The Leading Evaluations to Advance VA's Response to National Priorities (LEARN) Evidence-Based Policy Evaluation Center

背景和优先主题：严格的评估是循证决策的基础， 从而优化价值和运营效率。我们建议建立领先的评估 推动退伍军人事务部对国家优先事项(学习)循证政策评估中心的回应，该中心 将与退伍军人管理局领导人合作，设计并进行严格和响应性的评估，并传播 评估结果，以影响退伍军人政策和计划的持续改进。学有所为，学有所成 建设退伍军人管理局根据六个退伍军人管理局优先事项进行评价的能力：妇女健康倡议； 消除退伍军人无家可归方案的有效性和执行情况； 解决退伍军人健康差距和健康的社会决定因素；减少职业倦怠和改善 退伍军人管理局员工和实习生的经验和成果；虚拟护理的经验和质量 选择；以及电子健康记录的现代化。 具体目标：学习意愿：(1)设计符合退伍军人管理局高级领导层优先事项和 其他美国行政和立法领导人，与退伍军人管理局方案办公室和退伍军人事务部 与循证政策资源中心合作；(2)及时、严格地评估退伍军人政策 和计划，与计划合作伙伴和政策制定者合作，以满足 2018年《循证决策基础法案》；(3)支持退伍军人政策的持续改进 通过将评估结果和基于证据的建议传播给内部 和外部利益相关者；以及(4)扩大退伍军人管理局调查人员、工作人员和学术界的能力和专业知识 协作者设计和执行退伍军人事务部政策和计划的评估，并注意支持早期 职业调查员和扩大调查员的多样性、公平性和包容性。 方法：为了进行高影响力的评估，学习将利用由59名调查人员组成的广泛网络 是退伍军人管理局和学习协会学术分支机构中的主题和方法专家。学习还将建立在30多个 与20多个国家方案办公室合作多年的评价专业知识，在其总部位于 医疗创新、实施和政策(CSHIIP)。由学习型医疗保健系统指导 框架和QUERI路线图，LINE将使用退伍军人管理局的 强大的健康数据基础设施、快速定性分析和混合方法方法，可评估 实施、有效性、效率和总体影响(例如，预期和 退伍军人事务部政策和计划的意外后果)。与退伍军人管理局的战略计划保持一致，学习意志 评估政策或计划在多大程度上促进退伍军人管理局改善退伍军人接触、选择、 客户服务、信任、结果和健康公平，同时优化护理质量、运营效率和 促进供应商福祉和劳动力稳定。学习评估还将研究 跨团队和环境的实施和影响(例如，退伍军人和设施特征)、背景 可能影响这些差异的因素，以及促进政策或计划实施的战略。 学习还将在整个评估过程中与利益相关者进行沟通，并从他们那里接收反馈 进程。学习将同时指导一组不同的博士后研究员和早期职业生涯 调查人员，旨在培养退伍军人管理局调查员渠道，以进行严格和反应迅速的评估。 影响：了解评估将使退伍军人管理局和外部领导人积极参与立法和 行政部门利益攸关方参与丰富的政策讨论，以确保最佳利用退伍军人管理局资源，以满足 退伍军人的需求。将来自此类评估的知识整合到退伍军人管理局政策和计划决策中- 使退伍军人管理局的学习医疗系统能够进行循证的持续改进和 优化退伍军人管理局护理的创新。

Background and Priority Topics: Rigorous evaluation is foundational for evidence-based policymaking, which optimizes value and operational efficiencies. We propose to establish the Leading Evaluations to Advance VA’s Response to National Priorities (LEARN) Evidence-Based Policy Evaluation Center, which will partner with VA leaders to design and conduct rigorous and responsive evaluations, and disseminate evaluation findings, to influence continual improvements in VA policies and programs. LEARN will conduct and build VA’s capacity to perform evaluations aligned with six VA priorities: women’s health initiatives; effectiveness and implementation of programs to eliminate homelessness among Veterans; strategies to address Veteran health disparities and social determinants of health; reducing burnout and improving experience and outcomes among VA employees and trainees; Veteran experience and quality of virtual care options; and electronic health record modernization. Specific Aims: LEARN will: (1) design evaluation plans that respond to priorities of senior VA leadership and other United States executive and legislative leaders, in partnership with VA program offices and the VA Partnered Evidence-based Policy Resource Center; (2) conduct timely and rigorous evaluations of VA policies and programs, in partnership with program partners and policymakers, to fulfill core requirements of the Foundations for Evidence-based Policymaking Act of 2018; (3) support continual improvements in VA policies and programs through dissemination of evaluation results and evidence-based recommendations to internal and external stakeholders; and (4) expand capacity and expertise among VA investigators, staff, and academic collaborators to design and conduct evaluations of VA policies and programs, with attention to supporting early career investigators and expanding investigator diversity, equity, and inclusion. Methods: To conduct high-impact evaluations, LEARN will draw upon a broad network of 59 investigators who are topic and methods experts within VA and LEARN’s academic affiliates. LEARN will also build on over 30 years of partnered evaluation expertise, with over 20 national program offices, in its home at the Center for Healthcare Innovation, Implementation, and Policy (CSHIIP). Guided by the Learning Healthcare System framework and the QUERI Roadmap, LEARN will conduct partnered, theory-based evaluations, using VA’s robust health data infrastructure, rapid qualitative analyses, and mixed-method approaches, that assess the implementation, effectiveness, efficiency, and overall impacts (e.g., magnitude and scope of intended and unintended consequences) of VA policies and programs. Consistent with VA’s Strategic Plan, LEARN will assess the extent to which policies or programs advance VA’s goals of improving Veteran access, choice, customer service, trust, outcomes, and health equity, while optimizing care quality, operational efficiencies and promoting provider well-being and workforce stability. LEARN evaluations will also study variations in implementation and impacts across groups and settings (e.g., Veteran and facility characteristics), contextual factors that may influence these variations, and strategies for promoting policy or program implementation. LEARN will also communicate with, and receive feedback from, stakeholders throughout the evaluation process. LEARN will concurrently mentor a diverse group of post-doctoral fellows and early-career investigators, aiming to foster a VA investigator pipeline for conducting rigorous and responsive evaluations. Impact: LEARN evaluations will position VA and external leaders to proactively engage legislative and executive branch stakeholders in rich policy discussions to ensure the best use of VA resources to meet the needs of Veterans. With knowledge from such evaluations integrated into VA policy and program decision- making, the VA learning healthcare system can engage in evidence-based continual improvement and innovation that optimizes VA care.