Impact

As part of CHQOER’s commitment to improving the quality and structures of health care, our Investigators:

• Drive research that directly impacts health care;

• Participate in local and national workgroups; (click to this section)

• Guide the next generation of researchers, clinicians and health policy decision makers. (click to this section)

Recent High-Impact Research:

Improving Dental Preventative Care:  In partnership with the VA Office of Dentistry, CHQOER investigators have completed a national quality improvement initiative to incorporate the appropriate use of fluoride into VA dental practice. The initiative included a systematic review of the literature, incorporation of this evidence into VA policies, presentation to VA clinicians through webinars, changes in the national formulary, and routine monitoring and feedback on performance.

As a result of the intervention, the number of VA medical centers achieving the quality monitor goal of 75% of eligible patients receiving appropriate fluoride treatment increased from below 40% at the start of FY09 to over 90% by the end of FY10.  This program is expected to have a large impact in preventing the development of dental caries among veterans.  Ongoing research will assess development of dental caries among VA patients who receive appropriate fluoride.  For further information please email Dr. Judy Jones:  Judith.Jones2@va.gov.

Improving Mental Health Assessments:  The 24-item Behavior and Symptom Identification Scale (BASIS-24), a self-report mental health outcomes assessment instrument developed by CHQOER researchers, will be included in a planned release of new clinical instruments in the Mental Health Assistant software planned for Spring 2011. This will make the instrument available to all VA clinicians. The BASIS-24 serves to monitor overall mental health status and five specific domains including depression/functioning, interpersonal relationships, self-harm, emotionality, psychotic symptoms and alcohol/drug abuse. In addition to improving assessment of mental health treatment outcomes, the rollout of BASIS-24 throughout VA will facilitate program and system comparisons both within and outside the VA.  For further information please email Dr. Sue Eisen: Susan.Eisen@va.gov.

Development of a Supported Education Service for OIF/OEF Veterans with PTSD: The Post 9/11 GI Bill greatly increases opportunities for returning Veterans to advance their education, which in turn increases community stability and employment. However, PTSD and other service-connected disabilities frequently block vets from taking advantage of educational opportunities. Supported education is an emerging evidence-based practice that provides the rehabilitation counseling that Veterans with disabilities need in order to be successful in a school setting. CHQOER investigators have developed products in order to define and launch a supported education service in the VA. A manual for supported education service delivery and implementation guidelines has been developed and is being disseminated in VISN 1.  For further information please email Dr. Marsha Ellison:    Marsha.Ellison@va.gov

Enhanced Care Transitions for Hospitalized Veterans with Co-occurring Mental Illness and Substance Use Disorders: An intervention to assist veterans with mental health and substance abuse problems in the transition from inpatient to outpatient care has been implemented at several medical centers including VA New Jersey Health Care System, NY Harbor Health Care System and VA Pittsburg. The intervention was developed and tested by CHQOER investigators and has been shown to reduce rehospitalizations and enhance treatment engagement.

Preventing Pressure Ulcers in Hospitals:  A research team led by CHQOER’s director, Dr. Dan Berlowitz, has developed a Toolkit for improving quality of care in the prevention and treatment of pressure ulcers. These skin lesions bring pain, risk for serious infections, and increased health care utilization.  The aim of the toolkit is to assist hospital staff in implementing effective pressure ulcer prevention practices through an interdisciplinary approach to care.  The toolkit is available at:   http://www.ahrq.gov/research/ltc/pressureulcertoolkit/    For further information please contact Dr. Dan Berlowitz:  Dan.Berlowitz@va.gov.

 

Participation in local and national workgroups: 

CHQOER Investigators contribute their expertise, time and energy to a broad set of local and national work groups.  Our Investigators serve on steering committees for VA COEs, REAPs and Resource Centers.   Many investigators review research proposals as members of the HSRD Scientific Merit Review Board and the Career Development Award Review Panel.

CHQOER Investigators also serve with national groups including:

The VA Nursing Research Advisory Group -- advising the Office of Nursing Service on the implementation of its strategic plan for research;

The American Geriatrics Society Research Committee -- serving as the VA representative and working with ORD to review the portfolio of research on aging, develop a national symposium on VA-aging related activities, and promote research on aging;

The VA Oral Health Quality Group -- working directly to assess and improve the quality of VA dental care;

The VA MyHealtheVet Performance Evaluation Workgroup -- serving on the national committee that oversees evaluation of veterans experiences with the MyHealtheVet personal health record;

The National (non-VA) CMS/NCQA  -- assisting with evaluation of the Medicare Advantage Program through the analysis of data from the Medicare Health Outcomes Survey.

Guiding the next generation of clinicians, researchers, and health policy decision-makers: 

Training activities for physicians and PhD researchers are fully integrated into both the day-to-day operations of CHQOER and long-term strategic plans. Training activities serve to teach the skills of health services research through practical experience in VA settings, to foster the development of research careers in the VA and to increase the productivity of the Center by marshaling the efforts of highly motivated novice researchers.

CHQOER is a major training site for physicians interested in academic careers in both general and subspecialty fields. Clinician-researchers are supported by the VA Health Services Research Fellowship, Preventive Medicine Residency Positions, and other mechanisms.   The CHQOER HSR&D post-doctoral training program for PhD researchers is funded through the Office of Academic Affiliations (OAA) and typically supports two researchers per year.  

Developing researchers are encouraged to continue their work with the support of career development awards funded by VA.  Most graduates of CHQOER’s postdoctoral research training programs continue careers as clinicians and health services/policy researchers within the VA healthcare system.