Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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1048 — Translating Research Into Practice Using Quality Improvement at the Frontline: Early Results From the Learn. Engage. Act. Process. (LEAP) Program

Lead/Presenter: Julie Lowery, COIN - Ann Arbor
All Authors: Damschroder LJ (Ann Arbor Center for Clinical Management Research (CCMR)) Goodrich DE (Ann Arbor Center for Clinical Management Research (CCMR)) Robinson CH (Ann Arbor Center for Clinical Management Research (CCMR)) Yankey N (Ann Arbor Center for Clinical Management Research (CCMR)) Palmer M (Ann Arbor Center for Clinical Management Research (CCMR)) Lowery JC (Ann Arbor Center for Clinical Management Research (CCMR))

Objectives:
The Learn. Engage. Act. Process. (LEAP) Program is designed to empower frontline staff to implement and enhance evidence-based programs by building quality improvement (QI) skills and supportive networks within the context of significant constraints on time and resources. Results from a developmental pilot and the first cohort of teams recruited for a large-scale stepped-wedge randomized control trial will be presented.

Methods:
LEAP is a 21-week structured program designed to train frontline staff in fundamental aspects of QI through weekly hands-on participation in a team-developed QI project. LEAP teams are provided with training curriculum and user-designed data reports, delivered via a collaborative online platform (VA-Pulse). Additionally, virtual group and individual QI coaching is provided to teams through video conferencing calls. LEAP was developed around videos and other materials from the Institute for Healthcare Improvement and HarvardX, and was piloted with three teams interested in making improvements to their local MOVE! weight management program. LEAP was refined based on formative feedback from the pilot and then retested with four more teams. Measures of self-assessed QI skills and local organizational readiness for implementing change (ORIC) were administered before and after participation in LEAP.

Results:
Participating teams agreed that though challenging to fit into their existing workflow, LEAP was feasible to complete. Team members reported significant improvements in self-assessments across six categories of QI skills (e.g., ability to construct and interpret a run chart) before versus after participation in LEAP (p's < 0.013). Lack of time was the biggest challenge for all participating teams amid pressures of fulfilling other clinical responsibilities. One of the perceived benefits of LEAP was the ability to apply acquired knowledge and skills to a current, high priority issue while participating in the program, thereby enhancing understanding concurrent to improving healthcare delivery. All team leaders planned to continue in the maintenance program (LEAPOn).

Implications:
LEAP was successful in helping frontline teams gain QI skills and it improved readiness for implementing change even with significant constraints of time and resources.

Impacts:
LEAP is a scalable program with potential to empower frontline staff to engage in QI, an important foundation for VHA to be a learning health system.