From the Chief Research and Development Officer

Timothy O'Leary, MD, PhD

Timothy O'Leary, MD, PhD

Our Office of Research and Development proudly celebrated its 90^th birthday in May. From its earliest days to today, VA Research has always aimed to discover knowledge, develop VA researchers and health care leaders, and create innovations that advance health care for Veterans and the nation.

While our guiding principles have not changed, our organization has continually transformed itself to better accomplish its mission. One recent important transformation has been the development of the CREATE (Collaborative Research to Enhance Transformation and Excellence) funding mechanism to promote research that has a meaningful impact on Veterans Health Administration (VHA) priorities.

The CREATE initiative encourages Health Services Research & Development investigators to collaborate with other VHA health care professionals to conduct research on issues that affect the health and health care of Veterans.

CREATE is defined by a group of coordinated research projects conducted in focused areas by independent collaborating investigators and their partners. CREATE projects target critical areas of interest to Veterans. These include PTSD, women's health, pain management, mental health—and long-term care, a subject of special importance to older Veterans and their families.

Residents of VA's Little Rock (Ark.) community living center take part in a therapeutic "drum circle" with recreation therapists and volunteers. (Photo by Jeff Bowen)

Residents of VA's Little Rock (Ark.) community living center take part in a therapeutic "drum circle" with recreation therapists and volunteers. (Photo by Jeff Bowen)

Long-term care is an important part of the transformation process currently underway throughout VHA, and the projects the long-term-care CREATE is undertaking reflect that transformation. Currently, our researchers are partnering with VA's office of Geriatrics and Extended Care to transform VA's long-term-care system from one that is institutionally based to one that is more Veteran-centric and community-based.

The four projects our researchers are working on include:

• Improving the culture of care in VA's community living centers (CLCs) by creating a toolkit that will help CLC leadership and staff to facilitate culture change;
• Reducing the number of hospitalizations among CLC residents by enhancing staff skills and improving care processes through staff training interventions;
• Documenting successes and variations among VA facilities in accelerating the discharge of CLC residents, so that they can return to a less restrictive setting more quickly; and
• Evaluating the safety and efficacy of the medical foster home concept, a community-based long-term-care program that is an alternative to nursing-home placement for Veterans who prefer care in private homes instead of institutional settings.

Each of these projects focuses on a transformation initiative the office of Geriatrics and Extended Care is undertaking: from improving care within CLCs, to realigning the discharge process, to examining the role of alternative community service programs. We are proud to share our expertise with our VHA partners.

Long-term care is just one area of significant importance to older Veterans and their families. VA researchers are pursuing new treatments, care models, and preventive strategies to improve the quality of life of "golden Veterans" and to support their caregivers. This issue of VA Research Quarterly Update includes information on many exciting advances our researchers have made recently to combat the conditions of aging. Since more than half of all Veterans are above the age of 60, meeting the challenges they face is of special importance to us.

The Office of Research and Development remains committed to optimizing the health and well-being of older Veterans, and all older Americans, just as we were 90 years ago. I hope you find the information in this issue interesting and useful.