title: Facilitation of a Multihospital Community of Practice to Increase Enrollment in the Hospital to Home National Quality Improvement Initiative.
abstract: BACKGROUND
  Hospital to Home (H2H) is a national quality improvement (QI) initiative composed of three recommended hospital interventions to improve the transition of care for hospitalized patients with heart disease. A study was conducted to determine if enrollment of Department of Veterans Affairs (VA) hospitals in H2H and adoption of the recommended interventions would both increase following facilitation of an existing Heart Failure (HF) provider-based community of practice (COP) within the VA health care system. The VA HF COP includes more than 800 VA providers and other VA staff from VA inpatient medical centers.
  
  
  METHODS
  In 2010, 122 VA hospitals were randomized to facilitation using the VA HF COP (intervention) or no facilitation (control). COP members from intervention hospitals were invited to periodic teleconferences promoting H2H and received multiple e-mails asking members to report interest and then progress in H2H implementation.
  
  
  RESULTS
  Among the 61 hospitals randomized to HF COP facilitation, 33 (54%) enrolled in H2H, compared with 6 (10%) of 61 control hospitals (p<.001) at five months after randomization. Of 38 intervention hospitals responding to the follow-up survey, 13 stated they had initiated 22 QI projects as a result of the H2H campaign. Another 7 hospitals had planned H2H projects. Of 20 control hospitals that responded, 5 had initiated 9 projects as a result of H2H, and no additional hospitals had plans to do so.
  
  
  CONCLUSIONS
  Facilitation using the VA HF COP was successful in increasing enrollment in the H2H initiative and providing implementation support for recommended QI projects. Multihospital provider groups are a potentially valuable tool for implementation of national QI campaigns.
authors.affiliation: Chronic Heart Failure Quality Enhancement Research Initiative, Department of Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, California, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Heidenreich
authors.forename: Anju
authors.initials: A
authors.lastname: Sahay
authors.forename: Brian S
authors.initials: BS
authors.lastname: Mittman
authors.forename: Nancy
authors.initials: N
authors.lastname: Oliva
authors.forename: Parisa
authors.initials: P
authors.lastname: Gholami
authors.forename: John S
authors.initials: JS
authors.lastname: Rumsfeld
authors.forename: Barry M
authors.initials: BM
authors.lastname: Massie
mesh_terms: D002318:Cardiovascular Diseases / Q000628:therapy*; D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D006739:Hospital Administration; D006801:Humans; D008297:Male; D059065:Medication Reconciliation / Q000458:organization & administration; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration*; D014481:United States; D014493:United States Department of Veterans Affairs