JGIM Supplement Highlights VA's Partnered Research
This Journal of General Internal Medicine (JGIM) Supplement focuses on "partnered research." Partnered research has been defined as "activities where researchers and practitioners work together, with different roles, to use research both to solve practical problems and to contribute to science." HSR&D and VA's Quality Enhancement Research Initiative (QUERI) have made major efforts to enhance partnered research in order to produce more relevant research that is more likely to have an impact on the health and care of Veterans. In this JGIM Supplement, 12 articles describe partnered research at various stages – from conceptualizing partnered research to examples of findings borne from bi-directional collaborations with investigators and leaders from clinical operations. These articles cover a wide range of topics highly relevant to VA policy and practice, including performance measure implementation on provider motivation, opioid management, suicide prevention, homelessness, medical home models, and communication of adverse events. The majority of the papers in the Supplement describe partnerships with program offices within VA. Research partnerships at this level of the organization have an increased opportunity to influence national policy and practice directives and inform evidence-based strategic planning. Other papers focus on more field-based partnerships; for example, with one or more of the 21 Veterans Integrated Service Networks (VISNs) and/or local VA medical centers, closer to the point of care and delivery of routine practice.
Articles include the following examples of partnered research:
- Wu and colleagues' lung cancer screening (LCS) program is an example of a top-down initiative. Senior VA program leaders tasked the National Center for Health Promotion and Disease Prevention (NCP) to develop an LCS program. In turn, NCP reached out to systems engineers to develop needed electronic clinical tools – and to health services researchers to lead the program evaluation. This multi-level partnership among policy, clinical, and research leaders aims to inform a potential national implementation of an LCS program throughout the VA healthcare system.
- Kertesz and colleagues evaluated the implementation of VA's Housing First program. The partnership in this evaluation is described as a more "at arm's length" relationship, emphasizing the independence of the evaluation from VA's National Center on Homelessness among Veterans. The National Center provided early guidance to refine the researchers' study question, convened two expert panels, and reviewed and discussed study findings in interim reports and final manuscripts. This two-level partnership reflects a more traditional dissemination model with distinct roles laid out to minimize potential conflicts of interest in the interpretation and reporting of results.
- Damush and colleagues describe another two-level partnership between the VA Offices of Emergency Medicine and Specialty Care Services and Stroke-QUERI Center researchers to evaluate the implementation of acute stroke care centers. The QUERI team evaluated implementation barriers and facilitators, presented results to the operational partners, and then established monthly virtual meetings with field-based stroke clinicians to increase engagement.
- An example of bottom-up partner engagement is reflected in Dobscha and colleagues' initiation of a dialogue with VA's Mental Health Services' Suicide Prevention Office in an effort to identify opportunities to intervene with Veterans seen in primary care who may be at risk of suicide. They then developed a data sharing agreement with a VISN suicide prevention center to examine a decade's worth of state death certificates, linking them with VA utilization data to characterize patterns of primary care use among Veterans who had committed suicide vs. those who did not. Results of this 3-level partnership helped inform VA mental health strategic planning.
Journal of General Internal Medicine (JGIM) Supplement. November 2014;29(4 Suppl):