title: Accelerating Research Impact in a Learning Health Care System: VA's Quality Enhancement Research Initiative in the Choice Act Era.
abstract: Since 1998, the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI) has supported more rapid implementation of research into clinical practice.
  
  
  
  With the passage of the Veterans Access, Choice and Accountability Act of 2014 (Choice Act), QUERI further evolved to support VHA's transformation into a Learning Health Care System by aligning science with clinical priority goals based on a strategic planning process and alignment of funding priorities with updated VHA priority goals in response to the Choice Act.
  
  
  
  QUERI updated its strategic goals in response to independent assessments mandated by the Choice Act that recommended VHA reduce variation in care by providing a clear path to implement best practices. Specifically, QUERI updated its application process to ensure its centers (Programs) focus on cross-cutting VHA priorities and specify roadmaps for implementation of research-informed practices across different settings. QUERI also increased funding for scientific evaluations of the Choice Act and other policies in response to Commission on Care recommendations.
  
  
  
  QUERI's national network of Programs deploys effective practices using implementation strategies across different settings. QUERI Choice Act evaluations informed the law's further implementation, setting the stage for additional rigorous national evaluations of other VHA programs and policies including community provider networks.
  
  
  
  Grounded in implementation science and evidence-based policy, QUERI serves as an example of how to operationalize core components of a Learning Health Care System, notably through rigorous evaluation and scientific testing of implementation strategies to ultimately reduce variation in quality and improve overall population health.
authors.affiliation: *US Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, Washington, DC †Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI ‡VA Center for Healthcare Organization and Implementation Research and Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA §VA Ann Arbor Center for Clinical Management Research ∥Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: A Rani
authors.initials: AR
authors.lastname: Elwy
authors.forename: Anne E
authors.initials: AE
authors.lastname: Sales
authors.forename: David
authors.initials: D
authors.lastname: Atkins
mesh_terms: D002755:Choice Behavior; D003695:Delivery of Health Care; D019317:Evidence-Based Medicine; D006078:Government Programs; D006297:Health Services Accessibility; D006801:Humans; D058996:Quality Improvement; D011787:Quality of Health Care; D012106:Research; D014481:United States; D014493:United States Department of Veterans Affairs; D058014:Veterans Health