This Research Career Scientist award will support Dr. Christine W. Hartmann in expanding her scientific research, mentoring, and service contributions beyond what would be otherwise possible, thereby considerably increasing her positive impact on the missions of VA and HSR&D. Dr. Hartmann is a senior VA health services researcher and implementation scientist conducting rigorous, health system-relevant research. She works closely with VA operational partners and has had tremendous success in rapidly translating research findings into practice. The portfolio of her work as PI concentrates primarily on improving care for some of VA's most vulnerable and high-risk Veterans, those living in VA's Community Living Centers (CLCs, i.e., nursing homes). At an annual cost of almost $4 billion, the CLC system provides vital care for Veterans who frequently contend with multiple chronic conditions and are often rejected by community nursing homes. Yet CLCs vary greatly in the quality of care they provide, with poor quality care sometimes making front-page national news, drawing attention at the highest levels of VA and Congress. Dr. Hartmann's portfolio of work identifies and addresses these gaps in quality of care. She has made substantial clinical and policy contributions through her two main research foci: pioneering the measurement and investigation of quality of care and being an exemplar of using implementation science to improve care outcomes. Dr. Hartmann's work in CLCs has had enormous impact. One example is from a line of HSR&D studies in which she developed effective, evidence-based interventions and an implementation strategy to enable CLC staff to improve their quality of care. Based on the studies' success, the Office of Geriatrics and Extended Care rolled the resulting interventions out nationally and created a national CLC quality improvement center that Dr. Hartmann co-directs. This center has $7 million in funding to date and yearly support for over 7 FTEE. Dr. Hartmann is also spreading these interventions outside VA. She was awarded a 5-year, $7.2 million NIH pragmatic clinical trial in community nursing home corporations to improve sleep outcomes for nursing home residents with dementia. QUERI has also funded Dr. Hartmann's implementation strategy as a Training Hub to enable its use outside the CLC setting. This work has led to meaningful and demonstrable improvements in CLCs' clinical quality outcomes and changes to national CLC policy and is only one example of the impact of her studies. In total, Dr. Hartmann has led, as PI, 8 large VA and NIH grants totaling almost $15 million. Dr. Hartmann contributes significantly at the local and national levels. She participates on VA and NIH grant review panels, publishes in top journals, and mentors extensively, including VISN 1 and HSR&D CDA awardees. She was recruited to her current university in part to provide faculty mentoring in grant proposal development. She is a sought-after speaker on ...