In 1998, VA's Health Services Research and Development Service launched the VA Quality Enhancement Research Initiative (QUERI). The QUERI mission is to enhance the quality and outcomes of VA health care by systematically implementing clinical research findings and evidence-based recommendations into routine clinical practice. In evaluating quality of care, the QUERI process focuses on three elements:

• structure (provider and organizational characteristics),
• process (providers’ clinical actions toward patients), and
• outcome (health status, economic impact, satisfaction).

QUERI is founded on the principle that practice needs determine the research agenda, and research results determine interventions that improve the quality of patient care.

Several QUERI studies have already produced significant findings that will improve patient care. To read more about these studies, please see the individual QUERI group web sites.

Crosscutting issues that pertain to all of the conditions QUERI focuses on are included in its specific aims.

• Integrate research, clinical, operational, and policy expertise to improve health care policy.
• Target high priority disease or health delivery issues.
• Evaluate interventions and provide feedback to encourage best practices.
• Develop risk-adjusted quality improvement activities for comparison with public/private health care systems.
• Identify gaps in knowledge and create new data to inform policy decisions.

QUERI is a comprehensive, data-driven, outcomes-based, quality improvement program that utilizes a six-step process to facilitate the implementation of research findings and evidence-based clinical practices to achieve better health care outcomes for veterans. QUERI integrates and disseminates this information on a continuous basis. Particular emphasis is given to the documentation of best practices, implementation strategies, and dissemination.

Steps in the QUERI process are:

1. Identify high-risk/high volume diseases or problems;
2. Identify best practices;
3. Define existing practice patterns and outcomes across VA and current variation from best practices;
4. Identify and implement interventions to promote best practices;
5. Document that best practices improve outcomes; and
6. Document that outcomes are associated with improved health-related quality of life.

The QUERI Program is part of the Health Services Research and Development program within the VA's Office of Research and Development. Dr. David Atkins is the QUERI Director and Associate Director for Health Services Research and Development.

Oversight to the program is provided by the QUERI Research and Methodology Committee (R&M), which provides input on strategic planning for QUERI and reviews the strategic plans and annual performance of each QUERI Center. The R&M Committee includes nationally prominent researchers, network representatives, and VHA Central Office clinical program leaders.

Participants in QUERI include researchers, clinicians, and managers, with strong collaboration among several offices in VA Central Office and field operations. For example, close cooperation with the Office of Quality and Performance, Patient Care Services, and the Office of Information is essential. In addition, each QUERI Center has an Executive Committee which helps develop and update their strategic plans, review planned projects, and provides input on current issues in the health care system that are related to their specific condition.

David Atkins, MD, MPH
QUERI Director
Washington, DC
(202) 461-1507
David.Atkins@va.gov

Linda McIvor, MHS, MS
QUERI Senior Program Manager
Washington, DC
(202) 461-1516
Linda.McIvor@va.gov

Guillaume Cheron
QUERI Administrative Assistant
Washington, DC
(202) 461-1518
Guillaume.Cheron@va.gov

Chronic Heart Failure

Paul Heidenreich, MD
Research Coordinator
Palo Alto, CA
tel: (650) 493-5000 x64069
e-mail: paul.heidenreich@va.gov

Barry Massie, MD
Clinical Coordinator
San Francisco, CA
tel: (415) 221-4810 x2691
e-mail:Barry.Massie@va.gov

Diabetes
Eve Kerr, MD, MPH
co-Research Coordinator
tel: (734) 761-2422
e-mail: ekerr@umich.edu

Sarah Krein, PhD, RN
co-Research Coordinator
Ann Arbor, MI
tel: (734) 845-3621
email: Sarah.Krein@va.gov

Leonard Pogach, MD
co-Clinical Coordinator
tel: (973)676-1000 ext 1693
e-mail: leonard.pogach@va.gov

David Aron, MD, MS
co-Clinical Coordinator
tel: (216) 421-3098
e-mail: David.Aron@va.gov

HIV/Hepatitis
Allen Gifford, MD
co-Research Coordinator
tel: (858) 552-8585 ext 7674
e-mail: agifford@ucsd.edu or allen.gifford@va.gov

Steven Asch, MD, MPH
co-Research Coordinator
tel: (310) 478-3711 ext 41425
e-mail: sasch@rand.org or steven.asch@va.gov

Matthew Goetz, MD
Clinical Coordinator
tel: (310) 268-3015
e-mail: matthew.goetz@va.gov

Ischemic Heart Disease
Stephan (Steve) Fihn, MD, MPH
Research Coordinator
tel: (206) 764-2651
e-mail: Stephan.Fihn@va.gov

John Rumsfeld, MD, PhD
Clinical Coordinator
tel: (303) 370-7575
e-mail: john.rumsfeld@va.gov

Mental Health
Richard Owen, MD
Research Coordinator
tel: (501) 257-1710
e-mail: owenrichardr@uams.edu or richard.owen2@va.gov

Stephen Marder, MD
Clinical Coordinator
tel: (310) 268-4359 or 3647
e-mail: stephen.marder@va.gov or marder@ucla.edu

Lisa V. Rubenstein, PhD
co-Clinical Coordinator
tel:(818) 895-9449
e-mail: lisar@rand.org

Polytrauma and Blast-Related Injuries

Nina Sayer, PhD
Research Coordinator
Minneapolis, MN
tel:(612) 467-4623
e-mail:Nina.Sayer@va.gov

Barbara Sigford, MD, PhD
co-Clinical Coordinator
Minneapolis, MN
tel:(612) 467-2044
e-mail:Barbara.Sigford@va.gov

Steven G. Scott, DO
co-Clinical Coordinator
Tampa, FL
tel:(813) 972-7506
e-mail:Steven.Scott@va.gov

Spinal Cord Injury
Frances Weaver, PhD
Research Coordinator
tel: (708) 202-2414 or 5866
e-mail: frances.weaver@va.gov

Barry Goldstein, MD
co-Clinical Coordinator
tel: (206) 768-5401 or (206) 764-2061
e-mail: barry.goldstein@va.gov

Margaret Hammond, MD
co-Clinical Coordinator
tel: (206) 764-2332 or (206) 768-5401
e-mail: margaret.hammond@va.gov

Stroke
Linda Williams, MD
Research Coordinator
Indianapolis, IN
tel: (317) 554-0000 x2887
e-mail: linwilli@iupui.edu

Dawn Bravata, MD
co-Clinical Coordinator
West Haven, CT
tel: (203) 932-5711 x2346
e-mail: dawn.bravata@va.gov

Linda Hershey, MD
co-Clinical Coordinator
Buffalo, NY
tel: (716) 862-3139
e-mail: linda.hershey@va.gov

Substance Use Disorders
Thomas R. Kosten, MD
Research Coordinator
tel: (713) 794-7032
e-mail: Kosten@bcm.tmc.edu or Thomas.kosten@va.gov

Daniel Kivlahan, PhD
co-Clinical Coordinator
tel: (206) 768-5483
e-mail: daniel.kivlahan@va.gov

Katharine Bradley, MD, MPH
co-Clinical Coordinator
tel: (206) 764-2082
e-mail: katharine.bradley@va.gov