Comparative Effectiveness Research Key Function Committee (CER KFC) Monday, April 16 2012, 11:00 AM-12:00 PM ET

1. Comparative Effectiveness ResearchKey Function Committee(CER KFC)Monday, April 16 2012, 11:00 AM-12:00 PM ET Co-Chairs, Tim Carey and Tom Concannon PI Liaison, Harry Selker NIH Coordinator, Rosemarie Filart PM, Alecia Fair (C4)

2. CTSA CER Key Function Committee (KFC) Monthly Meeting AgendaMonday, April 16, 2012, 11:00 AM – 12:00 PM ET

3. All Members invited to participate in any group

4. Identify current activities and collaborations with CER KFC members with NIH I/Cs NIH Updates Rosemarie Filart 11:02 AM

5. Implementation science in the Veterans Health Administration: Example of the Organizational Readiness to Change Assessment (ORCA) CER SCIENTIFIC PRESENTATION Presented by: Christian D. Helfrich, MPH,PhDVA Puget Sound Health Care System Seattle Division, Seattle, WA11:05AM

6. Implementation science in the Veterans Health Administration: Example of the Organizational Readiness to Change Assessment (ORCA) Presentation to the CER Key Function Committee April 16, 2012 Christian D. Helfrich, MPH, PhDImplementation Research CoordinatorIschemic Heart Disease Quality Enhancement Research Initiative

7. VHA Commitment to Implementation Science • Quality Enhancement Research Initiative (QUERI) • Clinical operations & health services research collaboration • Activities • Diffusion & implementation grant mechanisms • Sponsored Implementation Science Journal • Enhancing Implementation Science training conference

8. VHA Commitment to Implementation Science • Veterans Engineering Resource Centers (VERC) • National Center for Organizational Development http://www.va.gov/NCOD/ • Every VA initiative evaluated on implementation & outcomes Evidence-based change  evidence-based medicine

9. Example of Organizational Readiness to Change Assessment (ORCA) Study to implement lipid screening & Tx (Sharp et al 2004) Readiness to change may have been evident at baseline >=43 instruments to assess organizational readiness (Weiner et al 2008; Holt et al 2006) “limited evidence of reliability or validity” Nancy Sharp & Anne Sales developed structured survey Promoting Action on Research Implementation in Health Services (PARIHS) Evidence, Context, Facilitation

10. ORCA • 77-item survey instrument, 5-point Likert scale • Target: clinicians & staff involved in implementation of specific evidence-based practice • Prognostic, diagnostic and implementation measurement applications • Preliminary evidence of scale reliability and factor structure (Helfrich et al 2009), and predictive validity (Hagedorn & Heideman 2010). • Systematic psychometric validation study (Helfrich et al 2011)

11. Systematic Validation Study

12. Sample and Data

13. Status and Next Steps Analyses ongoing; receiving last partner study data Developing user’s guide and short form of survey Fielding as part of specialty care transformational initiative evaluation Using to select in-depth study sites Support resources tailored to readiness

14. Acknowledgements Psychometric validation of an organizational readiness-to-change scale (RRP 07-280) • Anne Sales • Nancy Sharp • Yu-Fang Li Predicting implementation from organizational readiness to change (IIR 09-067) • Dean Blevins • Hildi Hagedorn • Tim Hogan • Rick Owen • Jeff Smith • Adam Kelly • Patricia Dubbert • Ina Gylys-Colwell • Rachel Orlando

15. References • Armenakis, A. A., S. G. Harris, et al. (1993). "Creating Readiness for Organizational Change." Human Relations 46(6): 681-703. • Hagedorn, H. J. and P. W. Heideman (2010). "The relationship between baseline Organizational Readiness to Change Assessment subscale scores and implementation of hepatitis prevention services in substance use disorders treatment clinics: a case study." Implement Sci 5(1): 46. • Helfrich, C., D. Blevins, et al. (2011). "Predicting implementation from organizational readiness for change: A study protocol." Implementation Science 6(1): 76. • Helfrich, C., Y.-F. Li, et al. (2009). "Organizational readiness to change assessment (ORCA): Development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework." Implementation Science 4(1): 38. • Holt, D., A. Armenakis, et al. (2006). Toward a comprehensive definition of readiness for change: a review of research and instrumentation. Research in Organizational Change and Development. Amsterdam, Netherlands, JAI Press. 16. • Sharp, N. D., S. L. Pineros, et al. (2004). "A Qualitative Study to Identify Barriers and Facilitators to Implementation of Pilot Interventions in the Veterans Health Administration (VHA) Northwest Network." Worldviews Evid Based Nurs 1(2): 129-139. • Weiner, B. J., H. Amick, et al. (2008). "Conceptualization and Measurement of Organizational Readiness for Change: A Review of the Literature in Health Services Research and Other Fields." Med Care Res Rev 65(4): 379-436.

