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Cited by 176Health Policy Implementation ScienceHealth Sciences Research and EducationHealthcare Quality and Management

Overview of the VA Quality Enhancement Research Initiative (QUERI) and QUERI theme articles: QUERI Series

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Stetler, Cheryl B, Mittman, Brian S, Francis, Joseph·2008·Implementation Science
DOI 10.1186/1748-5908-3-8PMC PMC2289837
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Abstract

BACKGROUND: Continuing challenges to timely adoption of evidence-based clinical practices in healthcare have generated intense interest in the development and application of new implementation methods and frameworks. These challenges led the United States (U.S.) Department of Veterans Affairs (VA) to create the Quality Enhancement Research Initiative (QUERI) in the late 1990s. QUERI's purpose was to harness VA's health services research expertise and resources in an ongoing system-wide effort to improve the performance of the VA healthcare system and, thus, quality of care for veterans. QUERI in turn created a systematic means of involving VA researchers both in enhancing VA healthcare quality, by implementing evidence-based practices, and in contributing to the continuing development of implementation science. The efforts of VA researchers to improve healthcare delivery practices through QUERI and related initiatives are documented in a growing body of literature. The scientific frameworks and methodological approaches developed and employed by QUERI are less well described. A QUERI Series of articles in Implementation Science will illustrate many of these QUERI tools. This Overview article introduces both QUERI and the Series. METHODS: The Overview briefly explains the purpose and context of the QUERI Program. It then describes the following: the key operational structure of QUERI Centers, guiding frameworks designed to enhance implementation and related research, QUERI's progress and promise to date, and the Series' general content. QUERI's frameworks include a core set of steps for diagnosing and closing quality gaps and, simultaneously, advancing implementation science. Throughout the paper, the envisioned involvement and activities of VA researchers within QUERI Centers also are highlighted. The Series is then described, illustrating the use of QUERI frameworks and other tools designed to respond to implementation challenges. CONCLUSION: QUERI's simultaneous pursuit of improvement and research goals within a large healthcare system may be unique. However, descriptions of this still-evolving effort, including its conceptual frameworks, methodological approaches, and enabling processes, should have applicability to implementation researchers in a range of health care settings. Thus, the Series is offered as a resource for other implementation research programs and researchers pursuing common goals in improving care and developing the field of implementation science.

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  • Current conceptions of research designs fail to maximize clinical utility for practicing clinicians and other decision makers, for example through a failure to focus on external validity or implementation-related barriers and facilitators to routine use and sustainability of effective practices.

    “In addition, it has been suggested that current conceptions of research designs fail to “maximize clinical utility for practicing clinicians and other decision makers”18; for example, through a failure to focus on external validity or implementation-related barriers and facilitators to routine use and sustainability of “effective” practices.4,21,22”

    From Effectiveness-implementation Hybrid Designs: Combining Elements of Clinical Effectiveness and Implementation Research to Enhance Public Health Impact (2012) · cites this paper as [22]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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  • Implementation research is focused on the adoption or uptake of clinical interventions by providers and/or systems of care, and its research outcomes are usually provider and/or system behaviors such as levels and rates of adoption and fidelity.

    “In contrast, implementation research is focused on the adoption or uptake of clinical interventions by providers and/or systems of care2,22,26; and research outcomes are usually provider and/or system behaviors, for example, levels and rates of adoption and fidelity to the clinical intervention.”

    From Effectiveness-implementation Hybrid Designs: Combining Elements of Clinical Effectiveness and Implementation Research to Enhance Public Health Impact (2012) · cites this paper as [22]

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Authors
Stetler, C. B., Mittman, B. S., & Francis, J.
Affiliations
  • Center for the Study of Healthcare Provider Behavior (US)
  • United States Department of Veterans Affairs (US)
Corresponding author
Stetler, Cheryl B
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2008-02-15
Volume
3
Issue
1
Pages
8-8
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/1748-5908-3-8
PMC
PMC2289837
OpenAlex
W1985620951
Cited by
176
References
51
Citations by year
2026: 5 · 2025: 8 · 2024: 6 · 2023: 5 · 2022: 6 · 2021: 8 · 2020: 12 · 2019: 9 · 2018: 8 · 2017: 7 · 2016: 7 · 2015: 5 · 2014: 16 · 2013: 11 · 2012: 11
FWCI
33.52
Type
journal article
Language
en
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
U.S. Department of Veterans Affairs
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
Keywords
evidence-based practice adoption, Veterans Affairs healthcare system, quality improvement, implementation framework, quality gap, health services research

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