Durham Center of Innovation to ADAPT

Function & Independence QUERI

Overview

The Function and Independence Quality Enhancement Research Initiative (Function QUERI) (add executive summary link) was launched in October 2016 as a series of projects to optimize access to and quality of VA care by implementing and evaluating evidence-based clinical practices (EBPs) to maximize function and independence in vulnerable Veterans. Function QUERI's work directly addresses VA FY2022-2028 Strategic Plan priorities focused on improving quality, timeliness, equity, outcomes, and experience of care to meet the unique needs of Veterans; and QUERI’s goal to optimize Veteran access, quality, efficiency, experience, and equity of care across in-person, virtual, and community care services.

Project Components

Function QUERI’s clinical practices are aligned with VA national and operational partners’ goals and fill identified gaps in clinical care for conditions that increase risk of health-related functional decline in Veterans.

Function QUERI will focus on advancing three VA research tested programs to the next stage of implementation, with a focus on equitable reach:

1. Group physical therapy for knee osteoarthritis (Group PT) (grouppt@va.gov)
2. Mobile health supported behavioral treatment for urinary incontinence in women (MyHealtheBladder) (mhb@va.gov)
3. Cognitive behavioral therapy for insomnia: Sleep Well, Live Well (SWELL) (swell@va.gov)

Function QUERI Cores

Methodology

Guided by the QUERI Implementation Roadmap, Dynamic Sustainability Framework, and Health Equity Implementation Framework, Function QUERI will use Replicating Effective Programs (REP) as the foundational approach to support implementation of each EBP. Given the critical research gap of tailored strategies to promote program reach, we will leverage EBPs that have been sustained over time (STRIDE and Gerofit) to refine and test a novel bundle of strategies to advance reach in an equitable way (Reach + Equity).

National, VISN, & Local Operational Partners

National

1. VHA Office of Physical Medicine and Rehabilitation Service
2. VHA Office of Geriatrics and Extended Care
3. VHA Office of Women’s Health
4. VHA National Sleep Medicine Program
5. VHA Office of Connected Care
6. VHA Office of Innovation and Learning
7. VHA Office of Mental Health and Suicide Prevention
8. VA Women’s Health Practice-Based Research Network

VISN

1. VISN 6 Network Director
2. VISN 6 Dissemination/Implementation Specialist

Local

1. Durham VA Healthcare System

Newsletters

Our newsletters are used to foster best practices and collaboration among front-line providers, clinical leaders, researchers, and patients to maximize impact and ultimately improve health outcomes for Veterans.

Fall 2025 QUERI Newsletter

Spring 2025 QUERI Newletter

Fall 2024 QUERI Newsletter

Spring 2024 QUERI Newsletter

Mentoring Core

The goal of the Function QUERI Mentoring Core is to train the next generation of investigators focused on implementing and evaluating EBPs to maximize Veterans’ function and independence. Within the last 5 years, Function QUERI has supported 5 scholars including 4 HSR CDAs and 1 ADIL awardee, with 100% actively involved in operations and implementation research. The Mentoring Core is committed to enhancing the knowledge and practical skills of mentees so they can apply implementation science to improve VA healthcare.

Mentee activities:

1. Curate an individual development plan with your mentor through creating SMART goals to work towards during the 24-month program.
2. Take a lead role in developing one conference abstract and/or manuscript.
3. Serve as a co-author on at least one other scientific product.
4. Involvement with preparation of other dissemination products such as our Function QUERI newsletter. 
5. Participate in Function QUERI Mentoring Core Quarterly Check-Ins.

Dr. Lena Makaroun	Dr. Brystana Kaufman	Dr. Sadie Wilson	Dr. Lauren Abbate

Function QUERI Accomplishments To Date

Awards

Noteworthy Publications

  (Scan to access Zotero library of Function QUERI publications)

