COIN Investigators & Staff
COIN Investigators
-
George Sayre, PsyD
- Title: Director, Qualitative Core (Seattle)
Clinical Assistant Professor, University of Washington School of Public Health - 2018 HSR Health System Impact Awardee
- Contact: George.Sayre@va.gov
- Location: Seattle
- University of Washington webpage
- See Dr. Sayre's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials
- The common aim of my work to provide insights into the experience of Veterans, VA providers, frontline staff, and community stakeholders, ensuring that their voices are heard by policymakers. I direct the COIN qualitative research core providing methods expertise and training across a wide range of HSR projects. My primary research focus is on partnered evaluation of national VA health system initiatives including access to care and EHR modernization. He is currently Co-PI of the Partnership Integrating Rapid Cycle Evaluation to Improve Cerner Implementation program (EMPRIC) and the Strengthening Cerner Implementation for Health Professions Trainees to Optimize Learning And Reinforce Veteran Care (SCHOLAR) QUERI partnered evaluations.
Receiving and providing healthcare is a deeply meaningful experience. I was honored to be the recipient of the 2018 HSR Health System Impact Award for critical contributions to VA’s efforts to ensure and improve Veterans’ access to care. This award reflected the work of many and I hope to continue working with amazing colleagues to contribute to the VAs mission to improve Veterans healthcare and the work experience of VA staff.
Recent Publications
2024
Kramer CB, Nelson KM, Sayre G, Williams JL, Spruill L, Fennell T, Gray KE, Weiner BJ, Fan V, Jones-Smith J, Rao M. "Veteran to Veteran, There's Automatically a Trust": A Qualitative Study of Veterans' Experiences in a Peer Health-Coaching Program for Hypertension. AJPM Focus. 2024 Jul 3;3(6):100257. doi: 10.1016/j.focus.2024.100257. PMID: 39415799; PMCID: PMC11481613.
PMID: 39415799.
Anderson E, Moldestad M, Brunner J, Ball S, Helfrich C, Orlander J, Rinne S, Sayre G. User Experiences of Transitioning From a Homegrown Electronic Health Record to a Vendor-Based Product in the Department of Veterans Affairs: Qualitative Findings From a Mixed Methods Evaluation. JMIR Form Res. 2024 Sep 10;8:e46901. doi: 10.2196/46901.
PMID: 39255006.
Ball SL, Rucci JM, Molloy-Paolillo BK, Cutrona SL, Brunner J, Mohr DC, Kim B, Moldestad M, Zepeda ED, Orlander JD, Anderson E, Cohen-Bearak A, Helfrich CD, Sayre G, Rinne ST. "For the first time…I am seriously fighting burnout": clinician experiences with a challenging electronic health record transition. JAMIA Open. 2024 Jul 15;7(3):ooae067. doi: 10.1093/jamiaopen/ooae067. PMCID: PMC11249389.
PMID: 39011033.
C. Bradley Kramer, Karin M. Nelson, George Sayre, Jennifer L Williams, Leon Spruill, Tiffanie Fennell, Kristen E. Gray, Bryan J. Weiner, Vincent Fan, Jessica Jones-Smith, Mayuree Rao. “Veteran to Veteran, there's automatically a trust”: A qualitative study of Veterans’ experiences in a peer health coaching program for hypertension., AJPM Focus, 2024, 100257, ISSN 2773-0654.
DOI: 10.1016/j.focus.2024.100257.
Ball SL, Kim B, Cutrona SL, Molloy-Paolillo BK, Ahlness E, Moldestad M, Sayre G, Rinne ST. Clinician and staff experiences with frustrated patients during an electronic health record transition: a qualitative case study. BMC Health Serv Res. 2024 Apr 26;24(1):535. doi: 10.1186/s12913-024-10974-5. PMCID: PMC11046755.
PMID: 38671473
2023
Simonetti JA, Holliday R, Mignogna J, Thomas S, Smith A, Betz M, Brenner LA, Sayre G. Patients' Perspectives on Medication-Related Suicide Prevention Interventions Delivered in Emergency Settings. Psychiatr Serv. 2023 Nov 7:appips20230178. doi: 10.1176/appi.ps.20230178. Epub ahead of print.
