Challenges of collaborative improvement in complex continuing care

The Improving Continence Care in Complex Continuing Care (IC 5) Collaborative Project was the first multi-hospital quality improvement project conducted by the Hospital Report Research Collaborative aimed at the complex continuing care sector. Using the Breakthrough Series collaborative methodology developed by the Institute for Healthcare Improvement, 12 teams from various hospitals across Ontario worked together for 10 months under the guidance of quality improvement consultants and content experts in continence care. The project was carried out by the University of Toronto IC 5 research team, composed of principal investigators, clinical and improvement experts, coaches and a project manager. This article shares what it was like to participate in the IC 5 Collaborative Project. It presents interviews conducted with a sample of the participants and the coaches to gain a richer understanding of their IC 5 experience. The article discusses key points for organizations to consider before they engage in an improvement collaborative, based on the participants' views of what worked well and challenges they experienced, and suggestions about what they would do differently.