• Zullig LL, Drake C, Webster A, et al. Organizational Characteristics of Hospitals Meeting STRIDE Program Adoption Benchmarks to Support Mobility for Hospitalized Persons. Inquiry. 2024;61:469580241274030. doi:10.1177/00469580241274030
• Harris-Gersten, M., Franzosa, E., Decosimo, K., Webb, S., Anderson, L., Byrd, K., Webster, A., Tucker, M., Christensen, L., McKenzie, J. L., Schoeps, D., & Van Houtven, C. H. (2025). Empowering Older Veterans Through Self-Directed Care: A Mixed Methods Evaluation of a Technology Enabled Respite Homecare Model Pilot. Journal of Applied Gerontology, 0(0).
• Allen, K.D., Webb, S., Coffman, C.J., Anderson, L., Cummin, G., Drake, C., Tucker, M., Sperber, N., Zullig, L.L., Hughes, J.M., Ballengee, L., Abbate, L., Hoenig, H., Fullenkamp, N., Van Houtven, C.H., Hastings, S.N. (2025) Implementation of Group Physical Therapy for Knee Osteoarthritis: A Cluster Randomized Clinical Trial. JAMA Netw Open. 2025;8(10):e2535038. doi:10.1001/jamanetworkopen.2025.35038
• Kappler CB, Coffman CJ, Stechuchak KM, et al. Evaluation of strategies to support implementation of a hospital walking program: protocol for a type III effectiveness-implementation hybrid trial. Implement Sci Commun. 2024;5(1):8. Published 2024 Jan 12. doi:10.1186/s43058-024-00544-5
• Shepherd-Banigan M, Choi Y, Shapiro A, et al. Provider Perspectives on the Need for Child Care Assistance During Veteran Health Care Appointments. J Gen Intern Med. Published online April 23, 2025. doi:10.1007/s11606-025-09517-3
• Hastings SN, Stechuchak KM, Choate A, Van Houtven CH, Allen KD, Wang V, Colón-Emeric C, Jackson GL, Damush TM, Meyer C, Kappler CB, Hoenig H, Sperber N, Coffman CJ. Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial. Ann Intern Med. 2023 Jun 6. doi: 10.7326/M22-3679. Epub ahead of print. PMID: 37276590.
• Drake, C., Webb, S., Anderson, L., Cummin, G., Tucker, M., Webster, A., Sperber, N., Coffman, C.J., Fullenkamp, N., Zullig, L.L., Hughes, J.M., Hastings, S.N., Van Houtven, C.H., Abbate, L.M., Hoenig, H., Ballengee, L.A., Allen, K.D. Implementation context of outpatient physical therapy clinics preparing to launch a new evidence-based clinical program for knee osteoarthritis: Findings from a national multisite implementation trial. Archives of Physical Medicine and Rehabilitation, Accepted for Publication.
• Hughes JM, Zullig LL, Choate AL, et al. Intensification of Implementation Strategies: Developing a Model of Foundational and Enhanced Implementation Approaches to Support National Adoption and Scale-up. Gerontologist. 2023;63(3):604-613. doi:10.1093/geront/gnac130
• Webb, S., Drake, C., Coffman, C.J., Sullivan, C., Sperber, N., Tucker, M., Zullig, L.L., Hughes, J.M., Kaufman, B.G., Pura, J.A., Anderson, L., Hastings, S.N., Van Houtven, C.H., Abbate, L.M., Hoenig, H., Ballengee, L.A., Wang, V., Allen, K.D. (2023) Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial. Implementation Science Communications, 4, 125 (2023). https://doi.org/10.1186/s43058-023-00502-7
• Kaufman BG, Hastings SN, Meyer C, et al. The business case for hospital mobility programs in the veterans health care system: Results from multi-hospital implementation of the STRIDE program. Health Serv Res. 2024; 1-11. doi:10.1111/1475-6773.14307
• Van Houtven CH, Decosimo K, Coffman CJ, Kota S, Drake C, Sperber NR, Hughes JM, Zullig LL, Tucker M, Webster A, Franzosa E, Blok A, Chadduck T, Christensen L, Kaufman BG, Shepherd-Banigan M, Allen KD, Hastings SN. Evaluating two implementation approaches to support a nationally mandated caregiver skills training in Veterans Affairs: A type III hybrid implementation-effectiveness randomized controlled trial. Submitted to Implementation Science.

Rapid Response Team Projects

Rapid Response Team (RRT) projects address time sensitive national priorities. Below are projects (completed or in progress) that the Function QUERI team has supported.

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