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QUERI Program Description
What is QUERI?
In 1998, VA’s Health Services Research and Development Service launched the VA Quality Enhancement Research Initiative (QUERI). The QUERI mission is to enhance the quality and outcomes of VA health care by systematically implementing clinical research findings and evidence-based recommendations into routine clinical practice. In evaluating quality of care, the QUERI process focuses on three elements:
- structure (provider and organizational characteristics),
- process (providers’ clinical actions toward patients), and
- outcome (health status, economic impact, satisfaction).
QUERI is founded on the principle that practice needs determine the research agenda, and research results determine interventions that improve the quality of patient care.
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Specific Aims for QUERI:
Crosscutting issues that pertain to all of the conditions QUERI focuses on are included in its specific aims.
- Integrate research, clinical, operational, and policy expertise to improve health care policy.
- Target high priority disease or health delivery issues.
- Evaluate interventions and provide feedback to encourage best practices.
- Develop risk-adjusted quality improvement activities for comparison with public/private health care systems.
- Identify gaps in knowledge and create new data to inform policy decisions.
The collaborative structure and systematic approach inherent in the QUERI process encourage continuous quality improvements in all areas of health care.
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What is the QUERI Process?
QUERI is a comprehensive, data-driven, outcomes-based, quality improvement program that utilizes a six-step process to facilitate the implementation of research findings and evidence-based clinical practices to achieve better health care outcomes for veterans. QUERI integrates and disseminates this information on a continuous basis. Particular emphasis is given to the documentation of best practices, implementation strategies, and dissemination.
Steps in the QUERI process are:
- Identify high-risk/high volume diseases or problems;
- Identify best practices;
- Define existing practice patterns and outcomes across VA and current variation from best practices;
- Identify and implement interventions to promote best practices;
- Document that best practices improve outcomes; and
- Document that outcomes are associated with improved health-related quality of life.
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QUERI Organization and Review Procedures
QUERI is led by Joseph Francis, MD, MPH, Associate Director, HSRD for QUERI. Participants in the initiative include researchers, clinicians, and managers, with strong collaboration among several offices in VA Central Office and field operations. For example, close cooperation with the Office of Quality and Performance, Patient Care Services, and the Office of Information is essential.
QUERI's National Advisory Council annually reviews QUERI’s progress and recommends changes, as necessary, to ensure the integration of QUERI with other VA initiatives. The Council is chaired by the Under Secretary for Health and is comprised of senior VA Central Office and Network leaders.
The QUERI Research and Methodology Committee (R&M) reviews all strategic plans and is responsible for prioritizing and approving requests for research solicitations. The R&M Committee includes nationally prominent researchers, network representatives, and VHA Central Office clinical program leaders.
In addition, a QUERI Executive Committee was established for each QUERI condition. These Committees develop the strategic plans that address current issues in the health care system that are related to their specific condition.
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QUERI Research and Clinical Co-Chairs
Chronic Heart Failure
Paul Heidenreich, MD, Research Coordinator
Palo Alto, CA
tel: (650) 493-5000 x64069
e-mail: paul.heidenreich@va.gov
Barry Massie, MD, Clinical Coordinator
San Francisco, CA
tel: (415) 221-4810 x2691
e-mail:Barry.Massie@va.gov
Diabetes
Eve Kerr, MD, MPH, Research Coordinator
tel: (734) 761-2422
e-mail: ekerr@umich.edu
Leonard Pogach, MD, Clinical Coordinator
tel: (973)676-1000 ext 1693
e-mail: leonard.pogach@va.gov
David Aron, MD, MS Co-Clinical Coordinator
tel: (216) 421-3098
e-mail: David.Aron@va.gov
HIV/Hepatitis
Allen Gifford, MD, co-Research Coordinator
tel: (858) 552-8585 ext 7674
e-mail: agifford@ucsd.edu or allen.gifford@va.gov
Steven Asch, MD, MPH, co-Research Coordinator
tel: (310) 478-3711 ext 41425
e-mail: sasch@rand.org or steven.asch@va.gov
Matthew Goetz, MD, Clinical Coordinator
tel: (310) 268-3015
e-mail: matthew.goetz@va.gov
Ischemic Heart Disease
Stephan (Steve) Fihn, MD, MPH, Research Coordinator
tel: (206) 764-2651
e-mail: Stephan.Fihn@va.gov
John Rumsfeld, MD, PhD, Clinical Coordinator
tel: (303) 370-7575
e-mail: john.rumsfeld@va.gov
Mental Health
Richard Owen, MD, Research Coordinator
tel: (501) 257-1710
e-mail: owenrichardr@uams.edu or richard.owen2@va.gov
Stephen Marder, MD, Clinical Coordinator
tel: (310) 268-4359 or 3647
e-mail: stephen.marder@va.gov or marder@ucla.edu
Lisa V. Rubenstein, PhD, co-Clinical Coordinator
tel:(818) 895-9449
e-mail: lisar@rand.org
Polytrauma and Blast-Related Injuries
Nina Sayer, PhD, Research Coordinator
Minneapolis, MN
tel:(612) 467-4623
e-mail:Nina.Sayer@va.gov
Barbara Sigford, MD, PhD, Clinical Co-Coordinator
Minneapolis, MN
tel:(612) 467-2044
e-mail:Barbara.Sigford@va.gov
Steven G. Scott, DO, Clinical Co-Coordinator
Tampa, FL
tel:(813) 972-7506
e-mail:Steven.Scott@va.gov
Spinal Cord Injury
Frances Weaver, PhD, Research Coordinator
tel: (708) 202-2414 or 5866
e-mail: frances.weaver@va.gov
Barry Goldstein, MD, co-Clinical Coordinator
tel: (206) 768-5401 or (206) 764-2061
e-mail: barry.goldstein@va.gov
Margaret Hammond, MD, co-Clinical Coordinator
tel: (206) 764-2332 or (206) 768-5401
e-mail: margaret.hammond@va.gov
Stroke
Linda Williams, MD, Research Coordinator
Indianapolis, IN
tel: (317) 554-0000 x2887
e-mail: linwilli@iupui.edu
Dawn Bravata, MD, Clinical Coordinator
West Haven, CT
tel: (203) 932-5711 x2346
e-mail: dawn.bravata@va.gov
Substance Use Disorders
Thomas R. Kosten, MD, Research Coordinator
tel: (713) 794-7032
e-mail: Kosten@bcm.tmc.edu or
Thomas.kosten@va.gov
Daniel Kivlahan, PhD, Clinical Coordinator
tel: (206) 768-5483
e-mail: daniel.kivlahan@va.gov
Katharine Bradley, MD, MPH, co-Clinical Coordinator
tel: (206) 764-2082
e-mail: katharine.bradley@va.gov
Several QUERI studies have already produced significant findings that will improve patient care. To read more about these studies, please see the individual QUERI group web sites.
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