Welcome

VA's Health Services Research and Development Service (HSR&D), works to identify and evaluate innovative strategies that lead to accessible, high quality, cost-effective care for veterans and the nation. HSR&D provides core funding to fifteen Centers of Excellence (COEs). Each COE develops its own research agenda, is affiliated with a VA Medical Center and collaborates with local schools of public health and universities to carry out its mission.

The Ann Arbor COE focuses on clinical practice management issues for those conditions that account for a large proportion of the costs and preventable morbidity and mortality in VHA. The main audience for our research is the facility-level and network-level clinical managers who must focus most of their time on those conditions that are the most common, treatable and costly, leaving less common conditions and nuances of care to subspecialty leaders working within well designed systems that the clinical managers have helped shape. As such, we do not consider any specific diseases or conditions central to our research focus, but rather our research is driven by issues in performance measurement, decision-making support, self-management support and clinical management and delivery systems that are important for disease and practice management more generally. In fact, we make a concerted effort to examine important issues across multiple diseases to better understand the generalizability and variability of the phenomena we study.

We separate our priority area of clinical practice management into three research foci:

1.  To improve our understanding of how to measure, monitor and understand quality and efficiency for a patient population with substantial disease burden;
2.  To rigorously examine alternative and innovative systems and strategies for efficiently improving quality and outcomes for common serious and chronic illnesses; and
3.  To develop and apply improved methodologies for informing policy makers regarding heterogeneity in the effectiveness and safety of proposed interventions and for assessing barriers to the implementation of high-priority care.

The Ann Arbor COE contains four programs, each focusing on a different aspect of health services research. These areas of study include diabetes (QUERI-DM), serious mental illness, health care decisions, and patient safety.  A description of each of these programs is provided below.

QUERI-DM
Since Spring 1998, the Ann Arbor HSR&D Center of Excellence has served as the Research Coordinating Center for the Quality Enhancement Research Initiative - Diabetes Mellitus (QUERI-DM).  The overall goal of QUERI-DM is to reduce rates of preventable morbidity and mortality among veterans with diabetes.  Within this overarching goal, we have identified several specific priority areas on which to focus.  These priority areas include:  (1) optimizing management of cardiovascular risk factors to prevent cardiovascular complications and mortality; (2) decreasing rates of other diabetes-related complications, with particular emphasis on prevention of visual loss, lower-extremity ulcers and amputation, and renal disease; (3) improving patient self-management; and (4) better management of patients with diabetes and other chronic co-morbid conditions.  In addition, QUERI-DM is actively engaged in work to advance clinically meaningful quality and performance measurement both for directly promoting quality improvement and for assessing the results of quality improvement interventions.  Click QUERI-DM for additional information.

National Serious Mental Illness Treatment Research and Evaluation Center (SMITREC)
In addition to conducting a number of funded studies, SMITREC receives funds from VA Mental Health and Behavioral Science Service to carry out projects, including several national patient registries, of system-wide interest to VHA.  Additional information can be found at SMITREC.

Center for Behavioral and Decision Sciences in Medicine (CBDSM)
In July 2005, the former Program for Improving Health Care Decisions (PIHCD) expanded to become the Center for Behavioral and Decision Sciences in Medicine (CBDSM), a Medical School-wide research center.  Established in 2000 by Peter Ubel (1998 ARCDA), MD, CBDSM is an interdisciplinary research center jointly sponsored by the VA Center for Clinical Management Research and the University of Michigan.  CBDSM researchers examine health behavior and health care decision making from many perspectives (including patients, physicians, and policy makers), with the goal of improving health care policy and health care practice.  The Center's Web site can be found at www.cbdsm.org .

VA/UM Patient Safety Program
Tim Hofer, MD, and Sanjay Saint, MD, direct the VA/UM Patient Safety Program, which was established with funds from AHRQ in 2001.  The overall goal of the Program is to assemble interdisciplinary teams of investigators, and mentor junior clinician investigators, to conduct creative, high impact research in the following areas:  (1) preventing hospital and nursing home adverse events; (2) enhancing patient safety in ambulatory care; (3) improving medical decision making by physicians and patients as an error reduction strategy; and (4) improving our understanding of the reliability and validity of error assessment.  The Program's Web site can be found at www.med.umich.edu/psep.

VA/UM Program on Quality Improvement for Complex Chronic Conditions (QUICCC)
This program, established in May 2006, is directed by Drs. John Piette and Eve Kerr from our Center.  QUICCC’s goal is to coordinate and advance our research projects to develop and evaluate novel interventions that improve the efficiency and quality of care for chronically ill VA and non-VA patients with an emphasis on identifying services that support effective primary care and patient self management.  The program is also designed to provide a forum for developing VA investigators interested in interventional health services research and the resources those junior investigators need to develop ideas and secure funding for larger studies.  The program’s Web site is:  www.med.umich.edu/QUICCC/index.htm

National

VA Research & Development

Centers of Excellence

Resource Centers

Address

USPS:
HSRD/SMITREC (11H)
P.O. Box 130170
Ann Arbor, MI 48113-0170

Fed Ex:
HSRD/SMITREC (11H)
2215 Fuller Road
Ann Arbor, MI 48105

Contact us

Seminars

The Ann Arbor VA HSR&D sponsors a monthly seminar series where investigators present new proposals, work in progress, and completed research in an informal setting, encouraging feedback from participants.

The seminars are generally held on Tuesdays or Thursdays.

Please contact Julie Lowery for a current schedule.

Staff
As of January 1, 2009, the Ann Arbor Center of Excellence has 33 core investigators (20 MDs, and 13 PhDs), representing a wide range of backgrounds and skills.  We have a total of over 151 staff engaged in over 107 research projects, funded by VA and other federal and non-federal sources.

Research Projects
Check out research projects for additional information.

Research Products
Center investigators published 201 journal articles in fiscal year 2008. These include articles by core investigators, as well as by affiliate investigators (articles by the latter are related to Center projects only).  In addition, our staff made 87 presentations at 32 different
regional, national, and international conferences and meetings.