Primary care staff perspectives on a virtual learning collaborative to support medical home implementation.
BACKGROUND
Many organizations rely on quality improvement collaboratives (QICs) to facilitate Patient-Centered Medical Home (PCMH) implementation, and there is a trend toward conducting QIC activities virtually to reduce costs and expand their reach. However, the evidence base for QICs is limited; questions remain about how QICs operate, why they succeed or fail, and how they are experienced by participants.


OBJECTIVE
We surveyed participants in an innovative Virtual Collaborative (VC) designed to support PCMH implementation within one Veterans Integrated Service Network, to understand why and for whom the VC was more/less effective and identify opportunities for improvement.


METHODS
This anonymous online survey was designed to assess participants' views on the VC's usefulness, impact, and acceptability, and to explore variations by role, practice setting, prior training, and overall engagement in VC activities.


METHODS
Respondents were 353 primary care staff, including providers, nurses, and support staff.
The survey comprised 32 structured and three free-response items. Structured items assessed participation in and perceived usefulness of VC activities; perceived acceptability of the training format; overall perceived impact; and basic demographics. Responses were dichotomized and compared using Chi-square tests. Free-response items inviting constructive criticism of the VC were coded and summarized to identify themes and illustrative quotes.


RESULTS
The VC most benefited respondents with prior PCMH training and those who fully participated in VC activities. Respondents especially valued the opportunity to share experiences with other teams. Non-providers and those new to PCMH felt learning content did not meet their needs. Reported barriers to full participation included staffing constraints, insufficient and/or unprotected time, and inadequate leadership support.


CONCLUSIONS
Our study offers practical lessons for others considering a virtual collaborative model for PCMH spread. Findings contribute to the evidence base for QICs overall and virtual QICs in particular, highlighting the value of seeking input from "the trenches."
Center for Evaluation of Patient Aligned Care Teams (CEPACT), Philadelphia Veterans Affairs Medical Center, 3900 Woodland Ave, Building 4100, Philadelphia, PA, 19104, USA, Anneliese.Butler@va.gov.
Anneliese
A
Butler
Anne
A
Canamucio
David
D
Macpherson
Jennifer
J
Skoko
Gala
G
True
D003299:Cooperative Behavior; D003625:Data Collection / Q000379:methods*; D006801:Humans; D018802:Patient-Centered Care / Q000379:methods*; D011320:Primary Health Care / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs; D014584:User-Computer Interface