16. ORCA Subscales and Scales Evidence Context Facilitation • Discord over evidence • Research • Practice experience • Patient experiences • Leadership culture • Staff culture • Opinion leader • Leadership practice • Evaluation/Accountability • Slack resources Organizational readiness to change Implementation outcomes • Leadership roles in planning • Project champion roles • Leadership roles in support • Implementation team roles • Assessment • Evaluation • Implementation plan • Communication • Project sources

17. UPCOMING CER SCIENTIFIC PRESENTATION May 16thLC Data Quest: FInDiT, Federated Information Dictionary ToolPresented by: Ching-Ping Lin, PhDInstitute of Translational Health Sciences, University of WashingtonWELCOME VOLUNTEERS or SUGGESTIONS

18. WORKGROUP REPORTS11:13AM

19. DIR Workgroup co-Leads: Paul Meissner and Jonathan Tobin October 2011 Fall –Winter 2011 2012 • Merged Collaboration and Dissemination and Implementation Workgroups launched into one WG: newly named as Dissemination and Implementation Research WG • White Paper on Stakeholder Engagement • - Working paper on CTSA wiki • - Submitted for peer review • 2. Best Practices in Translational Research • 7 interviews completed • Developed preliminary results • 15 interviews proposed & scheduled • Identification of variables of interest for D&I research from EHRs and other data sources. • 1. Stakeholder engagement demonstrations • Tufts EPC (5) • PPP KFC (1) • Other • 2. Best Practices in Translational Research • Manuscript on best practices • Variables of interest for D&I research • 4. Rapid D&I Network / Pilot DIR demonstrations • - Needs leadership Completed To be Completed

20. Methods Workgroupco-Leads: Sean Tunis , Mark Helfand, Jerry Krishnan and Peter Neumann October 2011- Jan 2012 Feb 2012-Summer 2012 June – October 2011 Fall 2012 Develop and conduct an Methods WG Mini-Workshop of the October 2011 CER KFC Annual meeting with stakeholders. Focus on specific ways to advance methods research as detailed in the forthcoming CER Methods Agenda Paper. Discuss WG projects in light of the current CER/PCOR environment. • Dec 2011– Jan 2012:   • Key informant interviews on current consortium efforts to expand national infrastructure for conducting community-based PCTs • Jan 2012: Compile findings from key informant interviews Feb-March 2012: Create prioritized list of discrete projects related to overall workgroup focus, and for discussion at summer workshop. Establish planning committee. 2012: Workshop to convene individuals and groups from CTSA program and other initiatives with shared interest in expanding national infrastructure for community-based PCTs • Fall 2012:   Produce white paper with strategic plans for CTSA CER methods workgroup to contribute to expansion of national infrastructure for community based PCTs Completed To be Completed

21. CER Informatics TaskforceOpen Discussion:Current Draft Project ideas and Prioritizing Projects/Activities would you like to see for the CER Informatics TaskforceCo-Leads: Joel Saltz and Bill Hersh

22. LIAISON REPORTS11:28AM

23. Liaison Member Reports

24. Membership Updates, Ideas, Suggestions, and NewsALL11:38AM

25. C4 UpdatesC4 Tech Team11:43 AM

26. Private collaborative space • Committee management and consortium targeted information • Collaborative space: ROCKET • A virtual sandbox for collaborative research activities • https://www.ctsacentral.org/editor/index.php?doc_id=253.  

27. CER KFC Monthly Meeting: Monday, May 14thfrom 11 AM-12PM Dissemination and Implementation Research Workgroup: Tuesday, April 17th from 4-5 PM EDT Methods Workgroup: Thursday, April 26thfrom 12-1 PM EDT Informatics Taskforce: Thursday, May 3rd from 12 - 1 PM EDT Operations Group: Tuesday, April 24th3-4 PM EDT *attended by Co-Chairs /WG-TF Leads/ KFC Coordinator/PI Liaison SGC #4 Bi-Monthly Meeting : Monday, May 21stfrom 11 AM- 12 PM EDT *attended by CER and Comm. Eng. KFC Co-Chairs /WG-TF Leads/ KFC Coordinator/PI Liaison CER KFC Upcoming meeting schedule

28. APPENDIX (Proceed If needed)

29. CTSA Consortium Executive Committee Three Objectives for SGC #4 Objective 1: (Recognized as the Priority Objective by CCEC) :Develop a CTSA Consortium-wide strategy for community-engaged and comparative effectiveness research that leads to improvements in the access, quality, and efficiency of healthcare delivery and the health of diverse communities and the public. (*Metric followed by CCEC). Objective 2: Collaborate and create synergies with a wide range of stakeholders (i.e., communities, health departments, CTSA and other academic medical centers, NIH Institutes and Centers and other DHHS Federal Partners) in planning and implementing community-engaged and comparative effectiveness research and in disseminating the research findings. Objective 3: Facilitate collaborations across CTSA institutions, PBRNs, and a broad cross-section of practice settings that increase the nation’s capacity for innovative community-engaged and comparative effectiveness research leading to the development of novel methodologies for both conducting research and for implementing and disseminating the findings of that research.

30. Mission Statement The Comparative Effectiveness Research (CER) Key Function Committee builds the field of comparative effectiveness research (CER) and patient-centered outcomes research by creating a learning community across CTSA institutions, spurring the development of methods, expanding training and education, promoting community and public engagement, applying CER findings and sharing successes and lessons learned. Vision Statement Through collaborative work products, the Comparative Effectiveness Research (CER) Key Function Committee facilitates the generation and synthesis of evidence about alternative interventions that results in actionable findings for policymakers, clinicians, patients, and purchasers to use in improving the quality and outcomes of patient-centered health care. CER KFC Mission and Vision Statements https://www.ctsawiki.org/wiki/display/CER/Comparative+Effectiveness+Research-+Home