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November 2011

HSR&D Research Briefs is an electronic newsletter designed to disseminate news and information to the HSR&D investigator community. In this issue:


Investigator Spotlight

Martin Charns, D.B.A.Investigator Spotlight offers an HSR&D investigator an opportunity to share insights about their past and present work, and provide colleagues with a sense of their work's potential impact within VA. This issue's spotlight features Martin Charns, D.B.A., Director of HSR&D's Center for Organization, Leadership, and Management Research (COLMR). Dr. Charns is also Professor of Health Policy and Management and Director of the Program on Health Care Organization Studies at the Boston University School of Public Health.


What are you currently working on?

For the past decade or so, the emphasis of my work has been on organizational change and implementation of evidence-based practice. Two good examples of that work include the Robert Wood Johnson Foundation-funded evaluation of the Pursuing Perfection Program. In these studies we keep seeing that the organizational context has a major impact on implementation of evidence-based practice and quality improvement. Some of my efforts are now shifting from studying "implementation" to also examining "sustainability" and "spread" of change in greater detail.

Certainly, the results presented in our Organizational Transformational Model (OTM) have been significant, both in it having served as a conceptual framework for several additional studies, and in its current use in the evaluation of the VHA Office of System Redesign's Improvement Capability Grants, involving 25 VAMCs and 5 VISNs.

Finally, my ongoing role as COLMR director is to guide and support the staff as they conduct a variety of ongoing health services studies.

Of your current work, what do you think might have the most impact on Veterans and VA healthcare?

I would hope that some of the foundational work surrounding coordination of care has had significant impact—particularly our initial collaboration with the developers of the VA National Surgical Risk model to validate the model. Part of that research collected data on coordination among surgeons, anesthesiologists, and nurses. The published results reported on the relationship between coordination and risk-adjusted surgical outcomes, and certainly, that study remains as the largest empirical study of coordination, not only in health care, but also in organizations in general.

In addition, one of COLMR's ongoing efforts is collaborating with the National Center for Organization Development for the administration of VA's all employee survey, which is conducted annually throughout VA and provides data for organizational improvement and for research.

What drew you to health services research?

I studied my first hospital while a doctoral student at Harvard Business School. I remember my initial impression was that hospitals couldn't be organized as they were traditionally organized, because it was the least effective way to facilitate the delivery of quality care. I was intrigued by the discrepancy between organizational theory and practice, and chose to focus my career on research on health care organization. In the 1970s, I suppose I was actually a health services researcher before the field was formally recognized.

Have you learned something from a study, project, or research investment that provided an unexpected result, and that you feel is valuable to share with your HS&RD colleagues?

In studying service lines in VA, we found that the processes of organizational change had much more impact on outcomes than we anticipated. In fact, the most interesting finding was that the VAMCs that were characterized by politics or other factors blocking implementation were the lowest performers in the whole study. In addition to those findings, one thing I learned was that it was not effective to attempt to study organizational phenomena with a study design that was insufficient to capture the complexity of interactions of structures and processes.

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News, Notices, & Recent Dissemination

Research News

Collaborative Research to Enhance Transformation and Excellence (CREATE) and Centers of Innovation (COIN) Updates

  • Of the 17 concept papers reviewed, 8 were approved to submit full proposals, which are due in December. CREATE proposals will have a two-staged review. First, on a separate day of the March Scientific Merit Review Board (SMRB), projects within each CREATE will be reviewed and scored as individual projects. The second stage will be a review of the entire CREATE, which is being planned for early April. The target for this first round is to fund four to six CREATEs. A second round of CREATE concept paper submissions will be due February 1, 2012.
  • The Centers of Innovation (COIN) RFA is near completion and is expected to be released later this Fall. It is expected that the deadline for COIN submissions will be between October 1 and November 1, 2012.

Have questions or want to learn more About CREATEs?

Mark your calendars! HSR&D Director Seth Eisen and Acting Deputy Director David Atkins will describe CREATEs and answer questions via two Cyberseminars, each targeted to a different audience. Seminar registration information will be emailed to all in early November.

  • For investigators—a Cyberseminar is planned for Tuesday Nov 22nd at 12:00PM to 1:00PM (ET).
  • For partners or potential partners—a Cyberseminar is planned for Monday, Nov 28th at 12:00PM to 1:00PM (ET).
  • If you have a specific question you would like addressed in the Cyberseminar, please email ahead of time to: Cyberseminar@va.gov.
  • Other Cyberseminars addressing CREATEs will be developed as needed.

HSR&D Spreading the Word About CREATEs

HSR&D leadership continues to help inform potential partners about CREATEs and the shift to partnered research. For example, HSR&D leadership made a presentation about the CREATE concept during a retreat for senior managers of the Office of the Deputy Under Secretary for Health for Policy and Services.

Other planning for educating partners and HSR&D investigators is underway, and will include: an Intranet-based website that will house CREATE FAQs, blog entries, and other tools to assist researchers and their operational partners.

Evaluation Center Proposal Reviews

The Office of Specialty Care Transformation (OSCT) and VA/HSR&D's Quality Enhancement Research Initiative (QUERI) have approved five research teams to develop proposals for Evaluation Centers. The Centers will review and assess specialty care transformation initiatives in areas such as prosthetics, vision, spinal cord injury, and women's health. Proposal reviews took place on October 14. The intent will be to fund at least two centers for two years by the beginning of November. Centers will be co-funded by OSCT and QUERI.

