Research Enterprise Optimization

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Client:

Veterans Health Administration (VHA), Office of Research and Development (ORD)

Challenge:

VHA oversees a research budget totaling approximately $2.69 billion, of which $729 million is from Congressional appropriation for medical and prosthetic research and  $1.96B is from other Department of Veterans Affairs (VA) and non-VA sources (e.g., National Institutes of Health, foundations). These funds support over 7,300 research projects and 3,600 principal investigators at over 100 research sites nationwide. These sites provide the full range of translational research ―  starting with T1 (basic science to clinical application) progressing through T2 (clinical innovation to patient care) and achieving T3 (clinical evidence to consistent practice). Seeing as more than 60% of Principal Investigators are also clinicians, VHA’s research is intimately connected to Veterans’ clinical needs and the care system that serves them. Our team is working with ORD leaders and staff in the development and implementation of an integrated research enterprise architecture to support the seamless and effective implementation of the full range of translational research.

Approach:

The team provides ORD with healthcare research professionals that support a wide range of tasks associated with optimizing an integrated research enterprise. By possessing a deep understanding of ORD’s portfolio, our team can align the requisite talent needed to support time sensitive and evolving research activities. For example, PFS staff provided program and change management support for 108 Department of Veterans Affairs (VAMC) as they transition to the enterprise-wide research platform (IRBNet); provided organizational planning support for the establishment of the National Artificial Intelligence Institute (NAII);  provided data science and analytics support (including COVID-19 Master Study List); and assisted ORD in establishing governance and standardization for the Central Biorepository.

Results:

Highlights include of our team’s support includes:

  • Developed and is helping to implement the VA Innovation and Research Reviews System (VAIRRS) Strategic Communications Plan that to amplify tactical, educational, and promotional communications to VHA leaders and Field staff.
  • Produced analytics support to gauge success, progress, and impact of individual programs ― including customized dashboards ― for stakeholders from VHA’s research community, VA leaders, Veterans, and the public.
  • Established and optimized two governing bodies of the Central Biorepository to review and decide on specimen and data request proposals.
  • Conducted an audit of information technology (IT) resources to serve as a foundation of a future central ORD IT Service Catalog, ensuring comprehensive and cost-effective oversight of critical assets.
  • Assisted in the establishment of the National Artificial Intelligence Institute (NAII).

Women’s Health Evidence Based Quality Improvement

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Client:

Veterans Health Administration (VHA), Office of Women’s Health Services

 

Challenge:

More women are choosing VHA for their health care than ever before. Women account for over 30 percent of the increase in Veterans served over the past 5 years. Based on the upward trend of women in all military Services, the expected number of women Veterans using VHA health care will continue to rise. However, many VHA facilities lack adequate capacity to serve the growing women Veteran population. The VHA engaged our team to assist with evaluating current services and developing action plans to enhance services to ensure the best quality of care for women Veterans.

 

Approach:

Women Veterans’ Achieving Comprehensive Health Innovation and Enhancement for Women Veterans through Evidence-Based Quality Improvement (WV-ACHIEVE) is a new program which combines successful strategies from prior health care facility assessments and evidence-based quality improvement (EBQI) initiatives at VHA Women’s Health Programs (WHP) across the nation. Our team is conducting an analysis of WHP service enhancement opportunities, working with Department of Veterans Affairs Medical Center (VAMC) and Veteran Integrated Service Network leaders to select areas of EBQI focus, and facilitating implementation of QI initiatives. The upfront data-driven analysis is not an assessment, but rather a collaboration in the design of a QI approach that fits the needs of each facility. The EBQI methodology, applied during WV-ACHIEVE, is a top-down/bottom-up methodology that integrates practice-, system-, and region-level priorities.

 

Results:

The team has assisted VHA with improving women Veteran healthcare by:

  • Developing the EBQI Methodology ― The team worked with the Office of Women’s Health Services to develop and refine an EBQI methodology that can be deployed across all VAMCs. The methodology identifies and prioritizes challenges/improvement areas based on evidence. For the quantitative analysis the team uses data from VHA’s Clinical Data Warehouse (CDW) —Women’s Assessment Tool for Comprehensive Health (WATCH), Quality Performance Measures, Healthcare Access Data, Enrollment Data, Patient Aligned Care Team (PACT) Panel Reports, and Survey of Healthcare Experiences of Patients (SHEP).
  • Developing and supporting action plan implementations that impact women Veterans care ― The team has completed EBQI initiatives at 21 VAMCs to date. The QI initiatives resulted in decreased wait times for services, increased women Veteran health screenings, increased provider knowledge of women Veteran health topics, and facility and equipment modifications to better care for women Veterans.
  • Implementing plans for further EBQI initiatives ― In 2022, the team will work with an additional 21 VAMCs to address areas of QI through WV-ACHIEVE.