Evidence-Based Quality Improvement Learning Network Hub Site

提供高质量护理的医疗保健系统的特点是系统性的能力方法， 为改善而建设。学习医疗保健系统使用质量改进（QI）和实施 科学的方法来识别，评估和改善质量问题，并支持全系统的传播， 成功的创新。循证质量改进（EBQI）是持续质量的一种形式。 这是针对支持学习医疗保健系统目标的改进。该战略旨在改善 通过确保QI计划受益于 最好的科学证据以及来自临床运营领导、数据和专业知识。EBQI促进 在研究-临床-患者合作伙伴关系中持续调整QI创新设计;在区域范围内， 设施和诊所级别的领导者;以及跨学科和计划的界限。EBQI倡议有 提高了对循证临床实践的采用，如协作护理，支持 就业，以病人为中心的医疗之家，并支持国家，地区和当地的临床 政策制定。拟议EBQI实施战略学习网络中心站点的目标 （“EBQI中心”）是为利益相关者提供各种VA角色（决策者、运营经理、一线 提供者和工作人员，以及研究人员）与应用EBQI所需的培训和资源。这样做 EBQI Hub将支持有效实践的实施、扩大、传播和可持续性， 目标是加强VA作为一个学习型医疗保健系统。具体目标是：（1）提供两个 每年对至少100名VA领导者、供应商和工作人员进行虚拟EBQI培训（约50人/周期）， 四名研究人员（~2/周期）;（2）在SharePoint网站上和通过 虚拟服务台;（3）为至少四名学员/学员团队提供为期六个月的密集指导辅导 （4）使用混合方法，评估：（a）Hub的利用率、有用性和可行性 （B）枢纽对参与者QI信心、知识和技能的影响;（c） EBQI枢纽，促进反映科学证据和交付系统优先事项的QI项目;以及（d） 受指导的QI项目的影响。EBQI中心专注于EBQI的教学和应用实践培训 理论和实践使用VA QUERI启动资金在2018财年开发的课程， 根据质量信息传播理论，EBQI中心将在全国范围内提供虚拟EBQI培训， 远程教育技术。培训由四个90分钟的在线研讨会模块组成;一个EBQI SharePoint网站，其中包含录制的网络研讨会、培训材料和QI工具;以及虚拟帮助台， EBQI Hub专家教师。EBQI中心还将为至少四个人提供为期六个月的指导指导。 学员和/或团队（特别是卓越计划金牌会员的传播）， 明确的创新。对EBQI Hub培训的需求已经很高，特别是因为EBQI Hub 教师拥有成功的EBQI培训和实施经验的良好记录。当前 有四项计划（VISN级和国家级）随时准备调用EBQI中心资源来推进 他们的目标。VISN 22内的所有八个医疗保健系统（为亚利桑那州的150万退伍军人提供服务， 新墨西哥州和南加州）已确认有兴趣参与EBQI中心培训，包括 至少20家临床试验机构;此外，VISN 22以外的10家临床试验机构已确认感兴趣。EBQI Hub 通过培训、支持和激励，支持系统现代化，更有效地集中资源 领导者，供应商和工作人员，以确定，地址，并解决当地的优先问题，使用证据- 基于基础的、多层次的、企业主驱动的方法，以实现所需的改进和创新。

Healthcare systems that deliver high-quality care are characterized by systematic approaches to capacity- building for improvement. Learning healthcare systems use quality improvement (QI) and implementation science methods to identify, assess, and improve quality issues, and to support system-wide spread of successful innovations. Evidence-based quality improvement (EBQI) is a form of continuous quality improvement that is directed at supporting learning healthcare system goals. The strategy aims to improve implementation of programs and practices in delivery systems by ensuring that QI initiatives benefit from the best scientific evidence as well as from clinical operations leadership, data, and expertise. EBQI promotes ongoing alignment of QI innovation design across the research-clinical-patient partnership; across regional-, facility-, and clinic-level leaders; and across disciplinary and programmatic boundaries. EBQI initiatives have resulted in improved uptake of evidence-based clinical practices such as collaborative care, supported employment, and the patient-centered medical home, and have supported national, regional, and local clinical policy development. The objective of the proposed EBQI Implementation Strategy Learning Network Hub Site (“EBQI Hub”) is to equip stakeholders in various VA roles (policymakers, operations managers, frontline providers and staff, and researchers) with the training and resources needed to apply EBQI. In doing so, the EBQI Hub will support increased implementation, scale-up, spread, and sustainability of effective practices, with the goal of strengthening VA as a Learning Healthcare System. The Specific Aims are to (1) provide two cycles of virtual EBQI training per year to at least 100 VA leaders, providers, and staff (~50/cycle), and at least four researchers (~2/cycle); (2) provide EBQI tools, resources, and guidance on a SharePoint site and via a virtual help desk; (3) Provide six months of intensive guided mentorship to at least four trainees/trainee teams annually; and (4) Using mixed methods, evaluate the: (a) utilization, usefulness, and feasibility of Hub components; (b) Hub’s impacts on participants’ QI confidence, knowledge, and skills; (c) effectiveness of the EBQI Hub in fostering QI projects that reflect both scientific evidence and delivery system priorities; and (d) impacts of the mentored QI projects. The EBQI Hub focuses on didactic and applied hands-on training in EBQI theory and practice. Using the curriculum developed with VA QUERI start-up funds in FY18 and guided conceptually by a theory of QI spread, the EBQI Hub will provide virtual EBQI training nationally using distance-learning technology. The training is comprised of four 90-minute live webinar modules; an EBQI SharePoint site with recorded webinars, training materials, and QI tools; and a virtual help desk staffed by EBQI Hub expert faculty. The EBQI Hub will also provide six months of guided mentorship to at least four trainees and/or teams (especially Diffusion of Excellence Initiative Gold Status Fellows) annually who have clearly specified innovations. Demand for EBQI Hub training is already high, especially because the EBQI Hub faculty has a strong track record of successful EBQI training and implementation experiences. Currently there are four initiatives (VISN-level and national) that stand ready to call upon the EBQI Hub resources to advance their objectives. All eight of the healthcare systems within VISN 22 (serving 1.5 million Veterans in Arizona, New Mexico, and Southern California) have confirmed interest in engagement in EBQI Hub training, including at least 20 sites of care; additionally, 10 sites outside of VISN 22 have confirmed interest. The EBQI Hub supports modernizing systems and focusing resources more efficiently by training, supporting, and motivating leaders, providers, and staff to identify, address, and solve local prioritized problems, using an evidence- based, multilevel, stakeholder-driven approach to implement needed improvements and innovations.