COIN Investigators & Staff
COIN Investigators
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Catherine T. Battaglia, PhD, MSHA, RN
- Title: Core Investigator; Dissemination & Implementation Methodologist; Co-Director VA Advanced Fellowship Program in HSR (Denver)
Professor, University of Colorado School of Public Health - Contact: Catherine.Battaglia@va.gov
- Location: Denver
- University of Colorado webpage
Dr. Battaglia is a nurse scientist and core investigator in the Denver-Seattle Center of Innovation (COIN) at the VA Eastern Colorado Health Care System. She has a strong background in health systems research, dissemination/implementation of interventions in routine clinical practice and mixed methods analyses. Dr. Battaglia is the Principal Investigator (PI) of the Triple Aim QUERI and two Transitions of Care quality improvement projects. She is the site PI for two Investigator-Initiated Research (IIR) grants. Dr. Battaglia also completed a VA Nursing Research Initiative (NRI) Merit Award (2009-2014), a Substance Use Disorder QUERI, and quantitative/qualitative evaluations for operational programs. In addition to research, Dr. Battaglia oversees the Denver Research Education and Mentor Program in the COIN, which is responsible for the Advanced VA Health Systems Research Postdoctoral Fellowship Program, a joint Grand Rounds series with COIN, RMIRECC, and GRECC as well as the Junior Faculty Leadership Seminars.
Dr. Battaglia is also a member of the ACCORDS (The Adult and Child Consortium for Health Outcomes Research and Delivery Science) Dissemination and Implementation Core and has planned several regional conferences. As an Associate Professor in the Health System Management and Policy Department in the Colorado School of Public Health at the University of Colorado Anschutz Medical Campus, Dr. Battaglia has mentored ~25 PhD, DNP, and master’s students, postdoctoral fellows, and a VA career development awardee over the past 13 years.
Grants & Funding
Value-Based Care to Improve the Quadruple Aim for Veterans and Stakeholders
Role: PI with Co-PIs: Joe Frank & P. Michael Ho
The Quadruple Aim Quality Enhancement Research Initiative (QUERI) aims to improve the care and experience for Veterans, clinician engagement, and reduce the cost of care. We will improve care coordination between Veterans Health Administration (VA) and community settings for Veterans using three evidence-based practices rooted in care coordination models to achieve consistently safe, efficient, and effective care for Veterans who are:
1) referred to home health care after discharge from VA,
2) receiving medication treatment for Opioid Use Disorders in the community, and
3) hospitalized or receiving emergency care in the community and return to VA or VA-assigned community PCP for ongoing care.
Veterans with complex medical and social needs will be case managed by a multidisciplinary team to ensure timely access to care and linkage to resources. The Quadruple Aim QUERI will improve health with optimal patient and clinician experience at a lower cost.
Funder: Veterans Affairs
NIH website
Designing for Dissemination and Implementation Training Hub
The Designing for Dissemination and Implementation (D4D&I) Training Hub aims to train Veterans Health Administration (VA) researchers, practitioners, and operational leaders/staff in the D4D&I implementation strategy.
The D4D&I strategy targets program adoption, implementation, sustainment, and scale-up and spread. The four multicomponent D4D&I implementation strategy bundles of the D4D&I strategy are:
1) Pre-implementation assessment for planning and evaluation of multi-level context using the Practical, Robust Implementation and Sustainability Model (PRISM) to ensure program success and sustainability,
2) Multi-level stakeholder engagement to learn what is important to end-users and garner program buy-in,
3) Implementation and adaptations guided by the pre-implementation assessment and stakeholders while retaining fidelity to care coordination program core components, and
4) Program evaluation using RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) to define program outcomes.
Funder: Veterans Administration
NIH website
Publications of note:
Designing for Dissemination and Implementation Training Hub
Optimizing Transitions for Dual-Use Veterans Living with Dementia following Hospitalization in the Community
Role: Co-Mentor/Co-I; PI: Roman Ayele
The VA mandated expanded community care services for Veterans with the MISSION Act of 2018. We have increasingly partnered with community-based facilities to provide acute care for Veterans Living with Dementia (VLWD).
