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Evidence-based Synthesis Program (ESP) Governance Structure

Program Description

HSR&D's Evidence-based Synthesis Program (ESP) was established to provide timely and 

accurate syntheses of targeted healthcare topics of particular importance to VA managers and 

policymakers, as they work to improve the health and healthcare of Veterans. The ESP 

disseminates these reports throughout VA. 

HSR&D provides funding for four ESP Centers and each Center has an active VA affiliation. 

The ESP Centers generate evidence syntheses on important clinical practice topics, and these 

reports help: 

Develop clinical policies informed by evidence;

Implementation of effective services to improve patient outcomes, and to support VA 

Clinical practice guidelines and performance measures; and

Set the direction for future research to address gaps in clinical knowledge.

Organizational Structure

Health Systems Committee

The Health Systems Committee (HSC) membership is made up of VA leadership including 

Directors and Chief Officers from VISNs and VAMCs, and Directors of VACO Offices. The HSC 

provides the following input and guidance to the Steering Committee:

Conduct a high-level review of the program to ensure the needs of key stakeholders are 

addressed;

Provide guidance to the program as a whole for quality improvement; 

Provide guidance on how the program can have more of an impact; and

Health Systems Committee

Steering Committee

Coordinating Center

Evidence-based Synthesis 

Program Centers

Durham ESP Minneapolis 

ESP Portland ESP West LA ESP

HSR&D
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Nominate appropriate staff members to serve on the ESP Steering Committee. 

The ESP Director, HSR&D, or designee will report to the Health Systems Committee on an 

annual basis.

Steering Committee Description

The Steering Committee membership is made up of participants from Patient Care Services 

(PCS), to include representatives from the VHA Pharmacy Benefits Management (PBM), 

Medical Advisory Panel (MAP), Technology Assessment Program (TAP) program, and others

named by the Chief PCS Officer; Office of Quality and Performance (OQP); Office of Nursing 

Services (ONS); HSR&D field-based investigators; VISN leadership; and others as designated 

appropriate by the HSC to ensure the needs of VA research and operations are met. The ESP 

Principal Investigators and synthesis team are not members of the Steering Committee; 

however, they are involved in the planning and conduct of the committee meetings. 

The Steering Committee, as key stakeholders and customers of the program, will provide the 

following input and guidance to the ESP for the following programmatic activities, implementing 

the direction provided by the HSC:

Help champion the program to increase nominations from the field, and drive the content of 

the program;

Review the program to ensure the needs of key stakeholders are addressed;

Guide the program’s quality improvement; and

Guide the program to increase its impact.

This committee will meet bi-annually, with assignments taking place between meetings. The 

committee will be chaired by ESP Director, HSR&D.

Coordinating Center

The Coordinating Center staffs the activities of the Steering Committee, develops and maintains

program processes, monitors progress of individual projects, coordinates dissemination 

activities, identifies best practices across reports, creates collaborations with VA leadership to 

identify new ESP topics of importance to the health system, and assists stakeholders in 

navigating their participation in the ESP. The Coordinating Center facilitates a monthly call of 

the ESP Principal Investigators and HSR&D leadership.

Mark Helfand, MD

Director

ESP Coordinating Center

Linda Humphrey, MD

Clinical Director

David Hickam, MD

Health Services

Investigator

Vivian Christensen, PhD

Health Services

Investigator

Nicole Floyd, MPH

Program Manager