Health Services Research & Development

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COIN: Center for Innovations in Quality, Effectiveness and Safety (IQuESt); Houston, TX

Director: Laura Petersen, M.D., M.P.H., F.A.C.P.

About the COIN

The IQuESt mission is to improve the quality, effectiveness, and safety of healthcare through patient-centered communication and coordination.


This Center's four main goals are to improve:


Improving Communication and Coordination of Care in VA Outpatient Primary Care Settings

The overall research goal (based on their CREATE) is to enhance communication and coordination of care in the VA outpatient setting by developing and implementing point-of-care interventions. IQuESt defines 'point of care' as any setting in which a provider evaluates clinical information and makes a healthcare decision. This broad definition encompasses both traditional face-to-face encounters at clinical visits, as well as non-face-to-face interactions (e.g., telephone calls, secure messaging, or information from the EHR). The four CREATE projects are:

1) Identifying and Delivering Point-of-Care Information to Improve Care Coordination,

2) Automated Point-of-Care Surveillance of Outpatient Delays in Cancer Diagnosis,

3) Automated Heart Failure Data for Patient Treatment Goals at the Point of Care, and

4) Point-of-Care Health Literacy and Activation Information to Improve Diabetes Care.


Improving the Effectiveness of Evidence-Based Mental Healthcare in Non-mental Healthcare Settings

The overall research goal is to improve the effectiveness and reach of evidence-based mental healthcare through the development of innovative models of coordinated mental healthcare. IQuESt will achieve this by developing and implementing coordinated care delivery models that target certain high-risk subgroups of Veterans, such as those with comorbid medical conditions, those living in rural settings and/or receiving healthcare in VA community-based outpatient clinics (CBOCs)


Improving the Fidelity and Reach of High-Quality, Veteran-Centered Cancer Care

The overall research goal is to improve the coordination and reach of high-quality, Veteran-centered cancer care. To address the broad and multi-faceted aspects of cancer care, this approach will include:

1) Expanded use of innovative technology-enabled interventions to improve coordination of cancer-care services;

2) Strategies that enhance communication among clinicians, Veterans, and family; and

3) Patient-centered, comparative-effectiveness studies in screening, surveillance and treatment of cancer.


Enhancing the Safety of EHR-enabled Communication

The overall research goal is to enhance the safety of EHR-enabled communication using informatics and human factors engineering-based approaches. Investigators will focus on developing and evaluating automated measurement and monitoring systems to track communication of abnormal test results, and also will refine and evaluate tools for improving the safety of EHR-based test-result communication systems.



Partner Offices

Each COIN works closely with operational partners throughout the VA healthcare system. IQuESt partners include:

Related Resources

 COIN: Center for Innovations in Quality, Effectiveness and Safety

COIN: Center for Innovations in Quality, Effectiveness and Safety