Christian Helfrich

faculty photo
Research Assistant Professor, Health Services

Postdoctoral Research Fellow
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


1100 Olive Way, Suite 1400
Seattle, WA 98101

campus box:   Mailstop S-152
voice:   206-277-1655
voice2:   206-764-2935

Organizational behavior; organizational culture; innovation implementation; change management

Ladebue AC, Helfrich CD, Gerdes ZT, Fihn SD, Nelson KM, Sayre GG. The experience of Patient Aligned Care Team (PACT) members. Health Care Manage Rev. 2014 Dec 23. [Epub ahead of print]  PMID: 25539056

Hannon PA, Helfrich CD, Chan KG, Allen CL, Hammerback K, Kohn MJ, Parrish AT, Weiner BJ, Harris JR. Development and Pilot Test of the Workplace Readiness Questionnaire, a Theory-Based Instrument to Measure Small Workplaces' Readiness to Implement Wellness Programs. Am J Health Promot. 2015 Sep 21. [Epub ahead of print]  PMID: 26389975

Dolan ED, Mohr D, Lempa M, Joos S, Fihn SD, Nelson KM, Helfrich CD. Using a Single Item to Measure Burnout in Primary Care Staff: A Psychometric Evaluation. J Gen Intern Med. 2014 Dec 2. [Epub ahead of print]  PMID: 25451989    PMCID: PMC4395610

Gale RC, Asch SM, Taylor T, Nelson KM, Luck J, Meredith LS, Helfrich CD. The most used and most helpful facilitators for patient-centered medical home implementation. Implement Sci. 2015 Apr 19;10:52. doi: 10.1186/s13012-015-0246-9.  PMID: 25924611    PMCID: PMC4414441

Ho PM, O'Donnell CI, Bradley SM, Grunwald GK, Helfrich C, Chapko M, Liu CF, Maddox TM, Tsai TT, Jesse RL, Fihn SD, Rumsfeld JS. 1-Year Risk-Adjusted Mortality and┬áCosts of Percutaneous Coronary Intervention in┬áthe Veterans Health Administration: Insights From the VA CART Program. J Am Coll Cardiol. 2015 Jan 27;65(3):236-42. doi: 10.1016/j.jacc.2014.10.048.  PMID: 25614420

view books/publications in WorldCat

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:    5/1/2015 - 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

Increasing Implementation of Evidence-Based Interventions at Low-Wage Worksites
National Institutes of Health (NIH)
PI:   Hannon           Dates:    5/1/2013 - 4/30/2014

Organizational culture and the VA cardiac initiative

Principal Investigator. Examining data on organizational culture from VHA employee survey conducted in 2004. The research has three objectives: 1) validate the organizational culture component of the survey, 2) test the association of organizational culture to changes in cardiac care process measures and mortality, and 3) describe differences between physician and nurse groups in perceptions of organizational culture adjusting for gender.

Measurement equivalence/invariance analysis of organizational culture

Principal Investigator. Assess the psychometric properties of a survey instrument to measure organizational culture to determine measurement equivalence of the instrument among employees of different supervisory levels, between clinicians and non-clinician employees, and employees from within the same medical centers over time. Data came from the 2004 and 2006 VA All Employee Surveys.

Evaluating the implementation of the VA cardiovascular assessment

Co-Principal Investigator. Evaluate implementation of VA Cardiovascular Assessment Reporting and Tracking System for Cath Labs (CART-CL) among 75 VA medical centers with onsite cardiac catheterization. Identify high and low implementing medical centers using catheterization laboratory registry data and CART-CL data; conduct interviews with staff at high and low implementation sites to identify, and compare and contrast implementation policies and practices; and conduct a survey of sites to identify technical and administrative barriers and facilitators to CART-CL installation and use.

Predicting implementation from organizational readiness to change

Principal Investigator. Quality improvement studies often report that different hospitals or organizations exhibit different levels of baseline readiness to change, such as in terms of planning, resources, and leadership support; and that baseline readiness is a powerful influence on subsequent success or failure of QI implementation. A reliable, valid way of assessing organizational readiness to change could be a useful tool both as a prognostic tool to understand when an organization has a high probability of implementing a new practice, and as a diagnostic tool to identify areas (e.g., planning and goal clarity) where readiness may weak but could be improved. This study builds on a successful pilot grant to conducting scale reliability and factor structure of a survey developed by the VA Ischemic Heart Disease Quality Enhancement Research Initiative. The current study conducts a range of psychometric tests, including combining data from 4 QI studies in the VA using the instrument prospectively; the study will determine if the ORCA scales and subscales predict effective implementation among VA hospitals implementing evidence-based quality improvement practices for depression, schizophrenia, Hepatitis, and eHealth remote access.

Process oriented, validated electronic performance measures pilot study

Co-Investigator. Develop and validate an automated performance measure for treatment of hyperlipidemia and hypertension in patients with ischemic heart disease using the VA electronic health record (EHR). The ultimate goal is to improve both the quality of care and the efficiency of performance measurement by translating performance measurement from labor intensive manual chart abstraction to automated extraction of continuously updated electronic data. Project active from 2007-2008.

Appropriateness of percutaneous coronary intervention

Co-Investigator. Percutaneous coronary intervention (PCI) is a costly clinical procedure that improves outcomes for certain high-risk cardiac patients but also carries a small, but significant risk of adverse outcomes. Recently, "appropriateness" criteria have been developed to help clinicians better identify patients who will benefit from PCI. The Veterans Health Administration is well-positioned to systematically integrate PCI appropriateness via the Cardiac Assessment Reporting and Tracking System - Cath Lab (CART-CL), a software package designed to create a single national VA data repository, procedure reporting, and quality improvement program for procedures performed in the 75 VA cardiac catheterization laboratories. The present study will develop the methods necessary to classify the appropriateness of PCIs performed nationwide in the VA through CART-CL. Project outcomes will be: (1) classification of appropriateness of PCI; (2) identification of data elements necessary for complete appropriateness classification of PCI; and (3) validation of CART-CL data elements for appropriateness classification. Project active from 2007-2011.