Promoting learning health system feedback loops: Experience with a VA practice-based research network card study

• Published in: Healthcare : the journal of delivery science and innovation 2021-06, Vol.8 (Suppl 1), p.100484-100484, Article 100484
• Main Authors: Golden, Rachel E., Klap, Ruth, Carney, Diane V., Yano, Elizabeth M., Hamilton, Alison B., Taylor, Stephanie L., Kligler, Benjamin, Whitehead, Alison M., Saechao, Fay, Zaiko, Yevgeniya, Pomernacki, Alyssa, Frayne, Susan M., Bean-Mayberry, Bevanne, Bhoopalam, Sudha, Buckholdt, Kelly E., DiNardo, Deborah, Dussán, Kathleen Bronson, Hardman, Lisa, Hill, Elizabeth E., Juiris, Tahira, Koutrouba, Denise, Mattocks, Kristin, Rawson, Gina G., Rylander, Jeanette, Sadler, Anne G., Santiago-Cotto, Agnes, Singhal, Divya, Thakar, Ishita
• Format: Article
• Language: English
• Subjects: Feedback; Female; Humans; Learning Health System; United States; United States Department of Veterans Affairs; Veterans; Veterans Health
• ISSN: 2213-0764; 2213-0772
• DOI: 10.1016/j.hjdsi.2020.100484

We tested the capacity of the 60-site VA Women's Health Practice-Based Research Network (WH-PBRN), embedded within VA, to employ a multisite card study to collect women Veterans' perspectives about Complementary and Integrative Health (CIH) and to rapidly return findings to participating sites and partnered national policy-makers in support of a Learning Health System (LHS) wherein evidence generation informs ongoing improvement. VA primary care clinic clerks and nurses distributed anonymous surveys (patient feedback forms) at clinics for up to two weeks in fiscal year 2017, asking about CIH behavior and preferred delivery methods. We examined the project's feasibility, representativeness, acceptability, and impact via a tracking system, national administrative data, debriefing notes, and three surveys of WH-PBRN Site Leads. Twenty geographically diverse and largely representative VA Medical Centers and 11 Community-Based Outpatient Clinics volunteered to participate. Over six months, N = 1191 women Veterans responded (median 57; range 8–151 per site). In under three months, we returned local findings benchmarked against multisite findings to all participating sites and summary findings to national VA partners. Sites and partners disseminated results to clinical and leadership stakeholders, who then applied results as warranted. VA effectively mobilized an embedded PBRN to implement a timely, representative, acceptable and impactful operations project. Card studies by PBRNs within large, national healthcare systems can provide rapid feedback to participating sites and national leaders to guide policies, programs, and practices. Self-selected respondents could have biased results. •VA Women's Health PBRN tested card study to support Learning Health System.•20 PBRN VA Medical Centers and 11 Community-Based Outpatient Clinics participated.•2-weeks of data collection at each site resulted in 1191 respondents over 6 months.•Participant/participating site characteristics/conditions reflect the VA overall.•Reports given to sites/national partners in under 1 year to close LHS feedback loop.