Impacts - Center for Care Delivery and Outcomes Research
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Center for Care Delivery and Outcomes Research


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Conducting innovative research which contributes to and benefits Veterans lives.


SPACE icon CCDOR researcher Dr. Erin Krebs and team worked with a panel of Veterans to develop an infographic to share results of the SPACE study with the community. Click the link below to view and share a copy of the infographic. 

HOMEFRONT icon Dr. Laura Meis collaborated with CCDOR’s Communication Committee to create a visual abstract of her article, “Sticking It Out in Trauma-Focused Treatment for PTSD: It Takes a Village,” that was published in the Journal of Consulting and Clinical Psychology.


Featured Impacts

Dr. Howard Fink published 3 systematic reviews on the diagnosis and treatment of Alzheimer’s dementia in Annals of Internal Medicine. The findings from these reviews are being used as the evidence base for development of a clinical guideline by the American Academy of Family Practice (guideline in press—anticipated publication Spring 2021).

Drs. Erin Krebs and Nina Sayer were on the National Academies of Sciences, Engineering, and Medicine committee that developed a consensus report entitled “Selected Health Conditions and Likelihood of Improvement with Treatment.” The Social Security Administration (SSA) requested this report to inform decisions regarding the timing of re-evaluation of social security disability beneficiaries. As such, this report has implications for SSA disability policy.

Minneapolis ESP Team has been conducting ongoing COVID-19 evidence synthesis work, which includes:

  • Conducting a weekly evaluation and summary of national and international COVID-19 clinical practice guidelines focused on the treatment of adults with critical COVID.
  • These summaries are disseminated to the VA HSR&D Director, Executive Director and National Program Directors for Medicine, Pulmonary and Critical Care and Emergency Medicine for their incorporation into VA Scope of Practice documents for care of patients with COVID-19.
  • Providing rapid responses to emergent informational needs based on critical review of practice patterns and new evidence.
  • Example: Dr. Duan-Porter published a rapid response evidence review examining ICU length of stay and ventilator time on the ESP website in June 2020. This brief and an additional update provided concise summaries of international evidence on intensive care resource utilization due to very severe COVID-19 disease. This brief assisted operational and clinical leadership in their planning for critical care resources for Veterans in VA care, and to support the broader Fourth Mission of supporting care for non-Veterans during the COVID-19 pandemic.

Dr. Erin Krebs was appointed as a member of the Foundation for Opioid Response Efforts’ (FORE) Scientific Advisory Council. FORE is a private national grantmaking foundation focused on addressing the opioid crisis by supporting programs and grants in four key areas: professional education, payer and provider strategies, policy initiatives, and public awareness.

Dr. Shannon Kehle-Forbes was interviewed for the HSR&D Podcast on her IIR study 14-030 that found that evidence-based psychotherapy for PTSD completers and non-completers differed in the type of working alliance they shared with their therapists, their interpretation of symptom worsening, their therapists’ patient-centeredness and flexibility in treatment delivery, the type of encouragement offered by the care team and other supports, and the perceived impact of treatment participation on functioning. These findings point to several intervention targets for improving completion rates in evidence-based PTSD psychotherapy including increasing the patient-centeredness of treatment delivery, leveraging of full care team in the goal of completion, and directly addressing patients’ functional concerns. The podcast was posted on the HSR&D website and iTunes channel, and this project was featured during PTSD Awareness Month.

After the murder of George Floyd and the resulting protests for racial justice, Dr. Diana Burgess wrote a statement on racial injustice for the Pain Management Collaboratory (PMC) to educate the public on racial disparities in pain and pain treatment. She also participated in an interview for their website. The statement and interview were to educate researchers, clinicians and the public about racial disparities in pain and pain management and to convey the PMC’s commitment to addressing barriers to high quality pain care for African Americans and other racial and ethnic minority groups as we conduct and disseminate our research. According to Bob Kerns, a Co-PI for the PMC coordinating center, this statement and interview brought attention to this issue within the PMC and beyond, including leaders in the NIH Helping to End Addiction Long-term (HEAL) initiative.

Dr. Hildi Hagedorn and her co-PI, Dr. Adam Gordon recorded a podcast for the Clinical Pharmacy Office in which they discussed their IIR study 16-145 (“ADaPT-OUD”) and their work supporting the Office of Mental Health and Suicide Prevention’s SCOUTT Initiative. ADaPT-OUD focuses on expanding access to evidence-based medication for opioid use disorder (MOUD) in low-performing VHA facilities while SCOUTT focuses on expanding access to MOUD outside of traditional substance use disorder specialty care settings, specifically pain, primary care and general mental health clinics. For the podcast, Drs. Hagedorn and Gordon specifically discussed the pivotal role that Clinical Pharmacy Specialists (CPS) have played in implementation teams at facilities involved in both ADaPT-OUD and SCOUTT. ADaPT-OUD and SCOUTT have increased access to MOUD at many of the involved facilities and have identified successful implementation models including new models capitalizing on the expertise and availability of CPSs.

In collaboration with the National Center for PTSD, Dr. Nina Sayer’s HSRD RVR project (PERSIST 3.0) team measured and improved the reach of evidence-based psychotherapies (EBPs) for PTSD by developing reports to audit the use of EBPs. Reports were distributed to 124 PTSD teams across the nation. They are being used to identify VISNs and sites that need assistance to make EBPs for PTSD more accessible and to monitor changes in EBP use associated with the COVID-19 pandemic and interventions.