Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

HSR&D Research Briefs

NOTE: beginning in December, 2018, HSR&D Investigator Quarterly replaces HSR&D Research Briefs.

HSR&D Research Briefs – Winter 2017

» Back to list of all HSR&D Research Briefs



Research Briefs Online header

February 2017

HSR&D Research Briefs disseminates news and information to the HSR&D investigator community. In this issue:


Spotlight


Spotlight: 2106 HSR&D Award Winners

Daniel Deykin Award for Outstanding Mentorship

Steve Asch, MD, MPH, is the Director of the HSR&D Center for Innovation to Implementation: Fostering High-Value Care

Steve Asch, MD, MPH

You received an award honoring your work as a mentor. How does mentoring translate into improved care for Veterans? How does it impact the VA healthcare system as a whole?
Mentoring researchers is probably the highest leveraged activity available to improve care for Veterans. Mentees go on to develop innovative new ways of caring for our Veterans, something that pays dividends far into the future.

What about mentoring do you most enjoy?
Mentoring is very much a two-way street. I enjoy learning from my mentees as much as I do teaching them. Helping them progress in their research careers stretches my own curiosity and methodologic breadth, making me a better researcher and mentor for others.

What does the professional recognition of an HSR&D award mean to you and your role as a mentor?
The recognition is incredibly gratifying. While it is something that I do for its own reward, knowing that others recognize it encourages me to redouble my efforts.

John Piette, PhD, is an HSR&D Research Career Scientist with the HSR&D Center for Clinical Management Research

John Piette, PhD

You received an award honoring your work as a mentor. How does mentoring translate into improved care for Veterans? How does it impact the VA healthcare system as a whole?
Mentoring and the support for junior investigators are critical to keeping HSR&D a vibrant, impactful program—which it's been since its inception. Mentees bring fresh eyes and fresh skills to the complex problems facing VA and the Veterans we serve. Through mentoring we ensure that the next generation of VA researchers has the knowledge base it needs to continue transforming VA healthcare given the always-evolving environment. Mentoring also helps us keep junior investigators' focus on putting Veterans first, despite the many pressures of an academic career.

What about mentoring do you most enjoy?
What I love more than anything is when a mentee takes an idea I had and makes it better—applying it in new ways so that it is even more powerful with respect to improving care for Veterans.

What does the professional recognition of an HSR&D award mean to you and your role as a mentor?
This award is a great honor for me because the recognition comes directly from the mentees with whom I've had the privilege to work. I'm so grateful that mentees have found our collaborations useful as they take on even more important challenges facing VA.

Health System Impact Award

Hardeep Singh, MD, MPH is a physician investigator with the HSR&D Center for Innovations in Quality, Effectiveness and Safety.

Hardeep Singh, MD, MPH

You received an award which honors research that directly and significantly impacts VA clinical practice and policy. Briefly describe how your work has, and will, directly impact care for Veterans and the VA healthcare system.
Our team's research—reducing missed and delayed diagnoses—has impacted patient safety in the VA outpatient setting by strengthening communication and follow-up of test results, identifying and reducing diagnostic errors, and refining use of the VA Computerized Patient Record System. We developed electronic "trigger" tools to identify patients with missed or delayed follow-up of test results, safety assessment guides for electronic health records, and decision-support software to improve patient follow-up. Recently, I had the privilege of co-developing the national VA policy and guidance on communication of test results to patients and providers. This policy is now in place at all 150-plus VA facilities and is impacting care for all Veterans. Our work is informing good clinical practices both within and outside VA.

What made you focus on this particular research topic?
Diagnosis is one of the most important tasks performed by clinicians. My passion to reduce misdiagnosis is what led me to transition from a full-time primary care physician to a research investigator. More than a decade ago, many in the patient safety research community considered this area to be one of the hardest to tackle. It's challenging to understand the complicated art and science of diagnosis and devise strategies for improvement. I got interested in bringing together a truly multidisciplinary team in order to do that.

What does the professional recognition of an HSR&D award mean to you and your future work?
Advancing and contributing to a research agenda for a topic so fundamentally important is one factor, but another is using science to make an impact on policy and practice both within and outside VA. This award recognizes this type of impact. In addition to impacting policies and clinical practice, we are also studying how best to engage patients to improve diagnosis. Ultimately, this recognition is all about research that makes a difference in patient outcomes and changes the system where we clinicians practice so we can provide Veterans with the best possible care.

Best Paper Award

Barbara Trautner, MD, PhD, is an investigator with the HSR&D Center for Innovations in Quality, Effectiveness and Safety.

Barbara Trautner, MD, PhD

You received an award for Best Paper for, "Effectiveness of an Antimicrobial Stewardship Approach for Urinary Catheter-Associated Asymptomatic Bacteriuria". Briefly describe how the work on which your paper was based impacts care for Veterans and the VA healthcare system as a whole.
Slowing the emergence of highly resistant bacteria through effective implementation of antimicrobial stewardship is a high priority topic in the United States. VA provides care for several demographic groups that are at high risk for receiving inappropriate antibiotics by virtue of their legitimate need for long-term urinary catheters and the resulting chronic bacteriuria (bacteria in the urine). Our "Kicking CAUTI: the No Knee-Jerk Antibiotics Campaign" successfully intervened to reduce inappropriate use of antibiotics in catheterized Veterans with asymptomatic bacteriuria.

What made you focus on this particular research topic?
I spent the first 10 years of my research career working with Veterans with spinal cord injury and long-term urinary catheters, trying to use probiotic bacteria to prevent their recurrent urinary tract infections. What I was struck by was how many courses of antibiotics they received over the years for bacteria in the urine, and how rarely these antibiotics seemed to benefit them. I also saw their urinary bacteria become more resistant over time. This got me thinking about how to help avoid this situation in all Veterans with urinary catheters, and then antibiotic stewardship became a hot topic in general.

What does the professional recognition of an HSR&D award mean to you and your future work?
What it means to me personally is that my work is finally reaching a larger audience, after many years of sounding the antibiotic stewardship warning. On another level, I received the notification of the best paper award at a very dark time in my life, when I had just been diagnosed with breast cancer. The award was not only a very bright spot, but was a ringing endorsement in support of my work toward improving healthcare for Veterans. We all deserve excellent healthcare. HSR&D approved funding for the dissemination project from Kicking CAUTI, "Less is More: Improving Antibiotic Stewardship for Asymptomatic Bacteriuria," and although some days it's an uphill struggle, I'm steadily working toward launching this exciting project.

Steve Zeliadt, PhD, MPH, is core investigator with the HSR&D Center of Innovation for Veteran-Centered and Value-Driven Care

Steve Zeliadt, PhD, MPH

You received an award for Best Paper for, "Attitudes and Perceptions about Smoking Cessation in the Context of Lung Cancer Screening". Briefly describe how the work on which your paper was based impacts care for Veterans and the VA healthcare system as a whole.
The study we conducted was intended to find new opportunities to talk about smoking cessation to Veterans who are longtime smokers as VA begins implementing new lung cancer screening guidelines among this higher risk population. We identified that lung cancer screening raises a lot of emotions, including fear and guilt about smoking. However, if sufficient time and resources aren't available to process those emotions, patients may succumb to cognitive biases and feel that participation in screening is sufficient to reduce the harms of smoking. This work has led to developing counseling strategies that are integrated with reporting screening results to patients that can be delivered by telephone. We are now conducting a pragmatic trial working with VA Quitline counselors to understand how to routinely integrate this counseling.

What made you focus on this particular research topic?
My research generally focuses on understanding how to provide high-value care. The absolute benefit of lung cancer screening is relatively low, with patients participating in screening potentially gaining about 15 weeks of increased life expectancy, and includes many tradeoffs such as false positives and harms from invasive procedures. Smoking cessation among Veterans who are the same age will gain, on average, more than four years of increased life expectancy with no significant harms associated with quitting. I was naturally drawn to this topic as lung cancer screening targets long-term smokers, and smoking cessation remains one of the most beneficial and cost-effective interventions we can deliver.

What does the professional recognition of an HSR&D award mean to you and your future work?
I have the pleasure of working with many outstanding clinicians and investigators across VA and other research organizations. The professional recognition of the HSR&D award is energizing as it confirms that continuing to focus my career in exploring ways to deliver high-value care, and collaborating with teams to implement these strategies is a worthwhile challenge.

top

Research News & Recent Dissemination


Research News & Calls for Submission


Recent Dissemination


top



Awards & Honors


  • Nasia Safdar, MD, PhD, was named a recipient of the Presidential Early Career Scientist Award for Scientists and Engineers. Learn more...
  • Jasvinder A. Singh, MD, MPH, is the recipient of the American College of Rheumatology's 2016 Henry Kunkel Young Investigator Award. Learn more...

To submit an award notice for possible publication on the HSR&D website, be sure that the award is recognized at a national and/or international level. Internal awards, such as departmental awards, are not accepted. The award can be for a Center-wide achievement or for an individual investigator.

top



Publication Notification and Search Tools


Search Tools
Looking for published research? The search tools for articles, presentations, citations, and HSR&D internal publications include the following:

  • Research by Topic. A search keyed to 21 of VA's priority topic areas. Results collect all current HSR&D projects, citations, reports, Cyberseminars, videos, or other products and resources available on the HSR&D website.
  • Citations. Search on citations from journals, meetings, conferences, and reports credited to HSR&D researchers.
  • Publications. A search option for HSR&D and QUERI-produced publications, as well as Evidence Synthesis Reports.
  • Women's Health Literature . A database of citations, studies, and publications about women Veterans health and healthcare.

Publication Notification
Please let us know as soon as you have an article accepted for publication. This applies to all publications based on an HSR&D-funded or managed project, and for publications authored/co-authored by an HSR&D-supported investigator, regardless of funding source.

To submit your notification, please use the VA Intranet-based PubTracker system. Instructions for accessing PubTracker are available on the Publication Notification Requirement page of the For Researchers section on the HSR&D website.

top



Newly Funded


Find links to studies for which funding began within the last three months.

top



Feedback


If you have feedback about Research Briefs, or suggestions for topics of interest about which you'd like to read, please send an email to: HSRDWeb.Boston@va.gov.

top


To cancel your Research Briefs Online subscription, please send an email to Cider.Boston@va.gov with UNSUBSCRIBE as the subject line.