COIN: Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP); Los Angeles, CA
Director: Elizabeth Yano, PhD, MSPH
About the COIN
CSHIIP’s mission is to develop and test innovations that markedly improve the effectiveness and value of VA health care, from system, provider, and Veteran perspectives, while advancing scientific methods for accelerating adoption, implementation, spread, and scale-up of evidence-based practice. Research projects conducted address a core set of strategic program areas including: primary care, women's health, and high-risk/high-need Veterans.
Research Focus Areas
The Center’s work focuses on the following:
- Primary Care
- Women Veterans’ Health
- High-Risk/High-Need Veterans
- Emerging Areas: complementary and integrative health/whole health, specialty care, and emergency management/disaster preparedness
Research to Impact for VeteRans (RIVRs)
The Research to Impact for VeteRans (RIVRs) program is a new HSR&D funding mechanism that gives researchers the opportunity to pursue a five-year impact goal. Each RIVR impact goal aligns with VA priority areas including VA legislative priorities (e.g., MISSION Act); cross-cutting ORD priorities (e.g. PTSD); other HSR&D defined clinical priorities (e.g. Health Equity); and HSR&D methodological priorities (e.g. Data Sciences, Implementation Sciences, Systems Engineering). Impact goals for RIVRS could include changes in VA policy or clinical guidelines, spread of operational processes across VISNs, scaling of an effective intervention to 2-3 additional sites, advancements in health services research methods, or any other impacts that have real-world effects on Veteran health and satisfaction.
Current RIVR project
Enhancing Tools and Resources to Improve Coordination of VA Primary Care
Principal Investigator: David Ganz, MD, PhD
The goal of this project is to foster improved coordination of care within VISN 22 VA primary care teams, between VA primary care teams and Veteran patients, and between VA primary care and other settings (e.g., specialty care, emergency department, hospital, nursing home or care in the community), as measured through the care coordination composite in the Survey of Healthcare Experiences of Patients (SHEP). Project efforts aim to improve care coordination for high-risk Veterans who often are unable to coordinate their own care without assistance and have substantially greater than average care coordination needs and challenges. Rather than focusing on specific disease states, investigators aim to address care coordination issues at a system level, with PACT as the central hub. Spread efforts will build upon new or existing tools and resources, including a) development and deployment of the PACT Intensive Management (PIM) Toolkit, b) maintenance of the Care Coordination QUERI Toolkit, c) upgrading the currently available VISN 22 Patient-Aligned Care Team (PACT) Demonstration Lab (VAIL) Toolkit, and d) adapting and deploying the Women’s Health PACT Toolkit on care coordination.
Additional Programs and Educational Efforts
In addition to the individual research projects conducted by CSHIIP investigators, the Center is also home to two Quality Enhancement Research Initiative (QUERI) Programs and three QUERI Partnered Evaluation Initiatives. The Enhancing Mental and Physical health of Women through Engagement and Retention (EMPOWER) QUERI program is designed to improve women Veterans' engagement and retention in evidence-based care for high-priority health conditions (prediabetes, cardiovascular risk, and anxiety/depression). The Care Coordination QUERI Program’s impact goal is to improve care coordination and experience of care across settings for high-risk Veterans in PACT (Patient-Aligned Care Teams) – and to develop novel approaches to coordinating care between the Veteran, his or her primary care team, and other settings, including specialty care, the emergency department, and home and community resources.
The QUERI Partnered Evaluations focus on comprehensive women’s healthcare, complementary and integrative health, and health equity. CSHIIP is also home to the VA Women’s Health Research Network (WHRN), which supports a national Consortium of VA investigators and a practice-based research network of 60 VA medical centers. We also support a new Patient Safety Center of Inquiry, and have close collaborative relationships with our GRECC and VISN 22 MIRECC.
CSHIIP has a robust commitment to training and educating the next generation of clinicians and investigators through its VA/UCLA Multi-Campus Primary Care and Health Services Research Fellowship Program. This program integrates education/mentoring activities across three VA-funded fellowship programs, alongside the UCLA/VA National Clinician Scholars program.
Each Center works closely with operational partners throughout the VA healthcare system. CSHIIP's partners include but are not limited to: