Working Group QUERI National Meeting 2008

1. Enhancing Clinical-Research Partnerships to Maximize the Benefits of Research in the Context of Urgent Policy Changes and System Needs Working Group QUERI National Meeting 2008

2. VA Leadership Perceptions of QUERI Role JL Smith, MJ Ritchie, RR Owen Mental Health QUERI Funding: VA HSR&D MNT 03-215 VA HSR&D MNH 98-000 VA HSR&D HFP 90-019

3. Background • New strategies or mechanisms are needed to enhance and optimize success of clinical-research partnerships • Efforts to optimize clinical-research partnerships may benefit from a better understanding of VA program leaders’ perspectives on the roles of QUERI Centers/investigators and QUERI program leaders in Central Office

4. Study Design • Purposive sample of 26 current or former VACO leaders and key staff that either: • Held leadership positions that could influence system adoption of collaborative care for depression, or • Had experience with large initiatives to implement new clinical programs in VA • Conducted semi-structured qualitative interviews with items asking about: • Partnerships between clinical leaders and researchers • Processes for integrating new clinical programs into VA structure • How to maintain support for such programs over time • Qualitative data analysis to identify key themes • Preliminary findings summarized here

5. QUERI Centers’ / Investigators’ Role • Implementation research • Develop/test strategies to implement EBPs that meet system needs • Evaluate research evidence to inform policy decisions, optimize use of system resources • Program evaluation • Evaluate new clinical programs • Partner with leadership to accomplish specific tasks • Provide assistance/consultation on CPG updates, performance measures • Collaborate on QI projects to address high priority gaps in clinical performance; be prepared to respond rapidly • Collaborate with leadership on strategic planning • Involve leadership in prioritizing QUERI topics; align QUERI research agenda with leadership priorities

6. QUERI Centers’ / Investigators’ Role(continued) • Disseminate QUERI findings / products • Inform leadership of findings that may inform policy • Keep leadership updated on “roll-out’ of evidence-based QUERI programs • Disseminate QUERI findings/products to clinical managers and clinicians • Disseminate findings in peer-reviewed journals, professional meetings • Develop relationships with VA leaders in offices with objectives relevant to QUERI research agenda • Develop and maintain communication channels • Involve VA leaders on QUERI planning committees to contribute info on system priorities, how QUERI can help • Include advances from the field in implementation research agenda; avoid singular focus on advances identified through QUERI research

7. QUERI Centers’ / Investigators’ Role(continued) • Advocate for system / policy change • Generate demand for QUERI innovations • Be “political” in trying to influence policy change to support implementation of QUERI innovations

8. QUERI Central Office’s Role • Act as liaison to assist QUERI investigators in establishing and maintaining relationships with VA offices and program leaders • Disseminate QUERI findings to VA leaders and clinical managers • Advocate for system and policy change • Facilitate career development for implementation researchers • Evaluate whether overall QUERI program is meeting its objectives

9. QUERI Research/Implementation Pipeline Clinical Research / Guideline Development Improved treatment and patient outcomes Implementation Research Mainstream Health Services Research Efficacy / Effectiveness Trials Phase 1 Pilot Projects Phase 2 Small-Scale Demonstrations Phase 3 Regional Demonstrations Phase 4 National Rollout