An HIV collaborative in the VHA: do advanced HIT and one-day sessions change the collaborative experience?
BACKGROUND
Many organizations participate in quality collaboratives, yet the return on investment of the associated time and costs is unclear.


METHODS
Semistructured interviews, surveys, and direct observation were used to assess experiences, improvement activities, and costs associated with participation in a year-long modified Institute for Healthcare Improvement-style collaborative designed to improve HIV care within the Veterans Health Administration. All nine sites had access to automated patient registries and semi-automated clinical measure reports; five sites also received computerized clinical reminders. Three one-day learning sessions were conducted.


RESULTS
Participants reported that burden was small and value high, although many suggested that more time for peer-to peer learning would have been helpful. Teams averaged five quality improvement activities per site and most reported improvements in HIV care processes. The average annual cost per site was dollars 28,000 but costs varied considerably by site.


CONCLUSIONS
Shortened learning sessions and the incorporation of health information technology can reduce some of the costs and burdens associated with collaboratives, yet peer-to-peer interaction and local organizational factors remain important to ensuring perceived effectiveness of collaboratives.
Fremont
Allen M
AM
Department of Veterans Affairs, Greater Los Angeles Healthcare System, CA, USA.
Joyce
Geoffrey
G
Anaya
Henry D
HD
Bowman
Candice C
CC
Halloran
James P
JP
Chang
Sophia W
SW
Bozzette
Samuel A
SA
Asch
Steven M
SM
D003299:Cooperative Behavior; D015658:HIV Infections / Q000191:economics / Q000628:therapy*; D006801:Humans; D007256:Information Systems / Q000191:economics / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D011785:Quality Assurance, Health Care / Q000191:economics / Q000458:organization & administration*; D017010:Reminder Systems; D014481:United States; D014493:United States Department of Veterans Affairs / Q000191:economics / Q000458:organization & administration*