Health Services Research & Development

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VHA's Priorities for Strategic Action

Spotlight on High-Performance Healthcare Network

November 2015

In October, the HSR&D website began highlighting research around VA Under Secretary for Health David Shulkin's five critical priorities:

  1. Access. Decrease appointment wait-times for Veterans, and address other challenges associated with their access to care.
  2. Employee Engagement. Improve recruitment, retention, and morale.
  3. Business practices. Ensure consistency of best practices by focusing on what's working well and ensuring that effective systems are supported with necessary resources.
  4. High-performance healthcare network. Develop a high-performing network that will reduce costs and improve quality of care.
  5. Restore pride, public trust, and confidence in VA.

Through its comprehensive research portfolio, VA's Health Services Research & Development Service (HSR&D) has—and will continue—to support the Under Secretary's priority goals. This month features an in-depth look at HSR&D-funded projects focused on building a high-performance healthcare network. The feature includes:

  • An in-depth review of the resources around implementing high-performance culture strategies. A comprehensive list of the many HSR&D research teams studying issues associated with creating a high-performance healthcare network. Learn more...
  • Unlearning and the Challenge of De-implementation. Launched in 2014, VHA's Choosing Wisely initiative included hypoglycemic safety as one of its targeted conditions. In this HSR&D study, Drs. Sherry Ball of theLouis Stokes Cleveland VA Medical Center and David Aron of theVA HSR&D Quality Enhancement Research Initiative, are looking at the simultaneous processes of de-implementation of clinically inappropriately tight glycemic control and the implementation of hypoglycemia risk reduction. Learn more...
  • Breaking Down Geographic Barriers to Evidence-Based, Veteran-Centered Specialty Care for Veterans with Complex Mental Health Conditions. Each year, more than 100,000 Veterans receive VA care for bipolar disorder—the single diagnosis most highly associated with completed suicide among Veterans. Since joining VA in the early 1990s, Dr. Mark Bauer, Associate Director of HSR&D's Center for Healthcare Organization and Implementation, has been conducting research to address treatment strategies for bipolar disorder among Veterans. Learn more...
  • Promoting Effective, Routine, and Sustained Implementation of Psychotherapies for PTSD. The prevalence of post-traumatic stress disorder (PTSD) is estimated to be 9%-15% among Vietnam Veterans and 10%-20% among Veterans of the Iraq and Afghanistan wars. In 2006, VA began national rollouts of two evidence-based psychotherapies for PTSD—Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE). Since that time, VA issued a policy requiring all Veterans with PTSD to have access to CPT or PE. However, available data indicates that CPT and PE are reaching only a small portion of Veterans with PTSD. Nina Sayer, PhD, Deputy Director, HSR&D's Center for Chronic Disease Outcomes Research, and Craig Rosen, PhD,Deputy Director, National Center for PTSD, Dissemination & Training Division,are currently conducting the Promoting, Effective, Routine, and Sustained Implementation of Psychotherapies for PTSD (PERSIST) study in an effort to identify organizational- and team-level factors that influence the extent of use (reach) and sustainability of evidence-based psychotherapies for PTSD in specialized PTSD teams. Learn more...