Center of INovation for Complex Chronic Healthcare (CINCCH)

描述（由申请人提供）：

DESCRIPTION (provided by applicant): The mission of the Center for INnovation in Complex Chronic Healthcare (CINCCH) is to improve health care and outcomes for Veterans with complex chronic illnesses. We will accomplish this through research, mentorship and career development with the collaboration of operational and clinical partners. Veterans with complex chronic healthcare needs include those with multiple chronic illnesses (e.g., patients with neurological conditions and secondary conditions) or those with one or more condition who have complicated social situations and/or use multiple healthcare systems (e.g., dual Medicare and VA users). To improve care and outcomes for Veterans with complex chronic healthcare needs, CINCCH investigators will engage in activities to enhance the provision of patient-centered and evidence-based care and to identify new effective models of healthcare delivery. The Focused Areas for Research for CINCCH are to: 1) Improve patient-centeredness of care through new models of care and 2) Improve delivery of care for patients with neurological conditions. The first focused area of research directly addresses key VA transformational initiatives: provision of patient-centered care and use of new healthcare models for care delivery such as through technology. To achieve this goal, CINCCH investigators will conduct research to i) test new ways to deliver patient- centered care (e.g., through telehealth) and ii) enhance patient-centeredness of patient-provider communication (such as innovative patient and provider training). These projects are designed to develop and evaluate strategies, innovations and tools that ensure care is patient-centered and that have a measurable impact on patient outcomes. The second focused area of research will target Veterans with neurological conditions such as spinal cord injury and disorder (SCI/D), traumatic brain injury, and Parkinson's disease. These Veterans often have complex chronic care needs because they experience conditions secondary to their neurological condition (such as SCI/D-related pressure ulcers) and/or issues of coordination of care across providers and settings. To achieve this goal, we will conduct research to i) characterize, prevent, and improve management of secondary conditions associated with neurological conditions, ii) improve access to and coordination of care, and iii) improve healthcare practice in prevention and control of healthcare associated infections. To achieve these goals, CINCCH will partner with the Office of Patient Centered Care and Cultural Transformation (OPCC&CT) and with SCI/D Services. The partnership with the OPCC&CT will be key in ensuring that the COIN's research advances the VA's transformational initiatives. The partnership with SCI/D Services represents a long-standing and fruitful relationship with CINCCH investigators that has developed over the past 14 years in conjunction with the SCI QUERI, which is also based at Hines VA and includes many of the investigators who will participate in the COIN. This partnership will ensure implementation of key findings in this vulnerable population of Veterans. Overall, through innovative research and key partnerships, CINCCH will build on almost 30 years of experience and accomplishments by investigators from our VA HSR&D program to conduct research that will remain at the forefront of efforts to improve health care for our Veterans.