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Improving performance through knowledge translation in the Veterans Health Administration
Joseph Francis1, Jonathan B Perlin
1Health Services Research and Development, Department of Veterans Affairs, Washington, DC, USA. joe.francis@va.gov
Summary
The Veterans Health Administration (VA) links research, technology, and performance measurement for quality improvement. Effective knowledge translation requires relevant evidence, studying implementation, and direct researcher-leader engagement.
Area of Science:
- Health Services Research
- Knowledge Translation
- Health System Quality Improvement
Background:
- The Veterans Health Administration (VA) is a large, complex health system.
- Linking performance measurement, information technology, and research is crucial for quality improvement.
Purpose of the Study:
- To examine how the VA facilitates quality improvement through integrated research and performance measurement.
- To identify key lessons for knowledge translation in large health systems.
Main Methods:
- Analysis of structured and informal dialogues between clinical researchers and VA leaders.
- Review of VA's engagement with policymaking bodies for clinical guidelines and performance measures.
- Examination of knowledge translation strategies within the VA system.
Main Results:
- VA utilizes structured initiatives (e.g., Quality Enhancement Research Initiative) and informal work groups for evidence implementation.
- Direct researcher access to policymakers and clinical leaders is vital for effective knowledge translation.
- Both top-down and bottom-up approaches are necessary for system-wide evidence integration.
Conclusions:
- Research must generate clinically relevant evidence tailored to patient populations.
- Studying the implementation process enhances a health system's performance improvement capabilities.
- Future VA knowledge translation needs to adapt to evolving care settings and veteran needs, requiring new evidence forms and direct veteran engagement.
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