Lessons learned about implementing research evidence into clinical practice. Experiences from VA QUERI.
The mission of the Veterans Health Administration's (VHA) quality enhancement research initiative (QUERI) is to enhance the quality of VHA health care by implementing clinical research findings into routine care. This paper presents lessons that QUERI investigators have learned through their initial attempts to pursue the QUERI mission. The lessons in this paper represent those that were common across multiple QUERI projects and were mutually agreed on as having substantial impact on the success of implementation. While the lessons are consistent with commonly recognized ingredients of successful implementation efforts, the examples highlight the fact that, even with a thorough knowledge of the literature and thoughtful planning, unexpected circumstances arise during implementation efforts that require flexibility and adaptability. The findings stress the importance of utilizing formative evaluation techniques to identify barriers to successful implementation and strategies to address these barriers.
Hagedorn
Hildi
H
Substance Use Disorders QUERI, Minneapolis VA Medical Center, Minneapolis, MN 55417, USA. Hildi.Hagedorn@va.gov
Hogan
Mary
M
Smith
Jeffrey L
JL
Bowman
Candice
C
Curran
Geoffrey M
GM
Espadas
Donna
D
Kimmel
Barbara
B
Kochevar
Laura
L
Legro
Marcia W
MW
Sales
Anne E
AE
D019985:Benchmarking; D019058:Community Networks / Q000458:organization & administration; D019317:Evidence-Based Medicine; D006302:Health Services Research; D006787:Hospitals, Veterans / Q000592:standards; D006801:Humans; D009294:Narcotics / Q000819:agonists / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000188:drug therapy; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians'; D017749:Total Quality Management; D014481:United States; D014493:United States Department of Veterans Affairs
D009294:Narcotics