PMID: 37933134
Donovan LM, McDowell JA, Pannick AP, Pai J, Bais AF, Plumley R, Wai TH, Grunwald GK, Josey K, Sayre GG, Helfrich CD, Zeliadt SB, Hoerster KD, Ma J, Au DH. Protocol for a pragmatic trial testing a self-directed lifestyle program targeting weight loss among patients with obstructive sleep apnea (POWER Trial). Contemp Clin Trials. 2023 Nov 5;135:107378. doi: 10.1016/j.cct.2023.107378. Epub ahead of print.
PMID: 37935303
Moldestad M, Petrova VV, Tirtanadi K, Mishra SR, Rajan S, Sayre G, Fortney JC, Reisinger HS. Improving the Usability of Written Exposure Therapy for Therapists in the Department of Veterans Affairs Telemental Health: Formative Study Using Qualitative and User-Centered Design Methods. JMIR Form Res. 2023 Nov 6;7:e47189. doi: 10.2196/47189.
PMID: 37930747
Ahlness EA, Molloy-Paolillo BK, Brunner J, Cutrona SL, Kim B, Matteau E, Rinne ST, Walton E, Wong E, Sayre G. Impacts of an Electronic Health Record Transition on Veterans Health Administration Health Professions Trainee Experience. J Gen Intern Med. 2023 Oct 5. doi: 10.1007/s11606-023-08283-4. Epub ahead of print.
PMID: 37798576
Molloy-Paolillo B, Mohr D, Levy DR, Cutrona SL, Anderson E, Rucci J, Helfrich C, Sayre G, Rinne ST. Assessing Electronic Health Record (EHR) Use during a Major EHR Transition: An Innovative Mixed Methods Approach. J Gen Intern Med. 2023 Oct 5. doi: 10.1007/s11606-023-08318-w. Epub ahead of print.
PMID: 37798584
Ahlness EA, Orlander J, Brunner J, Cutrona SL, Kim B, Molloy-Paolillo BK, Rinne ST, Rucci J, Sayre G, Anderson E. "Everything's so Role-Specific": VA Employee Perspectives' on Electronic Health Record (EHR) Transition Implications for Roles and Responsibilities. J Gen Intern Med. 2023 Oct 5. doi: 10.1007/s11606-023-08282-5. Epub ahead of print.
PMID: 37798577
Rucci JM, Ball S, Brunner J, Moldestad M, Cutrona SL, Sayre G, Rinne S. "Like One Long Battle:" Employee Perspectives of the Simultaneous Impact of COVID-19 and an Electronic Health Record Transition. J Gen Intern Med. 2023 Oct 5. doi: 10.1007/s11606-023-08284-3. Epub ahead of print.
PMID: 37798583
Ives J, Bagchi S, Soo S, Barrow C, Akgün KM, Erlandson KM, Goetz M, Griffith M, Gross R, Hulgan T, Moanna A, Soo Hoo GW, Weintrob A, Wongtrakool C, Adams SV, Sayre G, Helfrich CD, Au DH, Crothers K. Design and methods of a randomized trial testing advancing care for COPD in people living with HIV by implementing evidence-based management through proactive E-consults (ACHIEVE). Contemp Clin Trials. 2023 Jul 20:107303. doi: 10.1016/j.cct.2023.107303. Epub ahead of print.
PMID: 37481201
Fortney JC, Rajan S, Chen JA, Campbell SB, Nolan JP, Wong E, Sayre G, Petrova V, Simons CE, Reisinger HS, Schnurr PP. A mixed-methods evaluation of why an implementation trial failed to engage veterans with posttraumatic stress disorder in trauma-focused psychotherapy. J Trauma Stress. 2023 Jun 27. doi: 10.1002/jts.22946. Epub ahead of print.
PMID: 37370238
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Leonard C, Sayre G, Williams S, Henderson A, Norvell D, Turner AP, Czerniecki J. Perceived shared decision-making among patients undergoing lower-limb amputation and their care teams: A qualitative study. Prosthet Orthot Int. 2023 Apr 17. doi: 10.1097/PXR.0000000000000234. Epub ahead of print. PMID: 37079358
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Lott AM, Danner AN, Malte CA, Williams EC, Gordon AJ, Halvorson MA, Saxon AJ, Hagedorn HJ, Sayre GG, Hawkins EJ. Clinician Perspectives on Delivering Medication Treatment for Opioid Use Disorder during the COVID-19 Pandemic: A Qualitative Evaluation. J Addict Med. 2023 Mar 2. doi: 10.1097/ADM.0000000000001156. Epub ahead of print.
