Learning from the Virtual Breakthrough Series Collaboratives in the Veterans Health Administration

摘要

The concept of a Breakthrough Series (BTS) collaborative has been part of the health care improvement toolkit since it was first introduced by the Institute for Healthcare Improvement in the mid-1990s. Briefly, the BTS model convenes teams from health care or public health organizations to work on addressing a specific health topic or delivery process through a series of methods, including prework, assessments, learning sessions, Plan-Do-Study-Act cycles, action periods, and ongoing support (for example, conference calls, team reports, peer-to-peer visits, expert faculty consultation) in a relatively short period of time (6-15 months). BTS collaboratives have been implemented in various delivery settings to address a range of health issues (for example, congestive heart failure, HIV/ AIDS3) and organizational challenges such as employee absenteeism, wait times, and cost.2 More recently, there has been interest in leveraging the BTS model across health care systems using virtual approaches. The potential benefits of this approach are clear: A Virtual BTS (VBTS) collaborative can engage more clinical staff, involve a greater number of and more diverse delivery sites, and leverage expertise of top-notch faculty without the logistical, time, and cost restraints commonly encountered with an in-person collaborative. To date, however, limited research has investigated the implementation of the VBTS approach; additional evaluations are needed.