Implementation Evaluation of a Complex Intervention to Improve Timeliness of Care for Veterans with Transient Ischemic Attack
Damush T, Miech E, Rattray N, Homoya B, Penney L, Cheatham A, Baird S, Myers J, Austin C, Myers L, Perkins A, Zhang Y, Giacherio B, Kumar M, Murphy L, Sico J, Bravata D. Implementation Evaluation of a Complex Intervention to Improve Timeliness of Care for Veterans with Transient Ischemic Attack. Journal Of General Internal Medicine 2020, 36: 322-332. PMID: 33145694, PMCID: PMC7878645, DOI: 10.1007/s11606-020-06100-w.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackClinical improvementStepped-wedge implementation trialQI teamsGuideline-concordant careTimeliness of careQuality improvement interventionsVA healthcare systemComplex quality improvement interventionsPrimary outcomeTeam activationImplementation strategiesKey implementation strategiesImplementation trialImprovement interventionsClinical staffComplex interventionsConsolidated FrameworkQI programQI planExternal facilitationImplementation researchHealthcare systemPoint improvementAssessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack
Bravata DM, Myers LJ, Perkins AJ, Zhang Y, Miech EJ, Rattray NA, Penney LS, Levine D, Sico JJ, Cheng EM, Damush TM. Assessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack. JAMA Network Open 2020, 3: e2015920. PMID: 32897372, PMCID: PMC7489850, DOI: 10.1001/jamanetworkopen.2020.15920.Peer-Reviewed Original ResearchConceptsTransient ischemic attackQuality of careIschemic attackElectronic health record toolsRecurrent vascular eventsDiverse medical centersGuideline-recommended processesQuality improvement interventionsProportion of veteransHealth care systemImplementation periodIntervention associationsQI supportVascular eventsMost patientsPrimary outcomeMean ageCare existIntervention periodSymptom interventionMedical CenterQI interventionsMAIN OUTCOMEHigh riskTimely management