A5049377461- Health Policy Implementation Science
- Primary Care and Health Outcomes
- Public Health Policies and Education
- Spinal Cord Injury Research
- Palliative Care and End-of-Life Issues
- Mental Health and Patient Involvement
- Evaluation and Performance Assessment
- Opioid Use Disorder Treatment
- Cardiac Arrest and Resuscitation
- Musculoskeletal pain and rehabilitation
- Eating Disorders and Behaviors
- Mental Health Treatment and Access
- Health Sciences Research and Education
- Psychopathy, Forensic Psychiatry, Sexual Offending
- Ethics in Clinical Research
- Cancer survivorship and care
- Emergency and Acute Care Studies
- Obesity and Health Practices
- Substance Abuse Treatment and Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Pain Management and Opioid Use
- Cardiac, Anesthesia and Surgical Outcomes
- Childhood Cancer Survivors' Quality of Life
- Chronic Disease Management Strategies
- Economic and Financial Impacts of Cancer
VA Palo Alto Health Care System
2015-2024
Center for Innovation
2015-2024
VA Ann Arbor Healthcare System
2022-2024
VA Center for Clinical Management Research
2022-2024
National Center for PTSD
2024
United States Department of Veterans Affairs
2018-2023
VA New England Healthcare System
2023
Durham VA Health Care System
2023
Veterans Health Administration
2023
Health Services Research & Development
2016-2023
Abstract Background Qualitative approaches, alone or in mixed methods, are prominent within implementation science. However, traditional qualitative approaches resource intensive, which has led to the development of rapid approaches. Published often inductive nature and rely on transcripts interviews. We describe a deductive analysis approach using Consolidated Framework for Implementation Research (CFIR) that uses notes audio recordings. This paper compares our versus CFIR approach. Methods...
ther unnecessary, of low value or wasteful (Institute Medicine, 2013).The third plenary panel brought different perspectives on the enduring and evolving challenges in dissemination evidence evidence-based practices as well opportunities emerging from innovations digital health sector.The sessions were complemented by facilitated lunchtime discussions these topics, additional research priorities, which enabled more in-depth discussions, question answer time, brainstorming future...
Cancer is a leading cause of death in the United States. Although treatments have improved, patients and caregivers continue to report significant gaps their care. The objective this study was examine views on experiences with current cancer care delivery identify key strategies improve care.Semistructured interviews were conducted 75 45 across recorded, transcribed, analyzed using constant comparative method qualitative analysis.Participants reported multiple delivery, including barriers...
Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard care, yet knowledge and these are very low across diverse settings. This study evaluated the overall effectiveness multifaceted academic detailing program address this persistent quality problem in US Veterans Health Administration (VHA), as well context process factors that explained variation sites.An interrupted time series design, analyzed with mixed-effects segmented logistic...
Abstract Background The use of rapid qualitative methods has increased substantially over the past decade in quality improvement and health services research. These have gained traction implementation research practice, wherein real-time adjustments are often made to optimize processes outcomes. This brisk increase begs questions: what does rigor entail projects that analysis (RQA)? How do we define a pragmatic framework help teams design conduct rigorous valid projects? can authors...
Purpose: Neurogenic bladder and bowel (NBB) is a chronic condition hindering the functioning quality of life (QOL) people with spinal cord injury (SCI). NBB research has focused on men SCI leaving unanswered questions about women's experiences living NBB. The purpose this study was to identify describe Method: Secondary analysis semi-structured interviews from larger qualitative women (N = 50) carried out. Transcripts were coded for content. Pile-sorting techniques used emergent themes...
Objectives: Persistent gaps in end-of-life cancer care delivery and growing associated expenditures remain imminent US public health issues. The objective of this study was to understand clinical providers’ experiences delivering for patients at the end life their perspectives on potential solutions improve quality care. Methods: Semistructured interviews were conducted with 75 providers across United States. recorded, transcribed, analyzed using constant comparative method qualitative...
The Veterans Health Administration (VHA) Diffusion of Excellence (DoE) program provides a system to identify, replicate, and spread promising practices across the largest integrated healthcare in United States. DoE identifies innovations that have been successfully implemented VHA through Shark Tank style competition. facility regional directors bid resources needed replicate practices. Winning facilities/regions receive external facilitation aid replication/implementation over course year....
