COIN Investigators & Staff - Seattle-Denver Center of Innovation (COIN)
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Seattle-Denver Center of Innovation (COIN)


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COIN Investigators & Staff

COIN Investigators


George Sayre, PsyD
Title: Director, Seattle Denver COIN Qualitative Research Core
Department of Health Systems and Population Health, University of Washington
2018 HSR&D Health System Impact Awardee
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&D 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&D 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.

The following images visualize Dr. Sayre's work. The word cloud is drawn from publication titles. The research collaboration map shows research relationships (click the image to enlarge):

Dr. Sayre's publication titles indicate his primary work is care of Veterans
Word cloud from pub titles
Dr. Sayre's collaborations are primarily from the University of Washington
Research collaboration map
The following research fields have been used to summarize Dr. Sayre's publications and grants. The categories are based on 47 publications and 2 grants.
Publications Grants
Clinical Research Clinical Research
Health Services Health Services
Behavioral and Social Science Patient Safety
Prevention Behavioral and Social Science
Mental Health  
Clinical Trials and Supportive Activities  
Brain Disorders  
Post-Traumatic Stress Disorder (PTSD)  

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Recent Publications




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
Learn more about this publication on Dimensions.

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.
Learn more about this publication at Dimensions

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.
Learn more about this publication on Dimensions

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
Learn more about this publication on Dimensions

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.
Learn more about this publication on Dimensions

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.
Learn more about this publication on Dimensions

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
Learn more about this publication on Dimensions



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.



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.



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.

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Media (Video, Podcast, Other)


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:

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.

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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.

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Integrating Rapid Cycle Evaluation to Improve Cerner Implementation

NIH website: