Table 3 Examples of QUERI progress
Increased appreciation on the part of researchers for the complexity of sustainable implementation in clinical settings with multiple priorities, and increased appreciation for the knowledge and skill that researchers can bring to the identification and improvement of clinical quality problems. |
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Identification of numerous gaps in current practice for targeted patient populations/problems, and an implementation portfolio within each QUERI Center focused on those gaps [33,34,39]. Each portfolio is developed within QUERI's 4-phase framework, which consists of an expected sequence of implementation projects from initial feasibility assessment to national roll-out [12]. |
Adoption of specific performance measures by the Office of Quality and Performance; new policies, such as diabetes eye screening [32]; and the evidence-based removal or addition of targeted medications in the VA's formulary. |
Refinement or expansion of several existing VA information technology resources to enhance quality care "by developing entirely new databases and informatics tools, validating and refining existing databases, and analyzing and interpreting their contents [p, 348, [29]]." |
Provision of requested research-related information of specific interest to VA leadership or other stakeholders, and facilitation and evaluation of major organizational "best practice" changes under the direction of national clinical specialty leadership [38]. |
An increased number of publications on a wide range of implementation issues and projects, including papers in peer-reviewed journals on methodological issues and suggested solutions [12]. |
Beginning evidence of successful implementation, such as increased vaccination rates for spinal cord injury patients, an improved policy for eye care screening in veterans with diabetes, expansion of the number of methadone clinics within VA, and improvement in evidence-based alcohol screening [32,37,43,44,45]. |