This study investigated the beliefs and attitudes of older African American colorectal cancer (CRC) survivors that may influence health behavior changes after treatment. Drawing from existing theories change cultural about health, a semi-structured interview guide was developed to elicit survivors' perspectives. Qualitative focus groups interviews were conducted with 17 identified through Detroit Surveillance Epidemiology End Results registry. Using verbatim transcripts sessions NVivo...
Background In an effort to prevent opioid overdose mortality among Veterans, Department of Veterans Affairs (VA) facilities began implementing education and naloxone distribution (OEND) in 2013 a national program 2014. VA is the first health care system implement OEND. The goal this study examine patient perceptions OEND training kits. Methods Four focus groups were conducted between December 2014 February 2015 with 21 patients trained Participants recruited from residential facility...
Background: Many cancer patients do not receive recommended palliative care (PC). Oncologists' perspectives about PC have been adequately described qualitatively and may explain some of the gaps in delivery PC. Objective: To characterize U.S. oncologists' perceptions of: primary specialist PC; experiences interacting with specialists; optimal interface oncology providing Design: In-depth interviews practicing oncologists. Setting/subjects: Oncologists working in: general community, academic...
Abstract Background One goal of health systems seeking to evolve into learning is accelerate the implementation and sustainment evidence-based practices (EBPs). As part this evolution, Veterans Health Administration (VHA) developed Innovation Ecosystem, which includes Diffusion Excellence (DoE), a program that identifies diffuses Gold Status Practices (GSPs) across facilities. The DoE hosts an annual “Shark Tank” competition in leaders bid on opportunity implement GSP with 6 months support....
There are challenges associated with measuring sustainment of evidence-informed practices (EIPs). First, the terms sustainability and often falsely conflated: assesses likelihood an EIP being in use future while extent to which is (or not) use. Second, grant funding ends before can be assessed. The Veterans Health Administration (VHA) Diffusion Excellence (DoE) program one few large-scale models diffusion; it seeks identify disseminate across VHA system. DoE sponsors "Shark Tank"...
Nutrition knowledge, beliefs, and behaviors have important implications for managing preventing chronic injury-related secondary conditions in persons with spinal cord injuries disorders (SCI/D). Yet, the unique dietary nutritional needs recommendations specific to individuals SCI/D their eating beliefs been understudied. Aim is describe nutrition from perspectives of SCI/D.
The Veterans Health Administration (VHA) is the United States largest learning health system. Diffusion of Excellence (DoE) program a large-scale model diffusion that identifies and diffuses evidence-informed practices across VHA. During period 2016-2021, 57 were implemented 82 VHA facilities. This setting provides unique opportunity to understand sustainment determinants pathways. Our objective was characterize longitudinal pathways as they transition from initial implementation long-term...
Abstract Background The U.S. Veterans Health Administration (VHA) formed an Innovation Ecosystem that develops and disseminates innovative practices to enhance Veterans' health. Support of senior leadership their perception the innovation process is key Ecosystem's success. We aimed elicit insights on (1) how national VHA program office leaders define innovation, (2) important considerations in facilitating adoption innovations. Methods As part a quality improvement initiative, we conducted...
Heart failure (HF) management requires the participation of patients, their significant others, and clinical providers. Each group may face barriers to HF that be unique or overlap.The aim this study was compare facilitators as perceived by providers.Participants were recruited from a Veterans Health Administration facility. Eligible patients had diagnosis (ICD9 code 428.XX), 1 more HF-related visit in previous year, other who primary caregiver. Significant others adults with no history...
Introduction The development and spread of innovation are known challenges in health care. US Veterans Health Administration (VHA) created a "Shark Tank"-style competition directed at frontline employees. In this annual, systemwide competition, employees submit innovations to the winning receive support for implementation other facilities. Method A multiple case study design was used understand facility engagement relationship between organizational conditions. authors typology describe...
The availability and utility of services to address recidivism risk factors among justice-involved veterans is unknown. We explored these issues through qualitative interviews with 63 Specialists from the Department Veterans Affairs’ (VA) Justice Programs. To guide interviews, we utilized risk–need–responsivity (RNR) model offender rehabilitation. reported that generally have access most RNR-based (substance abuse, lack positive school/work involvement, family/marital dysfunction, prosocial...