title: Using a virtual breakthrough series collaborative to improve access in primary care.
abstract: BACKGROUND
  The Institute for Healthcare Improvement (IHI) pioneered the Breakthrough Series (BTS), a short-term improvement project that convenes, in three face-to-face meetings, hospital or clinic teams to make rapid, significant improvement. A distance-learning (virtual) version of the BTS-a VBTS-was conducted.
  
  
  METHODS
  A model VBTS was tested with 20 organizations, using a well-established topic: improving access and efficiency in primary care. This VBTS took place by Internet and telephone, using Web-based collaboration software and audioconferencing.
  
  
  RESULTS
  For the 17 organizations completing the VBTS, the average number of days to third-next-available appointment fell from 23 to 10 days (July 2004-June 2005). The Improvement Assessment Scale showed 59% of teams at level 4 or above ("significant" improvement, with most changes implemented, and evidence of sustained improvement in outcomes and plans for spread). Potential direct cost savings were about $12,000 as compared with a traditional collaborative. Six months after the VBTS's conclusion, 70% of the teams that achieved significant improvement either maintained gains or improved their results.
  
  
  CONCLUSIONS
  Outcomes in a VBTS are potentially comparable to those in a traditional collaborative, at substantially lower cost. Prerequisites for success include senior leadership's involvement, team members' ability to participate, and information technology support.
authors.affiliation: Institute for Healthcare Improvement, Cambridge, Massachusetts, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Boushon
authors.forename: Lloyd
authors.initials: L
authors.lastname: Provost
authors.forename: Janice
authors.initials: J
authors.lastname: Gagnon
authors.forename: Penny
authors.initials: P
authors.lastname: Carver
mesh_terms: D001071:Appointments and Schedules; D017046:Cost Savings; D020375:Education, Distance; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training / Q000379:methods; D020407:Internet; D017146:Models, Organizational; D009936:Organizational Innovation; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care / Q000379:methods; D014584:User-Computer Interface