Research shows that transitions across care systems are vulnerable times, resulting in fragmentation and worse health outcomes. Unfortunately, these Veterans are at an increased risk of adverse outcomes, resulting in physical and emotional deterioration.
Our work will evaluate transitions of care from community hospitals to VA care using a mixed-methods approach. We will identify important risk factors that lead to adverse outcomes during transitions for dual-use VLWD. We will then develop and pilot an intervention to improve transitions of care. This work is a high-priority area of the VA’s MISSION Act implementation. The VA Offices of Geriatrics and Extended Care, Community Care, and Emergency Medicine support it.
Funder: Veterans Administration
NIH Reporter: NIH website
Publications of note:
— Barriers and facilitators to goals of care conversations with Veteran residents of community nursing homes
Care Coordination and Outcomes for High Risk Patients: Building the Evidence for Implementation
Role: VA Partner
Purpose: Build evidence about the CCNA, processes, outcomes, and costs for high need, high risk Veterans seeking VA covered healthcare.
Funder: Veterans Administration, HSR
Veteran Access Research Consortium (VARC) Rapid Start Grant Proposal Improving Access to VA Mental Health and Suicide Prevention Services: A Pilot Study of Intensive Case Management between VA and Community Care
Role: Co-I
Purpose: This grant aims to develop and pilot test a case management intervention tailored to Veterans at risk for suicide who are referred out to the community for healthcare services (e.g., dual users) to ensure timely access to specialty mental health care and strengthen the suicide prevention safety net.
Funder: Veterans Administration, HSR
Building Supportive Learning Environments: Implementation Research in VA Cardiac Cath Labs
Role: Primary Mentor and Co-Investigator; PI: Heather Gilmartin
This project is relevant to all aspects of VA healthcare. It will develop and evaluate a training toolkit to assist healthcare teams in changing their culture toward learning to enhance Veteran care. This work will support the VA's transformation to a learning health system, so clinicians can see every patient encounter as a way to improve the next one.
By studying unit-level learning environments, we identify high-reliability practices supporting a learning culture and then use this knowledge to adapt a team training program to the culture and workflow of clinical units.
We will develop and test a training toolkit to empower teams to build their own learning culture and a rigorous mixed methods evaluation that leads to valid, generalizable lessons across healthcare settings. We expect this study to result in positive changes in learning environments, teamwork, and the highly-reliable use of evidence-based practices.
The findings will inform future studies to determine the impact of learning environments on Veteran outcomes.
Funder: Veterans Affairs
NIH website
Publications of note:
— Learning environments, reliability enhancing work practices, employee engagement, and safety climate in VA cardiac catheterization laboratories
— "Our Hands Are Tied Until Your Doctor Gets Here": Nursing Perspectives on Inter-hospital Transfers
— A pilot study to assess the learning environment and use of reliability enhancing work practices in VHA cardiac catheterization laboratories
Evaluation Care Coordination in Community Hospitalized Veterans to Improve Outcomes in Dual Use (ECHOeD)
Role: Site-PI/Co-Investigator
Purpose: The goal of the proposed research is to evaluate the Office of Community Care interventions related to care coordination of dual use Veterans.
Funder: Veterans Administration, HSR
Recent Publications
2024
Mu Q, Guzman-Clark J, Etchin AG, Sullivan SC, Battaglia C. Exploring the Roles, Functions, and Work Experiences of Nurse Scientists in the Veterans Health Administration. J Nurs Adm. 2024 Jun 1;54(6):378-384. doi: 10.1097/NNA.0000000000001442.
PMID: 38767529.
Gilmartin HM, Connelly B, Hess E, Mueller C, Plomondon ME, Waldo SW, Battaglia C. Developing a relational playbook for cardiology teams to cultivate supportive learning environments, enhance clinician well-being, and veteran care. Learn Health Syst. 2023 Aug 10;8(2):e10383. doi: 10.1002/lrh2.10383. PMCID: PMC11019383.
PMID: 38633018.
