Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT)

Durham Va Medical Center, Durham NC

Investigators

Linked publications & trials

Abstract

The goal of the Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) is to enhance the Veterans Health Administration’s (VHA) ability to continually improve health care and optimize Veteran wellbeing and independence. We approach this goal by generating and applying evidence to spur innovation in health care organization, finance, and delivery for Veterans and their families. In its 35-year history, Durham’s Health Services Research and Development Center, now named ADAPT, has conducted hundreds of policy-relevant studies influencing Veterans’ health care, trained 143 physician and postdoctoral fellows, and supported 32 VA Career Development Awardees. Comprising a large group of experienced investigators nested within a mature research infrastructure, ADAPT is ideally suited to continue to provide scientific leadership across the continuum from basic health services to implementation research. In this way, we will play a vital role in helping VHA meet the challenges of providing timely, coordinated, consistently high-quality care to more than 9 million Veterans each year. While proud of our track record, we recognize that new methods and models are required to meet the ever- changing needs of VHA and our Veterans, who experience a disproportionately high burden of disease related to poor health behaviors and other clinical and social factors, face challenges to accessing health care, and have greater need of long-term care services and supports than at any time in history. Based on a 1-year planning process involving extensive input from VHA leadership and other stakeholders, and drawing from the World Health Organization’s conceptual framework of resilient, or adaptive, health care systems, we have selected 3 focused areas of research for the next 5 years that align with VA strategic priorities: (1) promoting and sustaining healthy behaviors; (2) enhancing access through virtual care; and (3) optimizing function and independence. We have formed investigator teams to focus on each priority area in close collaboration with health system partners. Each team will support a portfolio of externally funded projects, catalyze new ideas through pilot studies and grant development workshops, provide intellectual leadership in the larger research community, and be a national resource to inform VA clinical care and policy decisions. To continue our longstanding commitment to training and career development, each research area will also attract and support promising junior investigators and provide individual mentorship to foster their scientific development. Scientific rigor, an essential underpinning of the work to be done in each research focus area, will be reinforced and advanced by the formation of 3 cross-cutting methods labs: 1) the Pragmatic Clinical Trials Lab will facilitate application of methods to evaluate effectiveness of interventions in real-life routine practice conditions; 2) the Non-Randomized Design Lab will support rigorous application of causal inference methods in observational studies and integration of novel data sources; and 3) our successful Implementation Lab will be expanded to incorporate Improvement Science. To ensure that research studies are designed to address VA’s highest priorities and that research findings are relevant and actionable, we will strengthen existing partnerships with VA stakeholders and foster new ones in all phases of research development, dissemination, and translation. ADAPT’s leadership team will direct all activities, ensuring integration across research focus areas and methods labs. Our aims for the next 5 years include: 1) catalyzing innovative health services research in health behaviors, virtual care, and function/independence; 2) advancing state-of-the-art methods to accelerate research discoveries; 3) translating research findings into practice transformation throughout VHA; and 4) training the next generation of researchers who will become leaders in VA research. ADAPT will amplify the impact of our individual investigators and meaningfully enhance VHA’s ability to care for our nation’s Veterans.