Karin Nelson, M.D., M.S.H.S.
Karin Nelson, M.D., M.S.H.S., part of HSR&D's Center of Innovation for Veteran-Centered and Value-Driven Care in Seattle, WA, is the first recipient of the HSR&D Best Research Paper of the Year Award, which honors a single article or collection of articles resulting from one or more HSR&D - or QUERI-funded investigations. Research studies also must involve Veterans, with results that are important to Veterans' health and care, and to the VA healthcare system. Published in JAMA Internal Medicine, Dr. Nelson's article "Implementation of the Patient-Centered Medical Home in the Veterans Health Administration: Associations with Patient Satisfaction, Quality of Care, Staff Burnout, and Hospital and Emergency Department Use" was chosen for several reasons, including its relevance to both VA and health systems in general, its rigorous methodology, as well as the utility of its results and their rapid adoption within VA. This work was performed as part of the PACT (Patient-Aligned Care Team) Demo Lab Initiative, which represents a collaboration among HSR&D and VA's Offices of Primary Care, Primary Care Operations, and Analytics & Business Intelligence.
Since 2010, VA has been implementing the patient-centered medical home model of care, called the Patient-Aligned Care Team, in order to restructure primary care to provide team-based care that is comprehensive, coordinated, and patient-centered. In the article, Dr. Nelson and colleagues report on their study which created an index that measured the extent and variation of PACT implementation across the VA healthcare system, and examined the association between the implementation index and key outcomes (e.g., patient satisfaction, rates of hospitalization, quality of care, and staff burnout). Their findings showed that the extent of PACT implementation, as measured by their index, was highly associated with important outcomes for patients and providers. Based on the quality, importance and relevance of this work, the implementation index has been adopted as a VA Agency Priority Goal for 2016 – and one of the six elements of VA's National Performance Review criteria.