Center for the Study of Healthcare Innovation, Implementation and Policy

描述(由申请人提供)： 背景/理论基础：VA大洛杉矶币，即VA HSR&D医疗创新、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，以及我们为建立高影响力研究的新途径而取得的理论和实证进展。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，以显着提高退伍军人管理局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，以加速有效卫生保健的多层次采用、实施、传播和可持续性。我们的战略目标是：#1(重点领域)：通过开发和研究退伍军人事务部以患者为中心的医疗之家(PACT)的创新，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，加快实施和获得对女退伍军人的高质量全面护理；#3(重点领域)：开展研究，系统地改善对弱势人群的护理，包括严重精神疾病的护理、老年人的护理和姑息护理；#4：利用研究推动新兴领域基于证据的实践和政策(例如，医疗服务基因组学、传染病、应急管理和综合医学)；#5：招募、培训和指导硬币公认的专业领域的研究人员，包括交叉方法(例如，卫生系统干预、实施科学、面向合作伙伴的研究)；以及#6：在合作的、面向系统的研究的开发、实施、实施和传播方面促进跨医疗中心和VISN的研究协作。方法：该中心的组织是为了最大限度地发挥我们研究在医疗保健和教育方面的影响。与退伍军人健康管理局(VHA)的战略框架保持一致，我们利用研究-临床合作伙伴关系为退伍军人提供以证据为基础并不断改进的个性化、主动性和以患者为导向的医疗保健。我们坚定地继续致力于培训下一代退伍军人健康服务研究人员，同时在我们的专业领域提供国家认可的先进方法方面的专业知识，以及多站点和多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，我们充分利用了我们对提供商和组织行为背后的因素的深刻理解。当缺乏数据时，我们的研究活动开始于确定患者、提供者和组织对护理差异的决定因素。基于这些结果，我们开发和评估了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，评估实施和推广循证做法的战略，以改善退伍军人管理局护理的影响和价值。

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.