Continuous quality improvement at the frontline: One interdisciplinary clinical team's four-year journey after...

Area of Science:

• Healthcare Management
• Quality Improvement Science
• Health Services Research

Background:

• The Veterans Health Administration (VHA) prioritizes learning health systems.
• Continuous quality improvement (QI) is crucial for learning system maturity.
• Frontline interdisciplinary teams are key to implementing QI initiatives.

Purpose of the Study:

• To describe a frontline VHA team's learning experience in a QI coaching program.
• To evaluate the impact of the Learn. Engage. Act. Process. (LEAP) program on QI skills and patient outcomes.
• To explore the relationship between team learning, job satisfaction, and system maturity.

Main Methods:

• Mixed methods case study of one interdisciplinary frontline team.
• Autoethnographic qualitative descriptions of team experiences.
• Multilevel linear modeling to assess patient weight loss outcomes before and after LEAP participation.

Main Results:

• LEAP participation equipped the team with QI skills and fostered a commitment to learning.
• Patients in the MOVE! weight management program experienced significant weight loss post-LEAP (mean 9.80 lbs) compared to pre-LEAP (mean -6.83 lbs).
• The team demonstrated feasibility of data-driven continuous learning at the frontline.

Conclusions:

• Frontline QI engagement is achievable and can enhance job satisfaction and team cohesion.
• Successful QI implementation contributes to the development of mature learning health systems.
• The LEAP program provides a model for fostering continuous learning and improving patient outcomes in integrated health systems.