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. 2017 Jul;55 Suppl 7 Suppl 1(7 Suppl 1):S4-S12.
doi: 10.1097/MLR.0000000000000683.

Accelerating Research Impact in a Learning Health Care System: VA's Quality Enhancement Research Initiative in the Choice Act Era

Amy M Kilbourne  1 , A Rani Elwy, Anne E Sales, David Atkins
Affiliations

Accelerating Research Impact in a Learning Health Care System: VA's Quality Enhancement Research Initiative in the Choice Act Era

Amy M Kilbourne et al. Med Care. 2017 Jul.

Erratum in

Abstract

Background: Since 1998, the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI) has supported more rapid implementation of research into clinical practice.

Objectives: With the passage of the Veterans Access, Choice and Accountability Act of 2014 (Choice Act), QUERI further evolved to support VHA's transformation into a Learning Health Care System by aligning science with clinical priority goals based on a strategic planning process and alignment of funding priorities with updated VHA priority goals in response to the Choice Act.

Design: QUERI updated its strategic goals in response to independent assessments mandated by the Choice Act that recommended VHA reduce variation in care by providing a clear path to implement best practices. Specifically, QUERI updated its application process to ensure its centers (Programs) focus on cross-cutting VHA priorities and specify roadmaps for implementation of research-informed practices across different settings. QUERI also increased funding for scientific evaluations of the Choice Act and other policies in response to Commission on Care recommendations.

Results: QUERI's national network of Programs deploys effective practices using implementation strategies across different settings. QUERI Choice Act evaluations informed the law's further implementation, setting the stage for additional rigorous national evaluations of other VHA programs and policies including community provider networks.

Conclusions: Grounded in implementation science and evidence-based policy, QUERI serves as an example of how to operationalize core components of a Learning Health Care System, notably through rigorous evaluation and scientific testing of implementation strategies to ultimately reduce variation in quality and improve overall population health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
QUERI national strategic goals: accelerating research impact in a Learning Health Care System. QUERI indicates Quality Enhancement Research Initiative; VHA, Veterans Health Administration.
FIGURE 2
FIGURE 2
QUERI program: general architecture. QUERI indicates Quality Enhancement Research Initiative; QI, Quality Improvement; VHA, Veterans Health Administration.
See this image and copyright information in PMC

References

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    1. Veterans Access, Choice and Accountability Act of 2014 (“Choice Act” US Public Law 113–146). 2014. Available at: https://www.congress.gov/113/plaws/publ146/PLAW-113publ146.pdf. Accessed December 7, 2016.

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