Mog AC, St Pierre CM, Moriarty HJ, Sullivan SC, Battaglia C. Looking back to move forward: Creating a blueprint for success for nurse scientists in the Veterans Health Administration. Appl Nurs Res. 2024 Feb;75:151764. doi: 10.1016/j.apnr.2024.151764. Epub 2024 Feb 23.
PMID: 38490795
2023
Ritchey KC, Yohannes AM, Locke ER, Chen S, Simpson T, Battaglia C, Trivedi RB, Swenson ER, Edelman J, Fan VS. Association between self-reported falling risk and risk of hospitalization for patients with chronic obstructive pulmonary disease. Respir Med. 2023 Nov 17:107466. doi: 10.1016/j.rmed.2023.107466. Epub ahead of print.
PMID: 37981244.
Connelly B, Hess E, Daus M, Battaglia C, Gilmartin HM. Conducting health systems research during the COVID-19 pandemic: experiences from the veterans health administration. BMC Health Serv Res. 2023 Nov 16;23(1):1267. doi: 10.1186/s12913-023-10296-y. PMCID: PMC10655445.
PMID: 37974219.
Learn more about this publication on Dimensions
Locke ER, Thomas RM, Simpson TL, Fortney JC, Battaglia C, Trivedi RB, Gylys-Colwell J, Swenson ER, Edelman JD, Fan VS. Cognitive and Emotional Responses to COPD Exacerbations and Patterns of Care Seeking. Ann Am Thorac Soc. 2023 Nov 15. doi: 10.1513/AnnalsATS.202303-287OC. Epub ahead of print.
PMID: 37966313.
Learn more about this publication on Dimensions
Radcliff T, Ayele R, McCreight M, Lui W, Battaglia C. Implementation of VA care coordination program to improve transitional care for veterans post-non-VA hospital discharge: an incremental cost analysis. Implement Sci Commun. 2023 Nov 13;4(1):135. doi: 10.1186/s43058-023-00513-4.
PMID: 37957780
Learn more about this publication at Dimensions
Gilmartin HM, Battaglia C. A methodological progress note: Introducing qualitative focus group research and the brainwriting premortem. J Hosp Med. 2023 Oct 26. doi: 10.1002/jhm.13227. Epub ahead of print. PMID: 37882241.
PMID: 37774091.
Learn more about this publication on Dimensions
Pattock AM, Locke ER, Hebert PL, Simpson T, Battaglia C, Trivedi RB, Swenson ER, Edelman J, Fan VS. Predictors of Patient-Reported and Pharmacy Refill Measures of Maintenance Inhaler Adherence in Veterans with COPD. Ann Am Thorac Soc. 2023 Sep 29. doi: 10.1513/AnnalsATS.202211-975OC. Epub ahead of print.
PMID: 37774091.
Learn more about this publication on Dimensions
Keniston A, McCreight MS, Burden M, Moore SL, Haugen H, Rice J, Battaglia C. Communicating Patient Discharge Readiness: An Implementation Evaluation in an Inpatient Hospital Medicine Setting. J Nurs Care Qual. 2023 Sep 8. doi: 10.1097/NCQ.0000000000000738. Epub ahead of print.
PMID: 37729000
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Hynes DM, Govier DJ, Niederhausen M, Tuepker A, Laliberte AZ, McCready H, Hickok A, Rowneki M, Waller D, Cordasco KM, Singer SJ, McDonald KM, Slatore CG, Thomas KC, Maciejewski M, Battaglia C, Perla L. Understanding care coordination for Veterans with complex care needs: protocol of a multiple-methods study to build evidence for an effectiveness and implementation study. Front Health Serv. 2023 Aug 15;3:1211577. doi: 10.3389/frhs.2023.1211577. PMCID: PMC10465329.
PMID: 37654810
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Mehta AB, Douglas IS, Battaglia C, Wynia MK. Utilization of Hospital Do-Not-Resuscitate Orders in Older Adults During COVID-19 Surges in 2020. J Palliat Med. 2023 Aug 24. doi: 10.1089/jpm.2023.0277. Epub ahead of print.
PMID: 37616551
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2022
Sjoberg H, Kenney RR, Morgan B, Connelly B, Jones CD, Ali HN, Battaglia C, Gilmartin HM. (2022). Adaptations to relational facilitation for two national care coordination programs during COVID-19. Frontiers in Health Services. DOI=10.3389/frhs.2022.952272
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Morrow CD, Perraillon MC, Wald HL, Nelson JL, Reeder BP, Battaglia C, Boxer RS. Challenges in Heart Failure Disease Management in Skilled Nursing Facilities: A Qualitative Study. J Gerontol Nurs. 2022 May;48(5):14-17. doi: 10.3928/00989134-20220404-04. Epub 2022 May 1.
PMID: 35511061
Learn more about this publication on Dimensions
Gilmartin HM, Hess E, Mueller C, Connelly B, Plomondon ME, Waldo SW, Battaglia C. Learning environments, reliability enhancing work practices, employee engagement, and safety climate in VA cardiac catheterization laboratories. Health Serv Res. 2022 Apr;57(2):385-391. doi: 10.1111/1475-6773.13907.
PMID: 35297037
Learn more about this publication on Dimensions
Locke ER, Young JP, Battaglia C, Simpson TL, Trivedi R, Simons C, Fortney JC, Hebert P, Swenson ER, Edelman J, Fan VS. Care-seeking and delay of care during COPD exacerbations. NPJ Prim Care Respir Med. 2022 Feb 15;32(1):7. doi: 10.1038/s41533-022-00269-9.
PMID: 35169140
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Sjoberg H, Liu W, Rohs C, Ayele RA, McCreight M, Mayberry A, Battaglia C. Optimizing care coordination to address social determinants of health needs for dual-use veterans. BMC Health Serv Res. 2022 Jan 12;22(1):59. doi: 10.1186/s12913-021-07408-x. PMCID: PMC8754195.
PMID: 35022053
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2021
Schuster ALR, Perraillon MC, Paul JJ, Leiferman JA, Battaglia C, Morrato EH. The Effect of the Affordable Care Act on Women's Postpartum Insurance and Depression in 5 States That Did Not Expand Medicaid, 2012-2015. Med Care. 2021 Oct 19. doi: 10.1097/MLR.0000000000001652. Epub ahead of print.
PMID: 34670222
Connelly B, Battaglia C, Gilmartin HM. A dissemination strategy to promote relational coordination in the veterans health administration: a case study. BMC Health Serv Res. 2021 Sep 27;21(1):1018. doi: 10.1186/s12913-021-07009-8.
PMID: 34579712
Hwang SS, Tong S, Pyle L, Battaglia C, McManus B, Niermeyer S, Sauaia A. Impact of State Prioritization of Safe Infant Sleep Programs on Supine Sleep Positioning for Non-Hispanic White and Non-Hispanic Black Infants. Am J Perinatol. 2021 Sep 20. doi: 10.1055/s-0041-1735262. Epub ahead of print.
PMID: 34544194
Suresh M, Young J, Fan V, Simons C, Battaglia C, Simpson TL, Fortney JC, Locke ER, Trivedi R. Caregiver Experiences and Roles in Care Seeking During COPD Exacerbations: A Qualitative Study. Ann Behav Med. 2021 Jun 24:kaab045. doi: 10.1093/abm/kaab045. Epub ahead of print.
PMID: 34165138
Gilmartin HM, Plomondon ME, Mueller C, Connelly B, Battaglia C, Waldo SW, Doll J. The Impacts of COVID-19 on Veterans Affairs Catheterization Laboratory Staff During the First Months of the US Response. J Cardiovasc Nurs. 2021 May 19. doi: 10.1097/JCN.0000000000000828. Epub ahead of print.
PMID: 34016839
Gilmartin HM, Hess E, Mueller C, Plomondon ME, Waldo SW, Battaglia C. A pilot study to assess the learning environment and use of reliability enhancing work practices in VHA cardiac catheterization laboratories. Learn Health Syst. 2020 Apr 8;5(2):e10227. doi: 10.1002/lrh2.10227. PMCID: PMC8051348.