PMID: 37579107
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Stryczek KC, Honsberger M, Ball SL, Barnard JG, Young JP, Felker B, Au DH, Ho PM, Kirsh SR, Sayre GG. VA Outreach Is an Essential Area for Improving Veterans' Health Care Accessibility. Mil Med. 2023 Feb 15:usad019. doi: 10.1093/milmed/usad019. Epub ahead of print.
PMID: 36790439.
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Henderson AW, Turner AP, Leonard C, Sayre G, Suckow B, Williams SL, Norvell DC, Czerniecki JM. Mortality conversations between male Veterans and their providers prior to dysvascular lower extremity amputation. Ann Vasc Surg. 2023 Feb 4:S0890-5096(23)00056-0. doi: 10.1016/j.avsg.2023.01.042. Epub ahead of print. PMID: 36746270
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2022
Spece LJ, Weppner WG, Weiner BJ, Collins M, Adamson R, Berger DB, Nelson KM, McDowell J, Epler E, Carvalho PG, Woo DM, Donovan LM, Feemster LC, Au DH, Au DH, Sayre G. Primary Care Provider Experience With Proactive E-Consults to Improve COPD Outcomes and Access to Specialty Care. Chronic Obstr Pulm Dis. 2022 Dec 5. doi: 10.15326/jcopdf.2022.0357. Epub ahead of print. PMID: 36472622.
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Schuttner L, Lee JR, Hockett Sherlock S, Ralston JD, Rosland AM, Nelson K, Simons C, Sayre GG. Primary Care Physician Perspectives on the Influence of Patient Values, Health Priorities, and Preferences on Clinical Decision-Making for Complex Patients with Multimorbidity: A Qualitative Study. Risk Manag Healthc Policy. 2022 Nov 16;15:2135-2146. doi: 10.2147/RMHP.S380021. PMCID: PMC9675988. PMID: 36415219.
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Hawkins EJ, Lott AM, Danner AN, Malte CA, Dulin PL, Fortney JC, Sayre GG, Baer JS. U.S. veterans' experiences and factors associated with use of a smartphone application to self-manage unhealthy alcohol use. Psychol Serv. 2022 Oct 13. doi: 10.1037/ser0000716. Epub ahead of print. PMID: 36227298
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Stevenson LD, Munro S, Klocko R, Sayre G. A mixed-methods evaluation of the national implementation of the Hospital-Acquired Pneumonia Prevention by Engaging Nurses (HAPPEN) initiative. Infect Control Hosp Epidemiol. 2022 Aug 30:1-8. doi: 10.1017/ice.2022.99. Epub ahead of print. PMID: 36039946
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Mog AC, Moldestad M, Kenney R, Stevenson L, Lee M, Ho PM, Sayre GG. "I was Unsure at First": A Qualitative Evaluation of Patient Perceptions of VA Clinical Video Telehealth Visits in the V-IMPACT Program. J Patient Exp. 2022 Jul 3;9:23743735221107237. doi: 10.1177/23743735221107237. PMCID: PMC9260561. PMID: 35813242
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Fortney JC, Rajan S, Reisinger HS, Moeckli J, Nolan JP, Wong ES, Rise P, Petrova VV, Sayre GG, Pyne JM, Grubaugh A, Simsek-Duran F, Grubbs KM, Morland LA, Felker B, Schnurr PP. Deploying a telemedicine collaborative care intervention for posttraumatic stress disorder in the U.S. Department of Veterans Affairs: A stepped wedge evaluation of an adaptive implementation strategy. Gen Hosp Psychiatry. 2022 Mar 26;77:109-117. doi: 10.1016/j.genhosppsych.2022.03.009. Epub ahead of print.
PMID: 35596963.
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Schuttner L, Hockett Sherlock S, Simons CE, Johnson NL, Wirtz E, Ralston JD, Rosland AM, Nelson K, Sayre G. My Goals Are Not Their Goals: Barriers and Facilitators to Delivery of Patient-Centered Care for Patients with Multimorbidity. J Gen Intern Med. 2022 May 23:1–8. doi: 10.1007/s11606-022-07533-1. Epub ahead of print. PMCID: PMC9126696.
