Quality Enhancement Research Initiative Implementation Roadmap

Kilbourne, Amy M.; Goodrich, David E.; Miake-Lye, Isomi M; Braganza, Melissa Z.; Bowersox, Nicholas W.

doi:10.1097/mlr.0000000000001144

Cited by 93 publications

(71 citation statements)

References 44 publications

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“…Another VHA initiative called Quality Enhancement Research Initiative (QUERI) is an internally-funded program to help the VHA translate research into practice more quickly and efficiently than traditional knowledge translation [ 45 , 47 , 48 ]. Four priority research projects were: 1) home- and community-based care for Veterans at risk of nursing home placement, 2) risk mitigation for patients receiving opioid prescriptions, 3) targeting care for patients at high risk for suicide, and 4) a telehealth tool to improve access to dermatology services.…”

Section: Resultsmentioning

confidence: 99%

Learning health systems in primary care: a systematic scoping review

et al. 2021

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Background Learning health systems have been gaining traction over the past decade. The purpose of this study was to understand the spread of learning health systems in primary care, including where they have been implemented, how they are operating, and potential challenges and solutions. Methods We completed a scoping review by systematically searching OVID Medline®, Embase®, IEEE Xplore®, and reviewing specific journals from 2007 to 2020. We also completed a Google search to identify gray literature. Results We reviewed 1924 articles through our database search and 51 articles from other sources, from which we identified 21 unique learning health systems based on 62 data sources. Only one of these learning health systems was implemented exclusively in a primary care setting, where all others were integrated health systems or networks that also included other care settings. Eighteen of the 21 were in the United States. Examples of how these learning health systems were being used included real-time clinical surveillance, quality improvement initiatives, pragmatic trials at the point of care, and decision support. Many challenges and potential solutions were identified regarding data, sustainability, promoting a learning culture, prioritization processes, involvement of community, and balancing quality improvement versus research. Conclusions We identified 21 learning health systems, which all appear at an early stage of development, and only one was primary care only. We summarized and provided examples of integrated health systems and data networks that can be considered early models in the growing global movement to advance learning health systems in primary care.

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Section: Resultsmentioning

confidence: 99%

Learning health systems in primary care: a systematic scoping review

et al. 2021

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“…The implementation plan ensures that leadership endorses the clinical intervention and that if proven effective, the intervention is feasible for implementation by existing providers who are not paid on the research trial. The implementation plan is based on the QUERI Implementation Roadmap22 and the hybrid effectiveness-implementation designs,23 which were developed to operationalize patient, provider, and leader involvement by incorporating implementation science methods and measures 14…”

Section: Resultsmentioning

confidence: 99%

Research Lifecycle to Increase the Substantial Real-world Impact of Research

et al. 2019

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Background: US health care systems face a growing demand to incorporate innovations that improve patient outcomes at a lower cost. Funding agencies increasingly must demonstrate the impact of research investments on public health. The Learning Health System promotes continuous institutional innovation, yet specific processes to develop innovations for further research and implementation into real-world health care settings to maximize health impacts have not been specified. Objective: We describe the Research Lifecycle and how it leverages institutional priorities to support the translation of research discoveries to clinical application, serving as a broader operational approach to enhance the Learning Health System. Methods: Developed by the US Department of Veterans Affairs Office of Research and Development Research-to-Real-World Workgroup, the Research Lifecycle incorporates frameworks from product development, translational science, and implementation science methods. The Lifecycle is based on Workgroup recommendations to overcome barriers to more direct translation of innovations to clinical application and support practice implementation and sustainability. Results: The Research Lifecycle posits 5 phases which support a seamless pathway from discovery to implementation: prioritization (leadership priority alignment), discovery (innovation development), validation (clinical, operational feasibility), scale-up and spread (implementation strategies, performance monitoring), and sustainability (business case, workforce training). An example of how the Research Lifecycle has been applied within a health system is provided. Conclusions: The Research Lifecycle aligns research and health system investments to maximize real-world practice impact via a feasible pathway, where priority-driven innovations are adapted for effective clinical use and supported through implementation strategies, leading to continuous improvement in real-world health care.

