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School of Public Health

Christian D. Helfrich

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Research Associate Professor, Health Services

Research Investigator
Veterans Administration Puget Sound Health Care System


PhD   University of North Carolina, 2005   (Health Services)
MPH   University of Washington, 2000   (Health Services)
BA   Gonzaga University, 1998

Contact Info


web site:

1100 Olive Way, Suite 1400
Seattle, WA 98101

campus box:   Mailstop S-152
voice:   206-277-1655
fax:   206-764-2935


Christian Helfrich has been a member of the research faculty since 2009.  He can be found on Twitter (@helfrich_c)

Dissemination and implementation research; implementation science; organizational change; change management; de-implementation of ineffective and harmful practice

Helfrich CD, Simonetti JA, Clinton WL, Wood GB, Taylor L, Schectman G, Stark R, Rubenstein LV, Fihn SD, Nelson KM. The Association of Team-Specific Workload and Staffing with Odds of Burnout Among VA Primary Care Team Members. J Gen Intern Med. 2017 Feb 23. doi: 10.1007/s11606-017-4011-4. [Epub ahead of print]  PMID: 28233221

Cooper DC, Helfrich CD, Thielke SM, Trivedi RB, Nelson KM, Reiber GE, Eugenio EC, Beaver K, Nugent-Carney J, Fan VS. Association Between Mental Health Staffing Level and Primary Care-Mental Health Integration Level on Provision of Depression Care in Veteran's Affairs Medical Facilities. Adm Policy Ment Health. 2016 Dec 1. [Epub ahead of print]  PMID: 27909877

Simonetti JA, Sylling PW, Nelson K, Taylor L, Mohr DC, Curtis I, Schectman G, Fihn SD, Helfrich CD. Patient-Centered Medical Home Implementation and Burnout Among VA Primary Care Employees. J Ambul Care Manage. 2017 Apr/Jun;40(2):158-166. doi: 10.1097/JAC.0000000000000160.  PMID: 27893518

Schopfer DW, Takemoto S, Allsup K, Helfrich CD, Ho PM, Forman DE, Whooley MA. Notice of Retraction and Replacement. Schopfer DW, et al. Cardiac Rehabilitation Use Among Veterans With Ischemic Heart Disease. JAMA Intern Med. 2014;174(10):1687-1689. JAMA Intern Med. 2016 Oct 10. doi: 10.1001/jamainternmed.2016.5831.  PMID: 27723859

Hannon PA, Hammerback K, Allen CL, Parrish AT, Chan KG, Kohn MJ, Teague S, Beresford SA, Helfrich CD, Harris JR. HealthLinks randomized controlled trial: Design and baseline results. Contemp Clin Trials. 2016 May;48:1-11. doi: 10.1016/j.cct.2016.02.011. Epub 2016 Mar 2.  PMID: 26946121    PMCID: PMC4885764

ORCID ID: 0000000298274768

Google Scholar: 2Vg4gDkAAAAJ

Scopus ID: 13407517300

Chair, capstone for Kayla Down
Synthesis of the Patient Aligned Care Team (PACT) initiative for the United States Department of Veterans Affairs, Veterans Integrated Service Networks (VISN)

Chair, capstone for Alice Liu
Developing an implementation guide for UROSCOAP

Chair, thesis committee for Lauren Lawler
Medical home components associated with self-reported improvements in delivery of patient-centered care in VA primary care

Increasing Implementation of Evidence-Based Interventions at Low-Wage Worksites
National Institutes of Health (NIH)
PI:   Hannon           Dates:    5/1/2016 - 4/30/2017

Increasing Implementation of Evidence-Based Interventions at Low-Wage Worksites
National Institutes of Health (NIH)
PI:   Hannon           Dates:    5/1/2015 - 4/30/2016

Increasing Implementation of Evidence-Based Interventions at Low-Wage Worksites
National Institutes of Health (NIH)
PI:   Hannon           Dates:    5/1/2014 - 4/30/2015

Improving Safety and Quality through Evidence-Based De-Implementation of Ineffective Diagnostics and Therapeutics

Dr. Helfrich serves as Co-PI of a five-year QUERI program studying de-implementation strategies of harmful and ineffective clinical practices across multiple settings. The program incorporates extensive data on organizational context and stakeholder needs, and includes close partnerships with both national clinical leaders and local clinical champions.

The Organizational Readiness to Change Assessment (ORCA)

The ORCA is a structured self-report survey tool to assess the collective readiness of a clinical team or unit to implement a specific evidence-based clinical practice change, such as introducing hepatitis C screening and treatment in substance-use disorder clinics, or use of an evidence-based dosing algorithm for titrating warfarin in anti-coagulation clinics. Dr. Helfrich led a multi-site psychometric study of the ORCA and currently serves as co-investigator on three multi-site implementation trials that are using the ORCA, or have adapted the ORCA as part of implementation support activities.

Evaluations of Veterans Health Administration Transformational Initiatives

Dr. Helfrich has helped evaluate four VA initiatives to improve specialty care access and care coordination through the use of alternative consultation modalities, such as electronic specialty consults (via the electronic health record), and to expand the capabilities of primary care providers to manage specialty conditions.

Evaluating Implementation of the VA Patient-Aligned Care Team (PACT) initiative

In 2010, the VA began national implementation of a patient-centered medical home model emphasizing team-based care, alternative modalities for communicating with patients, such as secure messaging, and population-based, proactive health care. Dr. Helfrich was part of the national PACT evaluation, chairing a working group of researchers and consultants to design and field a national primary care employee survey, with particular attention to assessing team-based care, barriers to effective team functioning and employee burnout. Many presentations of the findings from this work are available as video seminars: