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2007 HSR&D National Meeting Abstract

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National Meeting 2007

3087 — Building QUERI Research-Clinical Partnerships to Disseminate Collaborative Care for Depression

Smith JL (Mental Health QUERI, Central Arkansas Veterans Healthcare System) , Williams JW (Durham VA Medical Center HSR&D), Owen RR (Mental Health QUERI, Central Arkansas Veterans Healthcare System), Rubenstein LV (VA HSR&D Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System), Chaney EF (VA HSR&D Center of Excellence, VA Puget Sound Healthcare System)

Little is known about how researchers might best collaborate with clinical leaders to disseminate complex clinical innovations. This abstract describes processes undertaken and tools developed by the VA Mental Health Quality Enhancement Research Initiative (MH QUERI) to guide efforts to partner with organizational leaders to prepare for national dissemination of collaborative care for depression.

An evidence-based quality improvement (EBQI) process was utilized to develop an initial draft of goals to prepare for national dissemination of collaborative care (referred to as a “National Dissemination Plan” (NDP)). EBQI participants included researchers and clinical leaders with expertise in implementing collaborative care, knowledge of theoretical models for disseminating evidence-based practices, and/or knowledge of the types of structural supports likely to be necessary to support national dissemination. The initial NDP draft was distributed to a broader group of researchers and organizational leaders for review and feedback, which was incorporated into a final NDP draft that was approved by MH QUERI leadership. A formative evaluation framework and related tools was also developed to document processes, monitor progress, and identify barriers and facilitators encountered in addressing NDP goals.

The NDP reflects that disseminating collaborative care for depression will likely require attention to Guidelines and Quality Indicators (4 goals), Training in Clinical Processes and Evidence-based Quality Improvement (6 goals), Marketing (7 goals), and Informatics (1 goal). ‘Action Teams’ for each goal have flexibility to chart their own course in achieving NDP goals. Preliminary formative evaluation results indicate that common barriers encountered by Action Teams in addressing NDP goals include: (a) limited time for team members due to competing tasks/priorities; (b) difficulty engaging with busy organizational leaders; (c) turnover of organizational leaders/stakeholders; and (d) difficulty coordinating activities across teams on related goals.

Attention to important structural and policy factors may facilitate successful dissemination of complex clinical innovations like collaborative care for depression. MH QUERI has developed a focused, yet flexible, plan to partner with organizational stakeholders to address key factors to prepare for national dissemination.

Research-clinical partnerships to disseminate evidence-based practices represent new roles for researchers, and may require new skills as well as new funding mechanisms.

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