Center for Health Equity Research and Promotion
CHERP Research and Accomplishments
Team members Lauren Broyles, PhD, RN and Adam Gordon, MD, MPH
Lauren Broyles, PhD, RN Leads Implementation and Evaluation of New VHA Requirements for Inpatient Tobacco/Alcohol Screening, Intervention, Referral, and Follow-up
On January 1, 2014 VHA adopted new hospital accreditation and performance measures from The Joint Commission for inpatient screening for alcohol and tobacco use, brief intervention, referral to treatment, and follow-up. CHERP Investigator Lauren Broyles, PhD, RN, is leading the mandated implementation of these measures at VAPHS, and also evaluating this “roll-out” with pilot funding from the VA Office of Nursing Services.
While the standard of care for responding to alcohol and tobacco use is well-established in the VA primary care clinic setting, operationalizing the process in inpatient settings may be unique due to differences in patient acuity, staff roles, responsibilities, workflow, and culture. Dr. Broyles explains, “Lots of practical details need to be figured out, such as who will conduct screening, counseling, referral, and follow-up; when during the hospital admission these things will occur; and how documentation and referral will happen in the electronic medical record. This may look different for different types of inpatient units, and it’s critical to figure out how all of these intersecting roles can be shared by different professional disciplines.”
Implementation of the measures and the evaluation of the process itself are occurring in tandem. By interviewing patients, clinicians, and administrators before, during, and after roll-out, Dr. Broyles’ research team will inform the process in real-time with essential perspectives from patients front-line stakeholders. “Our goal is to develop clinical processes and procedures for addressing these measures that are patient-centered but simultaneously sensitive to the inpatient culture and clinicians’ needs for efficiency. The constant dialogue with stakeholders will allow us to do this.”
All VHA medical centers are expected to be fully compliant with these measures by January 1, 2015. “We hope that our own evaluation of what gets tried across different hospital units will also provide some creative options for other VAMCs as they too implement and tweak their roll-out of these measures over the next year. We all need processes of care that are patient-centered as well as viable over the long term. “
The team: Lauren Broyles, PhD, RN Adam Gordon, MD, MPH; Karen Mancini, MS, RN, CPHQ; Keri Rodriguez, PhD; Melissa Taylor, PhD, RN; Melissa Wieland, PhD; Monica DiNardo, PhD, RN; Andrea Confer, BA.
Project title: “Evaluating Inpatient Alcohol/Tobacco Performance Measure Implementation.”
Funding: VA Office of Nursing Services
