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Quality Enhancement Research Initiative in Mental Health

Fischer, Ellen P. PhD*; Marder, Stephen R. MD; Smith, G. Richard MD; Owen, Richard R. MD*; Rubenstein, Lisa MD, MSPH; Hedrick, Susan C. PhD; Curran, Geoffrey M. PhD*

Section Editor(s): Feussner, John R. MD; Demakis, John G. MD; Kizer, Kenneth W. MD, MPH

VA's Quality Enhancement Research Initiative

The Veterans Administration (VA) recently introduced its Quality Enhancement Research Initiative (QUERI) to facilitate the translation of best practices into usual clinical care. The Mental Health QUERI (MHQ) was charged with developing strategic plans for major depressive disorder (MDD) and schizophrenia. Twenty percent or more of VA service users are affected by 1 of these 2 disorders, disorders that often have a devastating impact on affected individuals. Despite the increasing availability of efficacious treatments for each disorder, substantial gaps remain between best practices and routine care. In this context, the MHQ identified steps critical to the success of a sustained process of rapid-cycle health care improvement for MDD and schizophrenia, including research initiatives to close gaps in knowledge of best treatment practices, demonstration projects to close gaps in practice and to expand understanding of effective strategies for implementing clinical guidelines, targeted enhancements of the VA information system, and research and dissemination initiatives to increase the availability of resources to support the accelerated incorporation of best practices into routine care. This article presents an overview of the elements in the initial MHQ strategic plans and the rationale behind them.

Address correspondence and requests for reprints to: Ellen P. Fischer, PhD, HSR&D Mental Health QUERI, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Dr (152/NLR), North Little Rock, AR 72114. E-mail:

*From the VA HSR&D Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System and the Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock, Ark.

From the Veterans Integrated Service Network (VISN) 22 Mental Illness Research, Education, and Clinical Center, West Los Angeles VA Medical Center, Los Angeles, Calif.

From the Departments of Psychiatry and Behavioral Sciences, and Medicine, University of Arkansas for Medical Sciences, Little Rock, Ark.

From the VA HSR&D Center for the Study of Healthcare Provider Behavior, Sepulveda VAMC, Sepulveda, Calif; the University of California at Los Angeles; and RAND, Santa Monica, Calif.

From the VA HSR&D Center for Outcomes Research in Older Adults, VA Puget Sound Health Care System, and Department of Health Services, University of Washington, Seattle, Wash.

© 2000 Lippincott Williams & Wilkins, Inc.