Center for Clinical Management Research (CCMR)

描述（由申请人提供）： 这是二十年来第二次，退伍军人健康管理局（VHA）正在经历一场重大变革。VA战略计划指导VHA变得更加以退伍军人为中心，利用技术更好地支持医疗保健服务，并提高其服务的810万退伍军人的适当性，安全性和护理效率。实现这些目标对于VHA在医疗成本上升和技术快速进步的时代保持其作为首要医疗保健系统的地位显然是必要的。随着医疗保健改革扩大了公民的选择，VHA必须成为一个医疗保健系统，在那里消息灵通的退伍军人选择获得他们的照顾。安阿伯临床管理研究中心（CCMR）拥有帮助VHA实现这些目标所需的专业知识、经验、基础设施、合作和伙伴关系。我们的愿景是通过研究和合作伙伴关系来提高退伍军人医疗保健的质量，有效性，安全性和效率，这些研究和合作伙伴关系是由临床管理中的重要挑战驱动的。 CCMR自1996年以来一直是HSR&D卓越中心，已经建立了必要的基础设施，以招募，指导和支持杰出的研究人员，促进具有高度影响力的研究，确保安全的研究实践，并发展持久的合作和伙伴关系。我们汇集了39名优秀的多学科核心研究人员，其中许多人是国家公认的专家，涉及广泛的学科，包括绩效测量，决策心理学，行为变化，系统设计，测量理论，健康技术和实施科学。我们的研究旨在对VHA产生可持续的临床和政策影响。因此，只要有可能，我们与我们的临床，政策和运营合作伙伴密切合作，因为我们首先制定研究思路和计划，并在整个项目中继续与他们合作，以帮助确保明确的实施路径和影响。我们的合作伙伴包括我们的VISN和VHA中央办公室的领导者，其中一些人资助了CCMR调查人员进行调查和评估，以推进其业务重点。 我们计划通过三个重点研究领域（FA）来改善VHA的临床管理：FA1：将个体患者临床数据和偏好纳入预测建模，决策支持工具和绩效指标，以提高护理的适当性和以退伍军人为中心。 在接下来的五年里，这项工作将开发方法和工具，帮助VHA开发和实施最先进的绩效管理系统，使患者和提供者能够针对常见的重要临床情况做出个性化的最佳护理决策。 FA2：开发，实施和评估基于系统的方法，以改善我们最脆弱，高风险和复杂患者的安全性和结果。 在接下来的五年里，我们的调查将 产生必要的工具，以系统地识别高风险患者的不良结果，识别和监测高风险的临床实践，并制定和实施基于系统的干预措施，以减轻风险和改善退伍军人的结果。 FA3：使用创新方法提高患者自我管理和治疗参与的有效性和效率。 在接下来的五年里，我们的研究将产生旨在提高自我管理和行为改变支持效率的资源，增加这些支持的可及性和有效性，并减少慢性疾病对退伍军人及其照顾者的不利影响。 总而言之，CCMR汇集了一批非常强大的调查人员和工作人员，以其专业知识，生产力和学科的协同组合而闻名。我们将共同进行创新研究，为我们国家退伍军人面临的常见且昂贵的临床管理挑战寻求解决方案。

DESCRIPTION (provided by applicant): For the second time in two decades, the Veterans Health Administration (VHA) is undergoing a major transformation. The VA Strategic Plan directs VHA to become more Veteran-centric, to use technology to better support health care delivery, and to improve appropriateness, safety, and efficiency of care for the 8.1 million Veterans it serves. Achieving these goals is clearly necessary for the VHA to retain its status as a premier healthcare system in the era of rising healthcare costs and rapid technology advancement. As health care reform broadens choices for citizens, VHA must become a healthcare system where well-informed Veterans choose to obtain their care. The Ann Arbor Center for Clinical Management Research (CCMR) has the expertise, experience, infrastructure, collaborations, and partnerships necessary to help VHA meet these goals. Our vision is to improve the quality, effectiveness, safety, and efficiency of Veteran's healthcare through research and partnerships that are driven by important challenges in clinical management. CCMR, an HSR&D Center of Excellence since 1996, has built the infrastructure necessary to recruit, mentor and support exceptional investigators, promote highly impactful research, ensure safe research practices, and develop enduring collaborations and partnerships. We have brought together 39 superb, multidisciplinary core investigators, many of whom are nationally recognized experts in a broad spectrum of disciplines, including performance measurement, decision-making psychology, behavioral change, systems design, measurement theory, health technology, and implementation science. Our research seeks to result in sustainable clinical and policy impacts in VHA. Thus, whenever possible, we work closely with our clinical, policy, and operations partners as we first develop research ideas and plans, and continue to work with them throughout the project to help ensure a clear path to implementation and impact. Our partners include leaders in our VISN and in VHA Central Office, several of whom have funded CCMR investigators to perform investigations and evaluations that advance their operational priorities. We plan to improve clinical management in VHA through three focused areas (FA) of research: FA1: To incorporate individual patient clinical data and preferences in predictive modeling, decision support tools, and performance measures that increase appropriateness and Veteran-centeredness of care. In the next five years, this work will develop the methods and tools to help VHA develop and implement a state-of-the-art performance management system that allows patients and providers to make individualized decisions about optimal care for common, important clinical situations. FA2: To develop, implement, and evaluate systems-based approaches to improve safety and outcomes for our most vulnerable, high-risk, and complex patients. In the next five years, our investigations will yield the tools necessary to systematically identify patients at high risk for poor outcomes, identify and monitor high-risk clinical practices, and develop and implement system-based interventions to mitigate risk and improve Veterans' outcomes. FA3: To use innovative approaches to improve the effectiveness and efficiency of patient self-management and treatment engagement. In the next five years, our research will produce resources designed to increase the efficiency of support for self-management and behavior change, increase the accessibility and effectiveness of these supports for Veterans, and decrease the adverse impacts of chronic disease on Veterans and their caregivers. In sum, CCMR has brought together an exceptionally strong group of investigators and staff notable for their expertise, productivity and synergistic mix of disciplines. Together, we will conduct innovative research that seeks solutions to common and costly clinical management challenges facing our nation's Veterans.