PMID: 35606644.
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Leonard C, Sayre G, Williams S, Henderson A, Norvell D, Turner AP, Czerniecki J. Understanding the experience of veterans who require lower limb amputation in the veterans health administration. PLoS One. 2022 Mar 18;17(3):e0265620. doi: 10.1371/journal.pone.0265620. PMCID: PMC8932557.
PMID: 35303030
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Moldestad M, Sayre G, Rinne S, Kaboli PJ, Reddy A, Sanders KM, Mao J, Henrikson NB, Sterling R, Nelson KM, Wong ES. Perspectives on Training and Working in the VHA: Implications for Primary Care Physician Recruitment and Retention. Acad Med. 2022 Feb 8. doi: 10.1097/ACM.0000000000004619. Epub ahead of print.
PMID: 35139527.
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Schuttner L, Hockett Sherlock S, Simons C, Ralston JD, Rosland AM, Nelson K, Lee JR, Sayre G. Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study. BMC Prim Care. 2022 Feb 5;23(1):25. doi: 10.1186/s12875-022-01633-x.
PMID: 35123398.
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Mog AC, Liang PS, Donovan LM, Sayre GG, Shaukat A, May FP, Glorioso TJ, Jorgenson MA, Wood GB, Mueller C, Dominitz JA. Timely Colonoscopy After Positive Fecal Immunochemical Tests in the Veterans Health Administration: A Qualitative Assessment of Current Practice and Perceived Barriers. Clin Transl Gastroenterol. 2022 Jan 19. doi: 10.14309/ctg.0000000000000438. Epub ahead of print.
PMID: 35060937.
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Leonard C, Kenney RR, Lee M, Greene P, Whittington M, Kirsh S, Ho PM, Sayre G, Simonetti J. Common Ground: Primary Care and Specialty Clinicians' Perceptions of E-Consults in the Veterans Health Administration. Fed Pract. 2022 Jan;39(1):42-47b. doi: 10.12788/fp.0214. Epub 2022 Jan 12. PMCID: PMC8849031.
PMID: 35185320
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2021
Donovan LM, Mog AC, Blanchard KN, Magid KH, Syed AS, Kelley LR, Spece LJ, Palen BN, Arfons LM, Kirsh S, Au DH, Sayre GG. Staff Experiences with a Team-based Approach to Sleep Medicine Referrals: A Qualitative Evaluation. Ann Am Thorac Soc. 2021 Nov 17. doi: 10.1513/AnnalsATS.202107-838OC. Epub ahead of print.
PMID: 34788585.
House TR, Wightman A, Rosenberg AR, Sayre G, Abdel-Kader K, Wong SPY. Challenges to Shared Decision Making About Treatment of Advanced CKD: A Qualitative Study of Patients and Clinicians. Am J Kidney Dis. 2021 Oct 18:S0272-6386(21)00919-7. doi: 10.1053/j.ajkd.2021.08.021. Epub ahead of print.
PMID: 34673161
Robustelli BL, Campbell SB, Greene PA, Sayre GG, Sulayman N, Hoerster KD. Table for two: Perceptions of social support from participants in a weight management intervention for veterans with PTSD and overweight or obesity. Psychol Serv. 2021 Sep 13. doi: 10.1037/ser0000577. Epub ahead of print.
PMID: 34516204
Hawkins EJ, Danner AN, Malte CA, Blanchard BE, Williams EC, Hagedorn HJ, Gordon AJ, Drexler K, Burden JL, Knoeppel J, Lott A, Sayre GG, Midboe AM, Saxon AJ. Clinical leaders and providers' perspectives on delivering medications for the treatment of opioid use disorder in Veteran Affairs' facilities. Addict Sci Clin Pract. 2021 Sep 6;16(1):55. doi: 10.1186/s13722-021-00263-5. PMCID: PMC8419813.
PMID: 34488892.
Hartmann CW, Gillespie C, Sayre GG, Snow AL. De-implementing and sustaining an intervention to eliminate nursing home resident bed and chair alarms: interviews on leadership and staff perspectives. Implement Sci Commun. 2021 Aug 24;2(1):91. doi: 10.1186/s43058-021-00195-w. PMCID: PMC8383405.
