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VA » Health Care » Durham Center of Innovation to ADAPT » Optimizing Function & Independence QUERI

Durham Center of Innovation to ADAPT

Optimizing Function & Independence QUERI

Overview

The Function & Independence Quality Enhancement Research Initiative (Function QUERI) was launched in October 2016 as a series of projects to improve Veteran function and to promote the rapid translation of research findings into clinical practice. Function QUERI capitalizes on implementation strategies to promote flexibility in program design for ease of uptake by medical centers of various size and complexity. Function QUERI also aims to enhance function and unity of healthcare teams for most effective delivery of innovative practices.

Project Components

Function QUERI involves the implementation and evaluation of three distinct but related intervention projects including STRIDE, Caregivers FIRST, Group PT.

Methodology

The core implementation strategy, Replicating Effective Programs (REP), focuses on promoting flexibility of clinical programs to fit local environments for ease of uptake. Function QUERI aims to evaluate uptake based on the "dose" of implementation support offered to teams launching each clinical program. Each team will be provided with a foundational level of support, with resources like a program toolkit, self-paced webinars, and data tracking support. Sites will be randomized to an option for enhanced support if they are unable to meet a priori benchmarks at specified timepoints. Higher intensity support will be offered for a period of 4-6 months (enREP) and feature the use of facilitation, a process of interactive problem solving that occurs in a context of a supportive interpersonal relationship.

Newsletters

With two QUERIs headquartered in the same Center, we combined forces for a new ADAPT QUERI bi-annual newsletter! This publication will be used to foster best practices and foster collaboration among front-line providers, clinical leaders, researchers, and patients to maximize impact and ultimately improve health outcomes and equity for Veterans.

Spring 2024 QUERI Newsletter

Previous Newsletters

National, VISN, & Local Operational Partners

National

VHA Physical Medicine and Rehabilitation Service;
VHA Safe Patient Handling and Mobility
VACO Geriatrics and Extended Care
VA Caregiver Support Program
VHA Diffusion of Excellence
VHA Office of Nursing Services
VHA National Center for Patient Safety

VISN

VISN 6 Network Director
VISN 6 Dissemination/Implementation Specialist
VISN 6 CSP VISN lead
VISN 12 CSP VISN lead
VISN 23 ECR Director

Local

Durham VA Healthcare System

Noteworthy Publications

Hughes JM, Zullig LL, Choate AL, Decosimo KP, Wang V, Van Houtven CH, Allen KD, Nicole Hastings S. Intensification of Implementation Strategies: Developing a Model of Foundational and Enhanced Implementation Approaches to Support National Adoption and Scale-up. Gerontologist. 2023 Mar 21;63(3):604-613. https://doi.org/10.1093/geront/gnac130 PMID: 36029028; PMCID: PMC10461172.
Bruening, R.A., Sperber, N., Wang, V. et al. Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study. J GEN INTERN MED 37, 4216–4222 (2022). https://doi.org/10.1007/s11606-022-07482-9
Webb, S., Drake, C., Coffman, C.J., Sullivan, C., Sperber, N., Tucker, M., Zullig, L.L., Hughes, J.M., Kaufman, B.G., Pura, J.A., Anderson, L., Hastings, S.N., Van Houtven, C.H., Abbate, L.M., Hoenig, H., Ballengee, L.A., Wang, V., Allen, K.D. (2023) Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial. Implementation Science Communications, 4, 125 (2023). https://doi.org/10.1186/s43058-023-00502-7
Decosimo, K., Drake, C., Coffman, C.J. et al. Implementation intensification to disseminate a skills-based caregiver training program: protocol for a type III effectiveness-implementation hybrid trial. Implement Sci Commun 4, 97 (2023). https://doi.org/10.1186/s43058-023-00475-7
Kaufman BG, Hastings SN, Meyer C, et al. The business case for hospital mobility programs in the veterans health care system: Results from multi-hospital implementation of the STRIDE program. Health Serv Res. Published online April 17, 2024. https://doi.org/10.1111/1475-6773.14307
Kappler, C.B., Coffman, C.J., Stechuchak, K.M. et al.Evaluation of strategies to support implementation of a hospital walking program: protocol for a type III effectiveness-implementation hybrid trial. Implement Sci Commun 5, 8 (2024). https://doi.org/10.1186/s43058-024-00544-5
Hastings SN, Stechuchak KM, Choate A, Van Houtven CH, Allen KD, Wang V, Colón-Emeric C, Jackson GL, Damush TM, Meyer C, Kappler CB, Hoenig H, Sperber N, Coffman CJ. Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial. Ann Intern Med. 2023 Jun;176(6):743-750. doi: 10.7326/M22-3679. Epub 2023 Jun 6. Erratum in: Ann Intern Med. 2023 Nov;176(11):1575. https://doi.org/10.7326/m22-3679

