Health Systems Research Career Scientist Award

About This Grant

Dr. Hysong is an internationally known industrial/organizational (I/O) psychologist with over 30 years of experience (pre- and post-doctoral) conducting implementation and organizational research in unique work settings including healthcare. Her cross-cutting, widely-cited research (3753 citations in 88 countries, 9 languages, 83 fields) has been disseminated internationally through 76 peer-reviewed publications in journals such as JAMA, Nature, JAMA Internal Medicine, and Implementation Science. Fueled by the cross-cutting vision that one can improve Veteran care by improving the work life of those who deliver it, Dr. Hysong's research translates I/O psychology to improve three foundational elements of the clinician's work environment: 1) advancing the science of actionable measurement, audit, and feedback (A&F) of clinical performance; 2) improving effective coordination of clinical teams; and 3) evidence-based policy evaluation. Audit and Feedback: A&F is one of the most fundamental healthcare quality improvement (HQI) tools to change provider behavior and one of the most ubiquitous yet misused implementation strategies in healthcare. How A&F is designed and delivered drives effectiveness: done poorly, A&F can impede the desired outcome. Dr. Hysong's work examines both components of A&F: on the audit side, she has identified performance measure characteristics that effectively and consistently help clinicians improve their work, and adapted methods from I/O psychology to develop new clinical performance measures aligned with those characteristics. On the feedback side, she aims to discover the features of effective A&F in the healthcare setting, translating that information into A&F interventions within VHA. Throughout her career, Dr. Hysong's work has created and streamlined A&F interventions leading to quality improvements of up to 40% and advanced science through a theoretical model of actionable feedback that has been used internationally to design up to 15 interventions, as recently as 2021. Current projects include expert advisory work by invitation to help design an A&F intervention for mitigating moral injury among healthcare workers; a brand new project (funding expected CY2025) also leverages Dr. Hysong's expertise to employ A&F as a strategy to implement and sustain a lung cancer screening learning community of champions. Coordination of clinical teams: To coordinate care effectively, team members need to coordinate effectively. Dr. Hysong's work in this area seeks to discover the best configurations of teams for delivering the highest quality care, and to find ways to assist to better coordinate with themselves to improve care coordination for patients. Her database review study of Patient Aligned Care Teams (PACTs) aiming to identify the optimal PACT configuration for improved primary care clinical performance (AHRQ 5R01 HS 025982), has shown the overwhelming negative impacts of understaffing and of continuous nurse turnover in pACTs on coordination and care quality. Evidence-based policy evaluation: As a result of her cross-cutting research portfolio, Dr. Hysong is now principal investigator (PI) of the Houston Evidence-based Rapid Measurement and EvaluationS center (HERMES), an HSR&D QUERI Policy Evaluation Center (EBP 22-103) focused on rigorous, timely evaluations of healthcare and clinical work-life initiatives that inform and drive VA health policy. In its two year lifespan HERMES has already become a force multiplier, attracting an additional $5.7M in funds to inform VA policy on the benefits of alternative work schedules for the healthcare workforce and the areas of greatest need for evaluating the impact of the VA PACT Act. This center will continue to serve as a central platform for expanding her clinical work-life portfolio and creating a pipeline of future social scientists into HSR. Overall, Dr. Hysong's work improves the work environment of VHA clinicians and advances Secretary McDonough's goal of empowering a “high-performing workforce to best serve Veterans and their families.”