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The Consolidated Framework for Implementation Research (CFIR) is a practical theory-based guide for systematically assessing potential barriers to and facilitators of implementation of evidence-based practices. It guides tailoring of implementation strategies and adaptations for the innovation being implemented and can help explain outcomes.
LEAP is designed to engage frontline teams in quality improvement (QI) within the demands of everyday clinical practice. By the end of the LEAP program, teams complete a project with the support of a coach and with a learning community comprised of other teams.
LEAP has been chosen to be one of the first 75 innovations featured on the VA Diffusion Marketplace’s new public-facing website. The Marketplace is a centralized repository of novel best and evidence-based practices across VA to help spread innovations more broadly. Diffusion Marketplace: LEAP
The VA Colonoscopy Collaborative includes creation of the largest, linked, longitudinal national endoscopic database in the United States, which leverages big data to: (1) measure and report colonoscopy quality; and (2) develop and validate a risk prediction model for colorectal cancer and high-risk polyps. Researchers can utilize their four-step framework to leverage big data for research and quality improvement purposes.
We developed a short geriatric assessment scale (< 10 minutes) that can be administered by surgical, non-physician staff to estimate the risk of postsurgical complications, including traditional postoperative occurrences, as well as novel geriatric outcomes such as delirium and falls. The tool can be used to identify patients in need of close monitoring.
We developed and validated a clinical decision score to identify patients likely to experience benefits of intensive blood pressure treatment (e.g., less chance of having a heart attack, stroke, etc.) and unlikely to experience harms (e.g., kidney failure). The score was developed from SPRINT trial data and tested using both SPRINT and ACCORD-BP trial data. Code for replication (in R): github.com/sanjaybasu/sprint-challenge. This work was awarded third place in the 2017 SPRINT data analysis challenge from 143 submissions.
The iCanDecide web site is an interactive and tailored breast cancer treatment tool, which focuses on knowledge building and values clarification. Our research showed the tool positively affected high quality decisions largely by improving knowledge compared with static online information.
This is a nation-wide dataset at the patient-day level, which provides data on day-by-day physiology. The statistical code to extract and clean laboratory values in the dataset has been published on Github. https://github.com/CCMRcodes/VAPD. Our VA collaborators in Salt Lake City are already using the Github code in their research. Examples of potential uses of this dataset include: finding patterns of patients at increased risk for recurrent infections, and finding patients at risk for inappropriate discontinuation of statins and anti-psychotics.
WeCareAdvisor is designed to educate and provide detailed assistance to families based on non- pharmacological behavior methodology. The tool provides information about dementia, daily tips, and treatment plans consisting of management tips tailored to symptom presentation. More information is available at Home | WeCareAdvisor Study