Partner or Perish: VA Health Services and the Emerging Bi-Directional Paradigm

Excerpt

The Veterans Health Administration (VHA) is the nation’s largest integrated healthcare system and has the benefit of a sizeable budget for research to improve Veterans’ health and healthcare. Thus, many outsiders assume that research has always been tightly integrated with VHA clinical operations and policy. In reality, for years researchers and operations leaders inhabited their separate silos, responding to the different priorities and time lines of their respective jobs. While connections between researchers and policy or clinical offices were numerous, with researchers serving as expert consultants in many initiatives, there were few incentives for the two groups to work closely together in a sustained effort. Policymakers wanted research that could help inform decisions, yet often found it lacked important context to make it relevant; however, policymakers didn’t have time or capacity to help design more useful research. Similarly, while researchers wanted to see their work affect VHA care, the crucial time needed to directly work with partners to maximize the impact of their work in day-to-day practice and the important insights gained through this process were not rewarded in the same way as time spent writing grants or journal manuscripts. The reality in VA and in similar settings involving academically affiliated healthcare organizations is that partnership is hard, takes time and energy, can occasionally be frustrating or fruitless, and has to meet the needs of both partners to truly succeed. …