PMID: 33889736
Hwang SS, Tong S, Smith RA, Barfield WD, Pyle L, Battaglia C, McManus B, Niermeyer S, Sauaia A. Persistent Racial/Ethnic Disparities in Supine Sleep Positioning among U.S.-born Preterm Infants, 2000-2015. J Pediatr. 2021 Mar 4:S0022-3476(21)00209-2. doi: 10.1016/j.jpeds.2021.02.070. Epub ahead of print.
PMID: 33676934
Fletcher DR, Grunwald GK, Battaglia C, Ho PM, Lindrooth RC, Peterson PN. Association Between Increased Hospital Reimbursement for Cardiac Rehabilitation and Utilization of Cardiac Rehabilitation by Medicare Beneficiaries: An Interrupted Time Series. Circ Cardiovasc Qual Outcomes. 2021 Mar 8:CIRCOUTCOMES120006572. doi: 10.1161/CIRCOUTCOMES.120.006572. Epub ahead of print.
PMID: 33677975
Morrow CD, Reeder BP, Perraillon MC, Ozkaynak M, Wald HL, Eber LE, Trojanowski JI, Battaglia C, Boxer RS. Information Needs of Skilled Nursing Facility Staff to Support Heart Failure Disease Management. AMIA Annu Symp Proc. 2021 Jan 25;2020:878-885. PMCID: PMC8075486.
PMID: 33936463
2020
Rugs D, Toyinbo P, Barrett B, Melillo C, Chavez M, Cowan L, Jensen PK, Engstrom C, Battaglia C, Thorne-Odem S, Sullivan SC, Powell-Cope G. A preliminary evaluation of full practice authority of advance practice registered nurses in the Veterans Health Administration. Nurs Outlook. 2021 Mar-Apr;69(2):147-158. doi: 10.1016/j.outlook.2020.11.005. Epub 2020 Dec 30.
PMID: 33388163
Gilmartin HM, Connelly B, Hebbe A, Battaglia C, Kwan BM. Assessing the impact of remote work during COVID-19 on clinical and translational scientists and staff in Colorado. J Clin Transl Sci. 2020 Dec 21;5(1):e71. doi: 10.1017/cts.2020.570. PMCID: PMC8027555.
PMID: 34192046
Galinsky T, Deter L, Krieg E, Feng HA, Battaglia C, Bell R, Haddock KS, Hilton T, Lynch C, Matz M, Moscatel S, Riley FD, Sampsel D, Shaw S. Safe patient handling and mobility (SPHM) for increasingly bariatric patient populations: Factors related to caregivers' self-reported pain and injury. Appl Ergon. 2021 Feb;91:103300. doi: 10.1016/j.apergo.2020.103300. Epub 2020 Nov 12.
PMID: 33190057
Gilmartin HM, Battaglia C, Warsavage T, Connelly B, Burke RE. Practices to support relational coordination in care transitions: Observations from the VA rural Transitions Nurse Program. Health Care Manage Rev. 2020 Nov 11. doi: 10.1097/HMR.0000000000000300. Epub ahead of print.
PMID: 33181554
McCarthy MS, Stonecipher JJ, Gilmartin H, El-Hajj D, Battaglia C. An interdisciplinary postdoctoral fellowship model: Opportunities for nurse PhDs. J Nurs Educ Pract. 2020;10(2):10.5430/jnep.v10n2p33. doi: 10.5430/jnep.v10n2p33. PMCID: PMC7590921.
PMID: 33117466
Morrow C, Perraillon MC, Daddato AE, Reeder BP, Wald HL, Battaglia C, Boxer RS. Patient Characteristics Are Not Associated With Documentation of Weight and Heart Failure Related Sign and Symptom Assessment in Skilled Nursing Facilities. J Am Med Dir Assoc. 2020 Oct 15:S1525-8610(20)30739-8. doi: 10.1016/j.jamda.2020.08.033. Epub ahead of print.
