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Optimizing Function & Independence QUERI

   

From left: Ashley Choate and Dr. Alyshia Smith

 From left: Dr. David Edelman, Ashley Choate, Dr. Nicki Hastings, Dr. Alyshia Smith, Dr. Ken Goldberg From left: Dr. Alyshia Smith and Dr. Nicki Hastings
Pictured above: The Function QUERI STRIDE Team accepting the 2022 National Diffusion Award!

Overview

The Function & Independence Quality Enhancement Research Initiative (Function QUERI) was launched in October 2016 as a series of projects to improve Veteran function and to promote the rapid translation of research findings into clinical practice. Function QUERI capitalizes on implementation strategies to promote flexibility in program design for ease of uptake by medical centers of various size and complexity. Function QUERI also aims to enhance function and unity of healthcare teams for most effective delivery of innovative practices.

Project Components

Function QUERI involves the implementation and evaluation of three distinct but related intervention projects:
  1. STRIDE - STRIDE is a supervised inpatient walking program designed to decrease length of hospital stay and increase likelihood of discharge from hospital to home.
  2. Caregivers FIRST (formerly iHI-FIVES) - Caregivers FIRST is a caregiver skills training program designed to increase days in the community (i.e. days not in a nursing home), facilitate Veteran independence, and decrease caregiver burden and depressive symptoms.
  3. Group PT - Group PT utilizes a group-based model of care delivery to improve knee function and osteoarthritis symptoms, aiming to improve patient satisfaction and access.

Methodology

Function QUERI is implementing STRIDE at 32 VA medical centers, Caregivers FIRST at 24 VA medical centers, and Group PT at 16 VA medical centers. The core implementation strategy, Replicating Effective Programs (REP), focuses on promoting flexibility of clinical programs to fit local environments for ease of uptake. 

Function QUERI aims to evaluate uptake based on the "dose" of implementation support offered to teams launching each clinical program. Each team will be provided with a foundational level of support, with resources like a program toolkit, self-paced webinars, and data tracking support. Sites will be randomized to an option for enhanced support if they are unable to get their programs off the ground during a six-month window.
 

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Operational Partners
  • VA Office of Geriatrics & Extended Care (GEC)
  • VA Caregiver Support Program (CSP)
  • VA Physical Medicine & Rehabilitation Service (PM&R)
  • VA Center for Development & Civic Engagement (CDCE)
  • VA Mid-Atlantic Health Care Network (VISN-6)
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