initiative design based on formal multilevel clinical partner consensus around implementation priorities;
  • Systematic interprofessional top-down (executive and middle management leaders) and bottom-up (frontline leaders and clinical staff) engagement; and
  • Use of feasible, research and practice data-informed QI measures.

Providing EBQI is directed at supporting learning healthcare system goals.

Anticipated Impacts:

Four VISN-level and national initiatives stand ready to utilize EBQI Hub resources. All eight healthcare systems within VISN 22 (Desert Pacific Healthcare Network, serving 1.5 million Veterans) have confirmed interest in EBQI Hub training, including at least 20 sites of care; additionally, 10 sites outside of VISN 22 have confirmed interest. Moreover, the EBQI Hub has the potential to change national practice and policy through:

  • Team-based, data-driven improvements in high-priority areas;
  • Employee engagement in systematic planning, processes, and tools that support the implementation of evidence-based practices and innovations;
  • Empowerment of employees toward a culture of quality improvement, enabling sustained capacity to arrive at innovative solutions to VA challenges; and
  • Supporting transformation to a Learning Healthcare System as a conduit to improved patient experience, care quality, and healthcare outcomes.

Operations partners: VISN 22 and VA Women’s Health Services.