Improving performance through knowledge translation in the Veterans Health Administration
Article first published online: 23 MAR 2006
Copyright © 2006 Wiley Periodicals, Inc.
Journal of Continuing Education in the Health Professions
Volume 26, Issue 1, pages 63–71, Winter 2006
How to Cite
Francis, J. and Perlin, J. B. (2006), Improving performance through knowledge translation in the Veterans Health Administration. J. Contin. Educ. Health Prof., 26: 63–71. doi: 10.1002/chp.52
- Issue published online: 23 MAR 2006
- Article first published online: 23 MAR 2006
- clinical evidence;
- health system;
- improved performance;
- Veterans Administration;
- continuing education;
- knowledge translation
The Veterans Health Administration (VA) provides a case study for linking performance measurement, information technology, and aligned research efforts to facilitate quality improvement in a large, complex health system. Dialogue between clinical researchers and VA leaders occurs through structured activities (e.g., the Quality Enhancement Research Initiative); engagement with formal policymaking bodies (e.g., development of clinical guidelines and performance measures); and informally through local, regional, and national work groups responsible for implementing evidence-based clinical initiatives. Important lessons for knowledge translation from the VA experience include the following: research needs to generate clinical evidence relevant to the needs of patients served by the health system; researchers need to systematically study the process of evidence implementation itself to increase the capability of the health system to improve performance; although print and Web-based dissemination structures are important, direct accessibility of researchers to policymakers and clinical leaders through formal and informal mechanisms is key; and both top-down and bottom-up activities are needed to integrate evidence-based practice across a large health system. As VA care moves from hospital and clinic into community-based settings and faces a new veteran population with different needs and expectations, knowledge-translation activities must develop new forms of evidence and more direct interaction with veterans and their caregivers.