Center for Healthcare Organization & Implementation Research
Long-Term Care
CHOIR, a leader in partnered research for improving safety and quality of care for Veterans, does considerable work in the long-term care research area. This area’s overarching goals are improving the quality of care for Veterans at the intersection of patient-centered care and safety in long-term care, geriatrics, and extended care. To achieve these goals, CHOIR applies its expertise in implementation and organizational culture change through projects funded by VA Health Services Research and Development (HSR&D), the Quality Enhancement Research Initiative (QUERI), and VA Central Office (VACO). This work aligns with VA Secretary's priorities of strengthening VA's foundational services.
Christine W. Hartmann, PhD, serves as principal investigator on many long-term care projects in this research area. Past and current projects include:
- Development and implementation of a structured observation tool to help community living center (CLC, the VA version of nursing home) staff focus on areas where they are doing well and “spread the bright spots” to improve person-centeredness of care,
- Identification of top performers in person-centered care so their successful practices can serve as roadmaps for other CLCs,
- Exploration of attitudes and beliefs about CLC resident safety with an accompanying tool kit to improve the overall CLC safety climate, and
- De-implementation of anti-psychotic usage in CLCs.
In addition, CHOIR investigator Jenny Sullivan, PhD, delves into resident-centered care, quality, and cost through the QUERI-partnered initiative GERI-PACT while Lauren Moo, MD, teams with the New England Geriatric Research Education and Clinical Centers (GRECC) for development and a clinical demonstration of a dementia home safety toolkit. CHOIR long-term care expertise also includes the prestigious work of CHOIR investigator Dan Berlowitz, MD, who continues to collaborate on several projects. National VA collaboration in this area includes working with teams at the Tuscaloosa VA Medical Center, the Center of Innovation for Veteran-Centered and Value-Driven Care in Seattle and Denver, as well as many others.
Long-term care research at CHOIR builds on operational partnerships across the VA, particularly a historically strong partnership with the Office of Geriatrics and Extended Care (GEC). This Office for example, has funded the CLCs' Ongoing National Center for Enhancing Resources and Training (CONCERT), co-directed by Dr. Hartmann and Dr. Lynn Snow (at Tuscaloosa VAMC). CONCERT supports CLCs nationally in their quality improvement activities, leading CLC- and VISN-based initiatives. CHOIR’s collaboration with GRECC is also rapidly growing. Moving forward, CHOIR hopes to expand its studies in long-term care hand-in-hand with its operational partners, translating more research into practice to improve care experiences for Veterans in long-term care, geriatrics, and extended care. For more information on the long-term care research area at CHOIR, please contact Dr. Christine W. Hartmann at Christine.Hartmann@va.gov.
