title: Quality improvement learning collaboratives in public health:  findings from a multisite case study.
abstract: OBJECTIVE
  This study was designed to (1) test a theory on the key drivers of a successful mini-collaborative, (2) describe the application of quality improvement (QI) approaches and techniques among mini-collaborative participants, and (3) identify key attributes that affect the spread and sustainability of QI efforts within a local public health agency.
  
  
  METHODS
  A multisite case study methodology was used to evaluate a subset of mini-collaboratives and their participating local health departments that were working in specific target areas. Data were collected during semistructured interviews and while observing mini-collaborative meetings. Documentation reviews were also conducted. We used standard techniques to code the data on the basis of themes and connections between themes.
  
  
  RESULTS
  The findings provide early evidence that support our case study theory on the drivers of a successful mini-collaborative including advanced planning, the selection of faculty, timely training and technical assistance, the role of senior leaders, the application of evidence-based practices, the use of an improvement model, evaluation efforts, communication, the availability of resources, target selection, and prior experience with and application of QI. While the case studies provided limited evidence of sustainability and broad spread of QI within participating states, mini-collaboratives appear to have had a major impact and will likely influence the work of participating local health departments going forward.
  
  
  CONCLUSIONS
  Our findings suggest that the mini-collaboratives served as a catalyst for engaging local health departments in the theory and practice of QI.
authors.affiliation: Muskie School of Public Service, University of Southern Maine, Portland, Maine 04104, USA. bjoly@usm.maine.edu
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Joly
authors.forename: Maureen
authors.initials: M
authors.lastname: Booth
authors.forename: George
authors.initials: G
authors.lastname: Shaler
authors.forename: Ann
authors.initials: A
authors.lastname: Conway
mesh_terms: D015980:Public Health Practice / Q000592:standards*; D058996:Quality Improvement / Q000458:organization & administration*; D014481:United States