PMID: 34429167
Hoerster KD, Tanksley L, Sulayman N, Bondzie J, Brier M, Damschroder L, Coggeshall S, Houseknecht D, Hunter-Merrill R, Monty G, Saelens BE, Sayre G, Simpson T, Wong E, Nelson K. Testing a tailored weight management program for veterans with PTSD: The MOVE! + UP randomized controlled trial. Contemp Clin Trials. 2021 Jun 16;107:106487. doi: 10.1016/j.cct.2021.106487. Epub ahead of print.
PMID: 34144246
Butler CR, O'Hare AM, Kestenbaum BR, Sayre GG, Wong SPY. An Introduction to Qualitative Inquiry. J Am Soc Nephrol. 2021 Jun 1;32(6):1275-1278. doi: 10.1681/ASN.2021040473. Epub 2021 May 26.
PMID: 34039668.
Donovan LM, Mog AC, Blanchard KN, Magid KH, Syed AS, Kelley LR, Palen BN, Parsons EC, McCall CC, Thompson W, Charlton M, Spece LJ, Kirsh S, Au DH, Sayre GG. Patient experiences with telehealth in sleep medicine: a qualitative evaluation. J Clin Sleep Med. 2021 Mar 23. doi: 10.5664/jcsm.9266. Epub ahead of print.
PMID: 33755010.
Hawkins EJ, Lott AM, Danner AN, Malte CA, Hagedorn HJ, Berger D, Donovan LM, Sayre GG, Mariano AJ, Saxon AJ. Primary Care and Mental Health Prescribers, Key Clinical Leaders, and Clinical Pharmacist Specialists' Perspectives on Opioids and Benzodiazepines. Pain Med. 2021 Mar 1:pnaa435. doi: 10.1093/pm/pnaa435. Epub ahead of print.
PMID: 33661287.
Marshall V, Stryczek KC, Haverhals L, Young J, Au DH, Ho PM, Kaboli PJ, Kirsh S, Sayre G. The Focus They Deserve: Improving Women Veterans' Health Care Access. Womens Health Issues. 2021 Feb 10:S1049-3867(20)30157-2. doi: 10.1016/j.whi.2020.12.011. Epub ahead of print.
PMID: 33582001.
Prabhu KM, Don C, Sayre GG, Kearney KE, Hira RS, Waldo SW, Rao SV, Au DH, Doll JA. Interventional Cardiologists' Perceptions of Percutaneous Coronary Intervention Quality Measurement and Feedback. Am Heart J. 2021 Feb 7:S0002-8703(21)00032-6. doi: 10.1016/j.ahj.2021.01.019. Epub ahead of print.
PMID: 33567319.
2020
Moldestad M, Stryczek KC, Haverhals L, Kenney R, Lee M, Ball S, Au D, Kirsh S, Sayre G, Young J. Competing Demands: Scheduling Challenges in Being Veteran-centric in the Setting of Health System Initiatives to Improve Access. Mil Med. 2020 Dec 8:usaa520. doi: 10.1093/milmed/usaa520. Epub ahead of print. PMID: .
PMID: 33289838.
Lee M, Leonard C, Greene P, Kenney R, Whittington MD, Kirsh S, Ho PM, Sayre G, Simonetti J. Perspectives of VA Primary Care Clinicians Toward Electronic Consultation-Related Workload Burden: A Qualitative Analysis. JAMA Netw Open. 2020 Oct 1;3(10):e2018104. doi: 10.1001/jamanetworkopen.2020.18104. PMCID: PMC7599439.
PMID: 33125494.
Parikh TJ, Stryczek KC, Gillespie C, Sayre GG, Feemster L, Udris E, Majerczyk B, Rinne ST, Wiener RS, Au DH, Helfrich CD. Provider anticipation and experience of patient reaction when deprescribing guideline discordant inhaled corticosteroids. PLoS One. 2020 Sep 17;15(9):e0238511. doi: 10.1371/journal.pone.0238511. PMC7498097.
PMID: 32941462.
Stryczek K, Lea C, Gillespie C, Sayre G, Wanner S, Rinne ST, Wiener RS, Feemster L, Udris E, Au DH, Helfrich CD. De-implementing Inhaled Corticosteroids to Improve Care and Safety in COPD Treatment: Primary Care Providers' Perspectives. J Gen Intern Med. 2020 Jan;35(1):51-56. doi: 10.1007/s11606-019-05193-2. Epub 2019 Aug 8. PMC6957635.
