Table 3.

An Example of Developmental FE

Spinal cord injury (SCI) QUERI: respiratory vaccine initiative

Implementation goal: one evidence-based strategy to improve preventive care delivery rates is a practitioner reminder system. As the VHA had a nationally developed and distributed computerized clinical reminder (CCR) for influenza that did not appear to be in wide use at study sites, SCI QUERI set a goal of having the CCR installed locally and used by practitioners in the SCI centers across the country.

FE activity: electronic questionnaires with follow-up interviews about the influenza CCR were administered to computer application coordinators at VA facilities with SCI centers and to personnel at each SCI center. From these data it was clear that the current version of the reminder was installed at all locations, but that local methods of installing and using the CCR varied widely. This indicated that the initial plan to develop a standard set of instructions was inappropriate. As an alternative, the research team developed general principles and encouraged SCI personnel to seek further help from their local information technology staff.35,36

Value: the information from this activity guided the research team's choice of methods to assist SCI center personnel to move toward the goal of using the CCR.

QUERI, quality enhancement research initiative; SCI, spinal cord injury; VHA, Veterans Health Administration; CCR,computerized clinical reminder; FE, formative evaluation.