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QUERI National Meeting – Closing Session. David Atkins QUERI Director December 11,2008. Closing Comments. Reflections on the meeting Building blocks to a new QUERI vision. Selected Lessons from the Meeting. Value of self-reflection Value of qualitative methods Managing complexity
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QUERI National Meeting – Closing Session David Atkins QUERI Director December 11,2008
Closing Comments • Reflections on the meeting • Building blocks to a new QUERI vision
Selected Lessons from the Meeting • Value of self-reflection • Value of qualitative methods • Managing complexity • Transactional management • Opportunities arising from crisis • Learning from other fields • Engaging stakeholders on priorities • Measuring implementation success • Engineering principles to improve implementation
Fundamental Questions • Who are our customers? • What are our strengths? • What are the challenges? • What do we want to accomplish?
Customers and Partners– Current or Potential • VA clinical leadership • Patient Care Services • OEHPH, ONS, OI • Quality and Safety • Other researchers • Network leadership/ Operations (10N)? • Facility leadership ?
What Are Our Strengths(what can we do better than anyone) • Clinical expertise • Really understanding the data
What Are Our Strengths(what can we do better than anyone) • Clinical expertise • Really understanding the data • Focus on what is most important • Over long term
What Are Our Strengths?(what we do better than anyone) • Understand clinical nuance and context • Really understand the data • Commitment to what is most important • Mix qualitative and quantitative methods • Independence
The Importance on Independence It is difficult to get a man to understand something if his salary depends on his not understanding it. Upton Sinclair
What Are Our Strengths?(what we do better than anyone) • Understand clinical nuance and context • Really understand the data • Commitment to what is most important • Mix qualitative and quantitative methods • Independence • Comprehensive view of outcomes (including unintended consequences and costs)
What Are the Challenges? • Who owns QI in the VA? • Are we building what they are buying? • How do we relate to other efforts with similar goals such as system redesign? • End of flush funding environment • Changing leadership • Competing for attention absent a crisis
What Do We Want To Accomplish? Smaller and Safer • Steady, marginal improvements in discrete but important clinical areas • Doable • Can make useful contribution • May be partly generalizable outside VA • Customer demand may vary
What Do We Want To Accomplish? Bigger and Bolder • Contribute to transformational change in the culture of quality in the VA • Re-establish VA’s leadership in quality • Imbedding evidence-based implementation • Creating a library of tools and solutions • Promoting population based quality management • Optimizing the potential of new technology • Building value