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Quality Enhancement Research Initiative in Mental Health.

E P Fischer¹, S R Marder, G R Smith

¹VA HSR&D Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System and the Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock 72114, USA.

|June 8, 2000

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The Veterans Administration

Area of Science:

Health Services Research
Mental Health Services
Clinical Quality Improvement

Background:

The Veterans Administration (VA) established the Quality Enhancement Research Initiative (QUERI) to integrate evidence-based practices into routine care.
Major depressive disorder (MDD) and schizophrenia significantly impact over 20% of VA users, despite available effective treatments.
Gaps persist between optimal treatment standards and current clinical practice for these conditions within the VA system.

Purpose of the Study:

To outline the strategic plans developed by the Mental Health QUERI (MHQ) for improving care for MDD and schizophrenia.
To detail initiatives aimed at bridging the gap between best practices and actual clinical delivery for these mental health conditions.
To present the foundational elements and rationale for the MHQ's initial strategic approach to healthcare improvement.

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Main Methods:

Development of strategic plans by the MHQ focusing on MDD and schizophrenia.
Identification of critical steps for sustained, rapid-cycle healthcare improvement.
Integration of research, demonstration projects, information system enhancements, and dissemination strategies.

Main Results:

The MHQ strategic plans encompass research to address knowledge gaps in treatment best practices.
Demonstration projects are proposed to close practice gaps and enhance guideline implementation.
Enhancements to the VA information system and resource dissemination are key components for accelerating best practice adoption.

Conclusions:

The MHQ's strategic plan provides a framework for advancing mental health care quality within the VA.
A multi-faceted approach combining research, implementation science, and system support is crucial for improving care for MDD and schizophrenia.
The outlined strategies aim to accelerate the incorporation of evidence-based practices into routine VA clinical care.