title: Implementation of new clinical programs in the VHA healthcare system: the importance of early collaboration between clinical leadership and research.
abstract: Collaboration between policy, research, and clinical partners is crucial to achieving proven quality care. The Veterans Health Administration has expended great efforts towards fostering such collaborations. Through this, we have learned that an ideal collaboration involves partnership from the very beginning of a new clinical program, so that the program is designed in a way that ensures quality, validity, and puts into place the infrastructure necessary for a reliable evaluation. This paper will give an example of one such project, the Lung Cancer Screening Demonstration Project (LCSDP). We will outline the ways that clinical, policy, and research partners collaborated in design, planning, and implementation in order to create a sustainable model that could be rigorously evaluated for efficacy and fidelity. We will describe the use of the Donabedian quality matrix to determine the necessary characteristics of a quality program and the importance of the linkage with engineering, information technology, and clinical paradigms to connect the development of an on-the-ground clinical program with the evaluation goal of a learning healthcare organization. While the LCSDP is the example given here, these partnerships and suggestions are salient to any healthcare organization seeking to implement new scientifically proven care in a useful and reliable way.
authors.affiliation: Health Services Research & Development (HSR&D) Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, HSR&D Services (152), 508 Fulton Street, Durham, NC, 27705, USA, Ryanne.wu@duke.edu.
authors.forename: R Ryanne
authors.initials: RR
authors.lastname: Wu
authors.forename: Linda S
authors.initials: LS
authors.lastname: Kinsinger
authors.forename: Dawn
authors.initials: D
authors.lastname: Provenzale
authors.forename: Heather A
authors.initials: HA
authors.lastname: King
authors.forename: Patricia
authors.initials: P
authors.lastname: Akerly
authors.forename: Lottie K
authors.initials: LK
authors.lastname: Barnes
authors.forename: Santanu K
authors.initials: SK
authors.lastname: Datta
authors.forename: Janet M
authors.initials: JM
authors.lastname: Grubber
authors.forename: Nicholas
authors.initials: N
authors.lastname: Katich
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: McNeil
authors.forename: Robert
authors.initials: R
authors.lastname: Monte
authors.forename: Nina R
authors.initials: NR
authors.lastname: Sperber
authors.forename: David
authors.initials: D
authors.lastname: Atkins
authors.forename: George L
authors.initials: GL
authors.lastname: Jackson
mesh_terms: D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D055088:Early Detection of Cancer / Q000592:standards*; D019317:Evidence-Based Medicine / Q000458:organization & administration; D006284:Health Plan Implementation / Q000458:organization & administration*; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D008175:Lung Neoplasms / Q000175:diagnosis*; D016730:Program Development; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*