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Director's Letter Given the national focus and debate about health care reform, it seems very timely that this issue of FORUM focuses on the topic of change. As both Drs. Francis and Atkins note in the opening Commentary and Response articles, VA has made tremendous progress in organizing to improve health care for Veterans, but many challenges remain. Specifically, how do we best implement changes that will improve the VA health care system now and for the future, enabling us to provide consistent, accessible, highquality, cost-efficient care for all Veterans? Health services researchers can play an integral role in assisting the organization to meet such challenges. For example, much has been learned about implementing cost-effective, evidence-based interventions into routine clinical practice from VA's Quality Enhancement Research Initiative (QUERI). In addition, there are many other health services research efforts that already have or will add to our knowledge about achieving and sustaining health care systems change. In this issue's Research Highlight articles, Drs. Charns and VanDeusen Lukas describe critical drivers of systems change and Drs. Hartmann and Berlowitz discuss challenges associated with changing the culture of nursing home care to one that is more resident centered. In other news, HSR&D will hold its Scientific Merit Review Board (SMRB) meeting in August. The SMRB consists of amultidisciplinary group of VA and non-VA experts who rigorously review VA health services research proposals covering an array of health care issues that affect Veterans' health and care. The August SMRB will review 113 research project proposals (an increase of 10 percent over the August 2008 review) and 82 pilot project proposals. HSR&D looks forward to supporting innovative, Veteran-centric research projects. Keep your proposals coming! Seth A. Eisen, M.D., M.Sc. | |
