Evidence map›Paper›PMID 40677606›Full record

ArticleLearning health systems2025

How senior leaders support innovations in large learning health systems: Insights from United States Veterans Health Administration national program office leaders.

Jaifred Christian F Lopez, Sallie Allgood, Kate Sheahan, Brandolyn White, M Amy Kirshner, Suzanne Shirley, Madison Coffey, Amanda Milo, Sarah L Cutrona, Laura Damschroder and 8 more

Abstract read
In one paragraph

Article in Learning health systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Jaifred Christian F LopezSchool of Medicine Duke University Durham North Carolina USA.ORCID https://orcid.org/0000-0002-8273-992X
Sallie AllgoodSchool of Medicine Duke University Durham North Carolina USA.
Kate SheahanCenter of Innovation to Accelerate Discovery and Practice Transformation Durham Veterans Affairs (VA) Health Care System Durham North Carolina USA.
Brandolyn WhiteCenter of Innovation to Accelerate Discovery and Practice Transformation Durham Veterans Affairs (VA) Health Care System Durham North Carolina USA.
M Amy KirshnerCenter of Innovation to Accelerate Discovery and Practice Transformation Durham Veterans Affairs (VA) Health Care System Durham North Carolina USA.
Suzanne ShirleyVeterans Health Administration Innovation Ecosystem Richmond Virginia USA.
Madison CoffeyVeterans Health Administration Innovation Ecosystem Richmond Virginia USA.
Amanda MiloRios Partners, LLC. Arlington Virginia USA.
Sarah L CutronaCenter for Health Optimization and Implementation Research VA Bedford Healthcare System Bedford Massachusetts USA.
Laura DamschroderVA Ann Arbor Center for Clinical Management Research Ann Arbor Michigan USA.
Gemmae M FixCenter for Health Optimization and Implementation Research VA Bedford Healthcare System Bedford Massachusetts USA.
Andrea L NevedalVA Ann Arbor Center for Clinical Management Research Ann Arbor Michigan USA.
Caitlin M ReardonVA Ann Arbor Center for Clinical Management Research Ann Arbor Michigan USA.
Marilla A Opra WiderquistVA Ann Arbor Center for Clinical Management Research Ann Arbor Michigan USA.
Maria ArasimVA Ann Arbor Center for Clinical Management Research Ann Arbor Michigan USA.
Allen L GiffordChobanian & Avedisian School of Medicine Boston University Boston Massachusetts USA.
Kathryn DeLaughterCenter for Health Optimization and Implementation Research VA Bedford Healthcare System Bedford Massachusetts USA.
George L JacksonCenter of Innovation to Accelerate Discovery and Practice Transformation Durham Veterans Affairs (VA) Health Care System Durham North Carolina USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The U.S. Veterans Health Administration (VHA) formed an Innovation Ecosystem that develops and disseminates innovative practices to enhance Veterans' health. Support of senior leadership and their perception of the innovation process is key to the Ecosystem's success. We aimed to elicit insights on (1) how national VHA program office leaders define innovation, and (2) important considerations in facilitating the adoption of innovations. Methods: As part of a quality improvement initiative, we conducted 19 semi-structured interviews via teleconference. Interviews involved 4 administration offices, 7 clinical and population health program offices, and 8 policy and quality improvement offices; 12 of these offices reported experience working with the Innovation Ecosystem. Responses were audio recorded, transcribed, and analyzed using constructs from the Consolidated Framework for Implementation Research. Results: Participants generally agreed that innovation within VHA is defined by evidence-based development and implementation of interventions that improve response to Veterans' needs. Considerations in facilitating innovations include: (1) implementation climate that promotes network-building, open communication, and well-executed planning processes; (2) implementation infrastructures that enable engagement with key players and augment existing resources; and (3) innovation evidence strength and responsiveness to patient needs. Individuals working in policy-related offices were more likely to identify complexity, leadership engagement, culture and available resources as factors in choosing innovations to adopt. Individuals who reported experience of working with the Ecosystem emphasized the importance of intra-organizational networks and a favorable implementation climate, while those without experience noted the importance of working with external change agents. CFIR 'inner setting' constructs were seen in responses across all categories; meanwhile, emerging constructs highlight how innovation should be balanced by the reality of operations. Conclusions: Among national VHA program office leaders, innovation is pursued to improve Veterans' health. Resources, networks, culture, and processes are considered important factors among program office leaders to support and encourage innovation.

Indexed as

CFIRimplementation scienceinnovationlearning health systemqualitativequality improvementVeterans Health Administration

Identifiers

PMID40677606
PMCPMC12264376

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.