VA Informatics and Computing Infrastructure (VINCI) Workspace Now Open

VINCI—the VA's initiative to improve researchers' access to VA data and to facilitate the analysis of that data while ensuring Veterans' privacy and data security—is proud to announce the public launch of the VINCI Workspace. In case you missed the three live Cyberseminars describing the tools and data available through VINCI, they are now available in the Cyberseminars archive online.

Recent Dissemination

VA HSR&D FORUM Available Online

The August and November 2011 issues of FORUM are now available online. The August issue is devoted to the topic of System Transformation and features a commentary article by USH, Dr. Petzel. The November issue addresses models of care, and features a commentary by Dr. Tuchschmidt, of VHA's Office of Health Care Transformation. Each issue features a research response to the commentary article, and three research highlight articles by your HRS&D colleagues.

QUERI/VIReC Case Study about HIT Now Available Online

In 2008, VA/HSR&D's Quality Enhancement Research Initiative (QUERI) asked HSR&D's VA Information Resource Center (VIReC) to conduct an evaluation of the role of health information technology in QUERI-supported implementation. That report, "Health Information Technology Approaches in QUERI Implementation Research: A Case Study," is now available online.

Improving Access to VA Care State of the Art Conference Papers Now Available

Papers associated with the state of the art (SOTA) conference, "Improving Access to VA Care", are now published as an e-publication ahead of print in the Journal of General Internal Medicine. The print version of the supplement will be released in November. (JGIM, Volume 26, Supplement 2. November 2011)

New ESP Reports Published

The VA Evidence-based Synthesis Program (ESP) was established to provide timely and accurate syntheses of targeted healthcare topics of particular importance to clinicians, managers, and policymakers as they work to improve the health and healthcare of Veterans. Eight new reports are now available online:

Administrative Notices

Conference Updates

  • HSR&D/QUERI Combined National Conference: Pending final approval, the 2012 HSR&D/QUERI National Conference will take place in February 2012. The conference will combine meetings for HSR&D, QUERI, and the Career Development Award program, and will be co-hosted by QUERI and the HSR&D Center for Health Services Research in Primary Care in Durham, NC. The conference theme is "Transforming Veteran Healthcare through Partner-Oriented Research." Currently, 642 abstracts and 37 workshops are under review. For more information, please visit the 2012 National Conference website.

  • The University of Iowa Hospitals and Clinics are sponsoring the 19th National Evidence-based Practice Conference from May 3-4, 2012. The conference is designed to address evidence-based practices as they relate to redesigning health care, nursing leadership for change, new models of care, and the future of nursing. More information about the conference, along with deadlines for abstract submissions, can be found here.

Scientific Merit Review Board

VA/HSR&D's Scientific Merit Review Board met in Seattle, WA, August 30-31, 2011, during which time seven HSR groups reviewed 100 proposals from the Investigator Initiated Research (IIR), Nursing Research Initiative (NRI), and Research Best Practices programs. Scores were released to principal investigators (PIs) on September 7, and key points and summary statements were released in late September. The "Notification of Review Outcome" letters—formerly known as Funding Decision Notifications—released via the HSR&D ART system in early October.

The Intent to Submit (ITS) form at HSR&D's ART Website winter 2012 Merit Award program closed on Tuesday, November 1, 2011. Proposals that have not completed the ITS will not be reviewed.

HSR&D has posted nine Request for Applications (RFAs) for the December 15 eRA verification deadline. The RFAs have been posted and are accessible via the VA Intranet at http://vaww.research.va.gov/funding/rfa.cfm. Please note that the Pilot Project Program continues to be suspended for this merit review cycle.

Updates to HSR&D Website

Recent updates in navigation have been made to the About, Centers, and Meetings pages on the VA/HSR&D website. The topics most commonly sought by the investigator community are now more prominent and easier to find. To access these new pages from the HSR&D homepage, click on the links located in the menu bar on the left side of the page. We welcome your feedback on any part of the HSR&D website. Please send comments to: HSRDWeb.Boston@va.gov.

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Awards & Honors

HSR&D investigators conduct groundbreaking research, much of it recognized nationally and/or internationally. Learn more about your colleagues who've been honored for their research and professional efforts:

  • B. Price Kerfoot M.D, was arecipient of the Presidential Early Career Award for Scientists and Engineers.

  • James Tulsky, M.D., was appointed to the Advisory Council of the National Institute of Nursing Research.

  • Kathryn Magruder, Ph.D., M.P.H., has been awarded a Fulbright scholarship and will study PTSD in civilians in Ankara, Turkey.

If you or your Center has been nationally recognized or honored, please send the information to: HSRDWeb.Boston@va.gov.

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Search Publications and Citations

Looking for published research? The search tools for articles, presentations, citations, and HSR&D internal publications include the following:

  • For citations from journals, meetings, conferences, and reports that were credited to HSR&D researchers, use the HSR&D citations search feature.

  • For HSR&D-produced publications and evidence synthesis reports, use the HSR&D publications search feature.

Publication Notification

Please let us know as soon as you have an article accepted for publication. This applies to all publications based on an HSR&D-funded, or HSR&D-managed project, or authored/coauthored by an HSR&D-supported investigator, regardless of funding source. To submit your notification, please use the VA Intranet-based PubTracker system. Instructions for accessing PubTracker are available on the Publication Notification Requirement page of the For Researchers section on the HSR&D website.

Newly Funded HSR&D Studies and QUERI Projects

Find links to studies for which funding began within the last three months.

Feedback

If you have feedback about Research Briefs, or suggestions for topics of interest about which you'd like to read, please send an email to: HSRDWeb.Boston@va.gov

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