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“…The Roadmap also builds upon the emerging implementation strategy literature, which has significantly advanced much of the “how to” of implementation, specifically in developing and defining theoretically-informed frameworks for identifying determinants of implementation success as well as strategies for improving EBI uptake. Notably, the Veterans Health Administration's QUERI Implementation Roadmap was developed to demystify implementation science and encourage active partnerships between implementers, health care leaders, and practitioners ( 13 ). The MIP Roadmap intends to accomplish similar goals with a specific focus on the challenges facing non-implementation scientists, both researchers and community partners, working in community-based settings.…”

Section: Discussionmentioning

confidence: 99%

“…Implementation Roadmaps aim to increase the efficiency of real-world implementation efforts by outlining, in advance, the different stages of the implementation process and identifying the actions practitioners might want to take to anticipate, accommodate, and/or alleviate barriers to successful EBI deployment. The Quality Enhancement Research Initiative (QUERI) Implementation Roadmap illustrates how a Roadmap can act as a researcher-community implementation guide, demonstrating the utility of this tool (13). A welldesigned Implementation Roadmap can help bridge the gap between implementation scientists and practitioners by leveraging implementation science expertise to help demystify the implementation process (14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

A Roadmap to Inform the Implementation of Evidence-Based Collaborative Care Interventions in Communities: Insights From the Michigan Mental Health Integration Partnership

Rusch

DeCamp

Liebrecht

et al. 2021

Front. Public Health

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Background: Despite increasing calls for further spread of evidence-based collaborative care interventions (EBIs) in community-based settings, practitioner-driven efforts are often stymied by a lack of experience in addressing barriers to community-based implementation, especially for those not familiar with implementation science. The Michigan Mental Health Integration Partnership (MIP) is a statewide initiative that funds projects that support implementation and uptake of EBIs in community-based settings. MIP also provides an in situ implementation laboratory for understanding barriers to the uptake of EBIs across a variety of settings. We report findings from a statewide qualitative study of practitioners involved in MIP projects to garner their perspectives of best practices in the implementation of EBIs.Methods: Twenty-eight semi-structured interviews of practitioners and researchers from six MIP Projects were conducted with individuals implementing various MIP EBI projects across Michigan, including stakeholders from project teams, implementation sites, and the State of Michigan, to identify common barriers, challenges, and implementation strategies deployed by the project teams, with the purpose of informing a set of implementation steps and milestones.Results: Stakeholders identified a number of barriers to and strategies for success, including the need for tailoring program deployment and implementation to specific site needs, development of web-based tools for facilitating program implementation, and the importance of upper-level administration buy-in. Findings informed our resultant community-based Implementation Roadmap, which identifies critical steps across three implementation phases—pre-implementation, implementation, and sustainability—for implementation practitioners to use in their EBI implementation efforts.Conclusion: Implementation practitioners interested in community-based EBI implementation often lack access to operationalized implementation “steps” or “best practices” that can facilitate successful uptake and evaluation. Our community-informed MIP Implementation Roadmap, offering generalized steps for reaching successful implementation, uses experiences from a diverse set of MIP teams to guide practitioners through the practices necessary for scaling up EBIs in community-based settings over pre-implementation, implementation and sustainability phases.

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Quality Enhancement Research Initiative Implementation Roadmap

Abstract: Special thanks to our operational partners in the Office of Mental Health Operations for the use of their materials in this manual. We also thank Robin Smith, PhD, for her editorial role in the production of the manual.

Cited by 93 publications

References 44 publications

Learning health systems in primary care: a systematic scoping review

Learning health systems in primary care: a systematic scoping review

Research Lifecycle to Increase the Substantial Real-world Impact of Research

A Roadmap to Inform the Implementation of Evidence-Based Collaborative Care Interventions in Communities: Insights From the Michigan Mental Health Integration Partnership

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