ity-of-care studies based on data from NCI’s Surveillance, Epidemiology, and End Results (SEER) registry program. In addition, NCI conducts an initiative on improving quality-of-care research within the institute’s clinical trials program, enhancing the quality of care by improving the quality of cancer communications, and increasing the extent to which available scientific evidence on quality measures and assessment informs federal decision making on cancer care. The vehicle for this initiative is the NCI-convened Quality of Cancer Care Committee, which currently supports three collaborative translation projects with HRSA, CDC, CMS, and the Department of Veterans Affairs, respectively.

In addition to research on developing outcome and process measures, NIH examines the relationship of performance measures and guidelines to outcomes across different settings of care, thereby testing the validity of quality measures. For example, the National Institute of Mental Health conducts research involving separate studies to determine how the implementation of treatment guidelines for depression and schizophrenia affects outcomes and processes of care. It also tests whether evidence-based protocols for improving the quality of care for depression are effective across multiple settings and delivery systems.

The National Heart, Lung, and Blood Institute evaluates strategies that can be used in clinical practice to improve the implementation of national, evidence-based clinical practice guidelines for the treatment of heart, lung, and blood diseases and related conditions. Focusing on the delivery of medical care, this research evaluates the factors that affect the adoption of a selected guideline in community practice. The research is designed to identify barriers to the implementation of guidelines and factors that can enhance adherence to guidelines.

The Diabetes Research and Training Centers of the National Institute of Diabetes and Digestive and Kidney Diseases focus on developing and implementing approaches to improving the acceptance of guidelines. The purpose of this translation effort is to develop and test evidence-based diabetes educational modules, targeted professional training, and active community outreach.

Veterans’ Health Administration

VHA has engaged in a number of research initiatives consistent with its use of informatics in the implementation of quality improvement strategies. Its research is structured through a number of programs and centers, including the Patient Safety Centers of Inquiry and the Quality Enhancement Research Initiative.

The Patient Safety Centers of Inquiry were created to analyze the elements of and develop better tools for improved patient safety. Located in



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