One-year follow-up after a collaborative breakthrough series on reducing falls and fall-related injuries.

BACKGROUND Multisite facilitated quality improvement (QI) projects, called collaborative Breakthrough Series (BTS), have been shown to improve care, but it is also important to evaluate the lasting effects and spread of changes of BTSs. A project focused on fall and injury-related prevention started in Spring 2001; after the project's end, support was provided through e-mail and periodic conference calls. METHODS One year after project completion, team contacts were interviewed to determine if they had maintained gains or made further improvements. RESULTS For the 34 (of 37 teams) interviewed, 82.4% reported they had stayed together as a team; 97.1%, that they continued to collect data; 93.9%, that they had maintained gains; 82.4%, that they had spread changes to new locations; and 85.3%, that they had begun to work on new topics. High team performance at one year correlated with first-meeting team characteristics Leadership Support (r = .456, p = .019) and Prior Experience with Quality Improvement and Teamwork (r = .393, p = .047) and with follow-up team characteristics Leadership Support (r = .614, p < .001), Teamwork Skills (r = .377, p = .033), and Skills Gained from the Project (r = .410, p = .020). CONCLUSIONS Leadership support, experience with quality improvement and teamwork, teamwork skills, and skills gained from the project were correlated with teams' abilities to achieve and maintain success.

[1]  Melissa Ahern,et al.  Improved clinical outcomes for fee-for-service physician practices participating in a diabetes care collaborative. , 2004, Joint Commission journal on quality and safety.

[2]  William B Weeks,et al.  Characteristics of successful quality improvement teams: lessons from five collaborative projects in the VHA. , 2004, Joint Commission journal on quality and safety.

[3]  M. Tinetti Clinical practice. Preventing falls in elderly persons. , 2003, The New England journal of medicine.

[4]  P. L. Green,et al.  Coaching and leadership for the diffusion of innovation in health care: a different type of multi-organization improvement collaborative. , 2002, The Joint Commission journal on quality improvement.

[5]  E. Rogers Diffusion of Innovations , 1962 .

[6]  S Cretin,et al.  Quality collaboratives: lessons from research , 2002, Quality & safety in health care.

[7]  Theodore Speroff,et al.  A Model for Improving the Quality and Timeliness of Compensation and Pension Examinations in VA Facilities , 2003, Journal of healthcare management / American College of Healthcare Executives.

[8]  William B Weeks,et al.  A multihospital safety improvement effort and the dissemination of new knowledge. , 2003, Joint Commission journal on quality and safety.

[9]  William B Weeks,et al.  Using aggregate root cause analysis to reduce falls. , 2005, Joint Commission journal on quality and patient safety.

[10]  D M Berwick,et al.  Reducing cesarean section rates safely: lessons from a "breakthrough series" collaborative. , 1998, Birth.

[11]  Paul D Cleary,et al.  Effects of a Quality Improvement Collaborative on the Outcome of Care of Patients with HIV Infection: The EQHIV Study , 2004, Annals of Internal Medicine.

[12]  Shan Cretin,et al.  An Evaluation of Collaborative Interventions to Improve Chronic Illness Care , 2004, Evaluation review.

[13]  J. Neily,et al.  Using aggregate root cause analysis to improve patient safety. , 2003, Joint Commission journal on quality and safety.

[14]  A. Wall,et al.  Book ReviewTo Err is Human: building a safer health system Kohn L T Corrigan J M Donaldson M S Washington DC USA: Institute of Medicine/National Academy Press ISBN 0 309 06837 1 $34.95 , 2000 .

[15]  L. Kohn,et al.  To Err Is Human : Building a Safer Health System , 2007 .

[16]  Orthopaedic Surgeons Panel On Falls Prevention Guideline for the Prevention of Falls in Older Persons , 2001 .

[17]  Edward H Wagner,et al.  Case studies from two collaboratives on diabetes in Washington State. , 2004, Joint Commission journal on quality and safety.

[18]  A L Kosseff,et al.  SSM Health Care clinical collaboratives: improving the value of patient care in a health care system. , 2001, The Joint Commission journal on quality improvement.

[19]  P E Plsek,et al.  Collaborating across organizational boundaries to improve the quality of care. , 1997, American journal of infection control.

[20]  Ronald D. Moen,et al.  The Improvement Guide: A Practical Approach to Enhancing Organizational Performance , 1996 .

[21]  C M Kilo,et al.  A Framework for Collaborative Improvement: Lessons from the Institute for Healthcare Improvement's Breakthrough Series , 1998, Quality management in health care.

[22]  Brian S Mittman,et al.  Creating the Evidence Base for Quality Improvement Collaboratives , 2004, Annals of Internal Medicine.

[23]  Janice M. Morse Preventing in-patient falls: The nurse's pivotal role. , 2017, Nursing.

[24]  Alastair Baker,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2001, BMJ : British Medical Journal.

[25]  E H Wagner,et al.  Quality improvement in chronic illness care: a collaborative approach. , 2001, The Joint Commission journal on quality improvement.

[26]  C M Kilo,et al.  Improving care through collaboration. , 1999, Pediatrics.

[27]  J Gosbee,et al.  Developing and deploying a patient safety program in a large health care delivery system: you can't fix what you don't know about. , 2001, The Joint Commission journal on quality improvement.

[28]  E. Wagner,et al.  A state-level application of the chronic illness breakthrough series: results from two collaboratives on diabetes in Washington State. , 2004, Joint Commission journal on quality and safety.

[29]  P B Batalden,et al.  Using an improvement model to reduce adverse drug events in VA facilities. , 2001, The Joint Commission journal on quality improvement.

[30]  G. J. Langley,et al.  The improvement guide : a practical approach to enhancing organizational performance , 1996 .

[31]  T W Nolan,et al.  Reducing adverse drug events: lessons from a breakthrough series collaborative. , 2000, The Joint Commission journal on quality improvement.

[32]  Charles S Cleeland,et al.  Rapid Improvement in Pain Management: The Veterans Health Administration and the Institute for Healthcare Improvement Collaborative , 2003, The Clinical journal of pain.