Hagedorn Hildi, Hogan Mary, Smith Jeffrey L, Bowman Candice, Curran Geoffrey M, Espadas Donna, Kimmel Barbara, Kochevar Laura, Legro Marcia W, Sales Anne E
Substance Use Disorders QUERI, Minneapolis VA Medical Center, Minneapolis, MN 55417, USA.
J Gen Intern Med. 2006 Feb;21 Suppl 2(Suppl 2):S21-4. doi: 10.1111/j.1525-1497.2006.00358.x.
The mission of the Veterans Health Administration's (VHA) quality enhancement research initiative (QUERI) is to enhance the quality of VHA health care by implementing clinical research findings into routine care. This paper presents lessons that QUERI investigators have learned through their initial attempts to pursue the QUERI mission. The lessons in this paper represent those that were common across multiple QUERI projects and were mutually agreed on as having substantial impact on the success of implementation. While the lessons are consistent with commonly recognized ingredients of successful implementation efforts, the examples highlight the fact that, even with a thorough knowledge of the literature and thoughtful planning, unexpected circumstances arise during implementation efforts that require flexibility and adaptability. The findings stress the importance of utilizing formative evaluation techniques to identify barriers to successful implementation and strategies to address these barriers.
退伍军人健康管理局（VHA）的质量提升研究计划（QUERI）的使命是通过将临床研究结果应用于常规护理来提高VHA医疗保健的质量。本文介绍了QUERI研究人员在最初尝试执行QUERI使命过程中学到的经验教训。本文中的经验教训是多个QUERI项目中普遍存在的，并且大家一致认为这些经验教训对实施的成功具有重大影响。虽然这些经验教训与成功实施努力中普遍认可的要素一致，但这些例子突出了这样一个事实，即即使对文献有透彻的了解并进行了深思熟虑的规划，在实施过程中仍会出现意外情况，这就需要灵活性和适应性。研究结果强调了利用形成性评估技术来识别成功实施的障碍以及解决这些障碍的策略的重要性。
