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Health Services Research & Development

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COIN: Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT); Durham, NC

Center of Innovation to Accelerate Discovery and Practice Transformation

Director: Nicki Hastings, MD, MHS

Website: http://www.durham.hsrd.research.va.gov/

About the COIN

ADAPT’s main objective is to enhance VA’s ability to continually improve health care and optimize Veteran wellness and independence.

Research Focus Areas

The Center’s work aims to build organizational resilience in VA through research in the following areas:

  • Promoting and Sustaining Healthy Behaviors
  • Improving Access through Virtual Care
  • Optimizing Function and Independence

ADAPT’s core faculty and staff conduct creative, high-quality health services research in close partnership with VA leadership for the benefit of our nation's Veterans. The Center offers organized research programs as well as cross-cutting methods labs and a stakeholder engagement core to ensure that research studies are designed to address VA’s highest priorities and that research findings are relevant and actionable. 

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

Advancing Measurement of Veteran Function and Independence: Pursuing a Set of Measures around the Patient-Centered Theme of ‘Home Time’

Principal Investigator: Courtney Harold Van Houtven, PhD

The goal of this project is to build upon past work evaluating administrative home time measures (e.g., days alive and not in an acute or post-acute care setting) to develop a person-centered definition of home time that reflects high quality of life and a shared understanding of its clinical utility. Through focus group discussions with caregivers and Veterans, investigators will learn how they value time at home versus time in various health care settings and develop a measure based on their definition of home time. With quantitative analyses, investigators will test how definitions of home time, including Veteran and caregiver definition(s), relate to well-established patient- and caregiver-reported outcomes known to reflect high quality of life.

Supporting Programs & Services

ADAPT has a rich tradition in conducting high-impact health services research, including a dedicated Implementation and Improvement Science Lab, as well as a Non-Randomized Designs Lab and a Pragmatic Clinical Trials Lab. Further, the center places a strong focus on career development via fellowships and the HSR&D Career Development Award Program.

In addition to its core HSR&D-funded projects, ADAPT is also home to the HSR&D Quality Enhancement Research Initiative’s Optimizing Function and Independence program, which leverages scientifically-supported quality improvement methods to implement evidence-based practices rapidly into routine care and improve the timeliness, quality, and safety of care delivered to Veterans and caregivers. ADAPT’s VA Evidence Synthesis Program was formed in 2008 to support high quality, rapid turn around evidence syntheses to inform VA clinical policy.

Partner Offices

Each COIN works closely with operational partners throughout the VA healthcare system. Durham’s partners include:


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Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.