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Implementing a user-driven online quality improvement toolkit for cancer care.

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  • 1Oregon State University, Corvallis, OR; Veterans Administration (VA) Greater Los Angeles Healthcare System, Los Angeles; VA Palo Alto Health Care System; and Stanford University, Palo Alto, CA jeff.luck@oregonstate.edu.

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The Veterans Health Administration (VA) developed online toolkits for cancer quality improvement, achieving widespread use. Active engagement was linked to quality improvement activities, demonstrating effective use of health information technology.

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Area of Science:

  • Health Services Research
  • Quality Improvement Science
  • Health Informatics

Background:

  • Integrated health systems need effective methods for sharing quality improvement (QI) lessons.
  • The Veterans Health Administration (VA) created online toolkits linked to cancer quality indicators to facilitate this sharing.

Purpose of the Study:

  • Evaluate awareness and usage of VA online cancer quality improvement toolkits.
  • Assess variation in toolkit use across facilities.
  • Examine the impact of social marketing on toolkit adoption.
  • Identify factors influencing toolkit utilization.

Main Methods:

  • Utilized a diffusion of innovations framework.
  • Collected user activity data from the VA Toolkit Series SharePoint site.
  • Administered an online survey to potential Lung Cancer Care Toolkit users.

Main Results:

  • The VA Toolkit Series site attracted 5,088 unique visitors in 22 months, with high engagement from a small user group.
  • Social marketing efforts correlated positively with site usage.
  • Awareness of facility-level lung cancer quality performance and participation in QI collaboratives were associated with higher toolkit use.
  • Facility-level implementation of lung cancer tools showed significant variation.

Conclusions:

  • The VA Toolkit Series demonstrated broad adoption and user engagement, though facility-level use varied.
  • Highly engaged users were actively involved in cancer care quality improvement initiatives.
  • Toolkit use was reinforced by concurrent quality improvement activities.
  • A hybrid approach combining user-driven and centralized toolkit development effectively leveraged health IT for disseminating QI tools.