Awards

Mentoring Core

Our Mentoring Core recruits two candidates per year for a 2-year training experience. We had one mentee begin in FY22 (Brystana Kaufman), whose HSR&D CDA application was accepted and is currently working on the STRIDE Business Case Analysis: conducting analysis and leading paper and has received implementation training by attending the Behavioral Health QUERI Implementation Facilitation Training. Two other mentees joined in FY23: Lauren Abbate, an investigator at the Denver, CO VAMC who is supporting Group PT, and Lena Makaroun, an investigator at the Pittsburgh, PA VAMC who is supporting Caregivers FIRST and among the CMSW partners working with Function QUERI to evaluate a new note template to evaluate cases of suspected abuse and neglect (RRT project). Sadie Wilson is leading the ADIL grant supplement to the Optimizing Function and Independence QUERI 1.0. The Mentoring Core also consulted with Indy QUERI about cross training opportunities and met with CEIR to discuss plan for mentees and other resources available.


Dr. Lena Makaroun	Dr. Brystana Kaufman	Dr. Sadie Wilson	Dr. Lauren Abbate

Rapid Response Team Projects

Project	Project Partner(s)	Summary	Project Years	Project Lead
Employee Perspectives of Covid-19 Vaccination	VA National Center for Health Promotion and Disease Prevention (NCP)	Identified factors underlying intention and decisions of VA employees in one health care system to obtain a Covid-19 vaccine.	12/20-05/21	Nina Sperber
Evaluation of a Veteran Desires for Childcare Assistance to Attend VA Medical Appointments	Office of Women’s Health	Evaluated Veteran need for childcare assistance and how VA could best meet that need to improve Veterans’ access, utilization, and satisfaction with VA care.	12/21-06/22	Megan Shepherd-Banigan
Formative Evaluation of a Mobility Bundle	Office of Nursing Services (ONS) and Safe Patient Handling and Mobility (SPHM)	Evaluated workflow and team function in delivery of concurrent inpatient mobility initiatives in VA Medical Centers across the country.	06/22-03/23	Nicki Hastings
Evaluation of Provider Perspectives on Veteran Child Care Assistance	Office of Women’s Health	Goal of this project is to collect preliminary data about provider perspectives regarding how lack of childcare interferes with patient/provider communication and quality of care.	06/23-02/24	Megan Shepherd-Banigan
Technology Enabled Respite Homecare Model (TERHM)	VHA Innovation Ecosystem	This six-site pilot will connect Veterans with a third-party agency, CareLinx, that will act as an intermediary between Veterans and their homecare aides. Function QUERI will develop, administer, and analyze quantitative and qualitative evaluation data that will be used to inform the future of this pilot.	01/24-09/24	Courtney Van Houtven
Reporting Concerns of Suspected Abuse and Neglect Note Template Implementation evaluation	Care Management and Social Work (12CMSW)	The purpose of this project is to support internal implementation and evaluation efforts to execute implementation of the note template across 10 sites by identifying key questions for assessment and collecting and analyzing data to make needed adjustments and prepare for national dissemination.		Nina Sperber

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