Center for the Study of Healthcare Innovation, Implementation and Policy

描述（由申请人提供）： 背景/基本原理：VA 大洛杉矶 COIN，即 VA HSR&D 医疗保健创新、实施和政策研究中心 (CSHIIP)，借鉴了我们 20 年来对医疗保健提供者行为的关注以及由此产生的理论和实证进展，以建立高影响力研究的新途径。我们的使命是开发和测试创新的护理模式和卫生系统干预措施，从而显着提高 VA 医疗保健的有效性和价值。 目标：我们的目标是推进科学方法，加速有效医疗保健的多层次采用、实施、传播和可持续性。我们的战略目标是：#1（重点领域）：通过开发和研究 PACT 创新，在 VA 以患者为中心的医疗之家 (PACT) 的背景下改善初级保健实践的提供和绩效； #2（重点领域）：通过妇女健康创建和相关研究，加速为女性退伍军人实施和获得高质量的综合护理； #3（重点领域）：开展研究，系统地改善弱势群体的护理，包括严重精神疾病的护理、老年人的护理和姑息治疗； #4：利用研究推进新兴领域（例如卫生服务基因组学、传染病、应急管理和综合医学）的循证实践和政策； #5：招募、培训和指导 COIN 公认的专业领域的研究人员，包括跨领域方法（例如卫生系统干预、实施科学、面向合作伙伴的研究）； #6：促进医疗中心和 VISN 之间的研究合作，以开发、开展、实施和传播面向系统的合作研究。 方法：该中心的组织目的是最大限度地发挥我们的研究对医疗保健和教育的影响。 根据退伍军人健康管理局 (VHA) 战略框架，我们利用研究与临床合作伙伴关系，为退伍军人提供个性化、主动且以患者为导向的医疗保健，这种医疗保健以证据为基础并不断改进。我们坚定地持续致力于培训下一代 VA 卫生服务研究人员，同时在我们的专业领域提供国家认可的先进方法专业知识，以及多地点和多 VISN 研究合作，以支持合作的、以实施为导向的研究。在我们的研究中，我们利用了对提供商和组织行为背后因素的深刻理解。当缺乏数据时，我们的研究活动开始于描述护理变化的患者、提供者和组织决定因素。根据这些结果，我们开发和评估新的护理模式和创新，以改善护理。当机会出现时，我们转向实施研究，评估实施和传播循证实践的策略，以提高 VA 护理的影响和价值。

DESCRIPTION (provided by applicant): Background/Rationale: The VA Greater Los Angeles COIN, the VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), draws from our 20 year focus on healthcare provider behavior and the resulting theoretical and empirical advances we have made to build new pathways to high- impact research. Our mission is to develop and test innovative care models and health systems interventions which markedly improve the effectiveness and value of VA healthcare. Objectives: We aim to advance scientific methods for accelerating multi-level adoption, implementation, spread and sustainability of effective health care. Our strategic goals are: #1 (Focused Area): To improve the delivery and performance of primary care practice in the context of VA's patient-centered medical home (PACT) by developing and studying PACT innovations; #2 (Focused Area): To accelerate implementation of and access to high-quality comprehensive care for women Veterans through the Women's Health CREATE and related research; #3 (Focused Area): To conduct research that systematically improves the care of vulnerable populations, including care for serious mental illness, care for older adults, and palliative care; #4: To use research to advance evidence-based practice and policy in emerging areas (e.g., health services genomics, infectious diseases, emergency management, and integrative medicine); #5: To recruit, train and mentor researchers in the COIN's recognized areas of expertise, including cross- cutting methods (e.g., health systems intervention, implementation science, partner-oriented research); and, #6: To promote research collaboration across medical centers and VISNs in the development, conduct, implementation and spread of partnered, systems-oriented research. Methods: This Center is organized to maximize the impacts of our research on health care and education. Aligned with the Veterans Health Administration (VHA) strategic framework, we use research-clinical partnerships to provide Veterans with personalized, proactive and patient-driven health care that is evidence- based and continuously improving. We have a strong continuing commitment to training the next generation of VA health services researchers while providing nationally recognized expertise in advanced methods in our areas of expertise, as well as multi-site and multi-VISN research collaboration in support of partnered, implementation-oriented research. In our research, we leverage our deep understanding of the factors underlying provider and organizational behavior. Our research activities begin, when data are lacking, by characterizing patient, provider and organizational determinants of variations in care. Based on these results, we develop and evaluate new care models and innovations to improve care. When opportunities arise, we move to implementation research that evaluates strategies for implementation and spread of evidence-based practices to improve the impact and value of VA care.