PMID: 31396814.
Oestreich T, Sayre G, O'Hare AM, Curtis JR, Wong SPY. Perspectives on Conservative Care in Advanced Kidney Disease: A Qualitative Study of US Patients and Family Members. Am J Kidney Dis. 2020 Sep 30:S0272-6386(20)31007-6. doi: 10.1053/j.ajkd.2020.07.026. Epub ahead of print.
PMID: 33010356.
Moldestad M, Greene PA, Sayre GG, Neely EL, Sulc CA, Sales AE, Reddy A, Wong ES, Liu CF. Comparable, but distinct: Perceptions of primary care provided by physicians and nurse practitioners in full and restricted practice authority states. J Adv Nurs. 2020 Nov;76(11):3092-3103. doi: 10.1111/jan.14501. Epub 2020 Sep 2.
PMID: 32875584.
Johnson NJ, Danielson KR, Counts CR, Ruark K, Scruggs S, Hough CL, Maynard C, Sayre MR, Carlbom DJ. Targeted Temperature Management at 33 Versus 36 Degrees: A Retrospective Cohort Study. Crit Care Med. 2020 Mar;48(3):362-369. doi: 10.1097/CCM.0000000000004159.
PMID: 31809279.
LeRouge C, Sangameswaran S, Frogner B, Snyder C, Rubenstein L, Kirsh S, Sayre G. The Group Practice Manager in the VHA: A View From the Field. Fed Pract. 2020 Feb;37(2):79-85. PMCID: PMC7138344.
PMID: 32269470.
2019
Stryczek K, Lea C, Gillespie C, Sayre G, Wanner S, Rinne ST, Wiener RS, Feemster L, Udris E, Au DH, Helfrich CD. De-implementing Inhaled Corticosteroids to Improve Care and Safety in COPD Treatment: Primary Care Providers' Perspectives. J Gen Intern Med. 2020 Jan;35(1):51-56. doi: 10.1007/s11606-019-05193-2. Epub 2019 Aug 8. PMCID: PMC6957635.
PMID: 31396814.
Media (Video, Podcast, Other)
Phenomenological Research and Health Services: Understanding the Lived Experience of Veterans with Lower Limb Amputations
8 June 2023
by Chelsea Leonard, PhD; George Sayre, PsyD
Clinician Experiences with VA’s Electronic Health Record Modernization: Initial Findings from the EMPIRIC QUERI Evaluation
This archive is available on the intranet only.
If you have intranet access, go to:
http://vaww.hsrd.research.va.gov/for_researchers/cyber_seminars/archives/video_archive.cfm?SessionID=4046
Understanding Access on the Ground: The Experience of Veterans, Providers and Staff
by George Sayre, PsyD
Seminar date: 4/18/2019
Description: This presentation will provide an overview of research focused on access to care and the VA’s efforts to improve access from the perspectives of Veterans, providers, and staff. Findings from these studies show a commitment to providing Veterans with the care they need, when they need it through both improved practice management and the implementation of innovative care delivery modalities. Associated challenges, barriers and unintended consequences will also be discussed. These findings provide an understanding of the complexity and subjectivity of access which are not fully reflected in purely numerical measures. Intended audience: Researchers and operational partners.
View online: Understanding Access on the Ground: The Experience of Veterans, Providers and Staff
Beyond Open-Ended Questions: Purposeful Interview Guide Development to Elicit Rich, Trustworthy Data
by George Sayre, PsyD ; Jessica Young, MPH, MSW
Seminar date: 3/21/2018
Description: This session will cover the following: a. Describe rigorous framework for qualitative interview data collection; b. Apply core concepts and methods for developing interview questions and guides; c. Understand the process of developing and refining interview questions and guides. Intended audience: New and experienced qualitative researchers, investigators using mixed methods, and interviewers.
View online: Beyond Open-Ended Questions: Purposeful Interview Guide Development to Elicit Rich, Trustworthy Data
Grants
Integrating Rapid Cycle Evaluation to Improve Cerner Implementation
NIH website: https://reporter.nih.gov/project-details/10178440
