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2019 HSR&D/QUERI National Conference Abstract

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4063 — VA Women's Health Evidence-Based Quality Improvement Collaborative: Spreading Practice Innovations in a Practice Based Research Network

Lead/Presenter: Diane Carney,  COIN - Palo Alto
All Authors: Carney DV (HSR&D Center for Innovation to Implementation, VA Palo Alto Health Care System), Yano E (HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Health Care System), Hamilton A (HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Health Care System) Pomernacki A (HSR&D Center for Innovation to Implementation, VA Palo Alto Health Care System) Golden R (HSR&D Center for Innovation to Implementation, VA Palo Alto Health Care System) Klap R (HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Health Care System) Combs A (HSR&D Center for Innovation to Implementation, VA Palo Alto Health Care System) Frayne SM (HSR&D Center for Innovation to Implementation, VA Palo Alto Health Care System)

Objectives:
The 60-site Veterans Affairs (VA) Women's Health Practice Based Research Network (WH-PBRN) facilitates multi-site WH research and quality improvement (QI) projects through a network of partnered VA facilities, and fosters bi-directional partnership of clinicians and researchers to improve the health and health care of women Veterans. The WH-PBRN serves as an excellent platform for spreading innovations through Evidence-Based QI (EBQI), which involves engaging multilevel, inter-professional leaders and staff as stakeholders in reviewing evidence and setting and acting on QI priorities. We characterized WH-PBRN local site priorities for QI topics and interest in participating in an inaugural multi-site Evidence-Based QI Collaborative.

Methods:
The Practice Priorities Questionnaire (PPQ), a 13-item survey that lists WH QI topic areas, was emailed to the WH-PBRN Site Leads. For each topic area, Site Leads were asked to rate (on a scale from "1" low-"5" high): How important is it to improve care of women Veterans in this domain, and how feasible is it to improve care for women Veterans in this domain. We then assessed site level interest in participating in the EBQI Collaborative for the topic areas that were rated mostly highly in terms of importance.

Results:
The overall PPQ response rate was 87 percent. For the 13 QI topic areas, mean importance scores ranged from 3.3 to 4.6 and mean feasibility scores ranged from 3.6 to 4.1. The four topic areas most highly rated based on importance were: changing VA culture, teratogen prescribing in women of childbearing age, abnormal mammogram follow-up, and assignment of women patients to a WH Primary Care Provider. In response to a follow-up query, 24 sites indicated interest in participating in the Evidence-Based QI Collaborative in at least one of the topic areas.

Implications:
The PPQ proved an efficient way to prioritize topic areas. Most Site Leads completed the survey and a large number wanted to participate in an Evidence-Based QI Collaborative, indicating a high level of activation across the WH-PBRN and readiness for innovation uptake.

Impacts:
The WH-PBRN holds promise for spread of practice-based innovations using EBQI.