PMID: 33071159
Gilmartin, H., Connelly, B., Hebbe, A., Battaglia, C., & Kwan, B. (2020). Assessing the Impact of Remote Work During COVID-19 on Clinical and Translational Scientists and Staff in Colorado. Journal of Clinical and Translational Science, 1-26.
doi:10.1017/cts.2020.570
Ayele RA, Liu W, Rohs C, McCreight M, Mayberry A, Sjoberg H, Kelley L, Glasgow RE, Rabin BA, Battaglia C. VA Care Coordination Program Increased Primary Care Visits and Improved Transitional Care for Veterans Post Non-VA Hospital Discharge. Am J Med Qual. 2020 Aug 10:1062860620946362. doi: 10.1177/1062860620946362. Online ahead of print.
PMID: 32772849
Boggs JM, Beck A, Ritzwoller DP, Battaglia C, Anderson HD, Lindrooth RC. A Quasi-Experimental Analysis of Lethal Means Assessment and Risk for Subsequent Suicide Attempts and Deaths. J Gen Intern Med. 2020 Jun;35(6):1709-1714. doi: 10.1007/s11606-020-05641-4. Epub 2020 Feb 10.
PMID: 32040838
Glasgow RE, Battaglia C, McCreight M, Ayele RA, Rabin BA. Making Implementation Science More Rapid: Use of the RE-AIM Framework for Mid-Course Adaptations Across Five VA Health Systems Research Projects in the Veterans Health Administration. Front Public Health. 2020 May 27;8:194. doi: 10.3389/fpubh.2020.00194. eCollection 2020.
PMID: 32528921
2019
McCreight MS, Rabin BA, Glasgow RE, Ayele RA, Leonard CA, Gilmartin HM, Frank JW, Hess PL, Burke RE, Battaglia CT. Using the Practical, Robust Implementation and Sustainability Model (PRISM) to qualitatively assess multilevel contextual factors to help plan, implement, evaluate, and disseminate health services programs. Transl Behav Med. 2019 Nov 25;9(6):1002-1011. doi: 10.1093/tbm/ibz085.
PMID: 31170296
Ayele RA, Lawrence E, McCreight M, Fehling K, Glasgow RE, Rabin BA, Burke RE, Battaglia C. Perspectives of Clinicians, Staff, and Veterans in Transitioning Veterans from non-VA Hospitals to Primary Care in a Single VA Healthcare System. J Hosp Med. 2019 Oct 23;14(3):E1-E7. doi: 10.12788/jhm.3320. Epub ahead of print. PMCID: PMC7064299.
PMID: 31634102
Awards/Recognition
American Academy of Nursing Fellow - 2023
In June 2023 Cathy was inducted as a Fellow in the American Academy of Nursing.
The American Academy of Nursing's approximately 2,900 Fellows are nursing leaders in education, management, practice and research. Fellows represent association executives; university presidents, chancellors and deans; elected officials; state and federal political appointees; hospital chief executives and vice presidents for nursing; nurse consultants; and researchers and entrepreneurs.
Invitation to Fellowship is more than recognition of one's accomplishments within the nursing profession. Academy Fellows also have a responsibility to contribute their time and energies to the Academy, and to engage with other health leaders outside the Academy in transforming America's health system by:
- Enhancing the quality of health and nursing;
- Promoting healthy aging and human development across the life continuum;
- Reducing health disparities and inequalities;
- Shaping healthy behaviors and environments;
- Integrating mental and physical health; and
- Strengthening the nursing and health delivery system, nationally, and internationally.
Media (Video, Podcast, Other)
QUERI Implementation Research Group
Putting Science into Practice is Hard: But There is Help!
by Cathy Battaglia, Ph.D., RN ; Heidi Sjoberg, MSW, LCSW
Seminar date: 1/24/2022
Description: Abstract: Dissemination and Implementation Science (D&I) is a critical investment for the VA to improve the delivery of evidence based (EBP) healthcare and apply most up-to-date EBP in clinical practice. The presenters will review how to use D&I science to design for dissemination, implementation, and sustainability of EBP through the pre-implementation phase of planning an EBP, the implementation phase focusing how to implement an EBP with a D&I approach to enhance uptake of EBP, and lastly the sustainment phase of using D&I to evaluate an EBP and enhance sustainment.
Watch: Putting Science into Practice is Hard: But There is Help!
DOWNLOAD: PDF handout | Audio only (mp3) | transcript will be available at HSR webpage
