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Learn. Engage. Act. Process. QI Learning Program (LEAP)

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LEAP is designed to engage frontline teams in quality improvement (QI) within the demands of everyday clinical practice. By the end of LEAP, teams will complete a project with the support of a coach and with a learning community comprised of other teams.

This innovation is replicating across multiple facilities as its impact continues to be validated. See more replicating innovations.

Adoptions:

57 successful

Awards and Recognition:

QUERI Implementation Training Hub

Partners:

Quality Enhancement Research Initiative, Systems Redesign and Improvement

Contact Team

Overview

Problem

Integrating evidence-based innovations (EBIs) into sustained use is challenging, and implementations in health systems often fail. LEAP's goal of increasing the QI capability of frontline teams seeks to combat this challenge by increasing implementation readiness and success of EBI implementation.

Solution

LEAP has been developed as a training program designed to increase frontline teams' QI skill capability and embrace QI as a foundational strategy to optimize an evidence-based intervention.

LEAP offers frontline employees virtual QI training that is supportive, user-friendly, and immediately relevant. LEAP helps frontline teams develop projects that addre
... See more

Results

LEAP participants develop greater confidence in applying QI methods within the demands of everyday clinical practice and report intending to continue QI to optimize care for their patients, cultivating a culture of continuous learning to benefit Veterans.

One recent study of LEAP found VA facilities that did not participate in LEAP experienced declining
... See more

Metrics

  • Engagement in QI by clinical teams

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

AR: Fayetteville VA Medical Center (Fayetteville, Arkansas) AZ: Tucson VA Medical Center (Tucson) CA: Fresno VA Medical Center (Fresno) CA: San Francisco VA Medical Center (San Francisco) CO: Grand Junction VA Medical Center (Grand Junction, Colorado) DC: Washington VA Medical Center (Washington, District of Columbia) FL: Bruce W. Carter Department of Veterans Affairs Medical Center (Miami) FL: C.W. Bill Young Department of Veterans Affairs Medical Center (Bay Pines) FL: Malcom Randall Department of Veterans Affairs Medical Center (Gainesville) FL: Orlando VA Medical Center (Orlando) FL: West Palm Beach VA Medical Center (West Palm Beach) IA: Iowa City VA Medical Center (Iowa City, Iowa) ID: Boise VA Medical Center (Boise) IL: Danville VA Medical Center (Danville, Illinois) IN: Fort Wayne VA Medical Center (Fort Wayne) IN: Muncie VA Clinic (Muncie)
  • Started adoption on 09/2021, ended on 03/2022.
KS: Colmery-O'Neil Veterans' Administration Medical Center (Topeka) KS: Robert J. Dole Department of Veterans Affairs Medical and Regional Office Center (Wichita) MA: Edward P. Boland Department of Veterans Affairs Medical Center (Central Western Massachusetts) MA: Jamaica Plain VA Medical Center (Jamaica Plain) ME: Togus VA Medical Center (Togus) MI: Flint VA Clinic (Flint)
  • Started adoption on 09/2021, ended on 03/2022.
MI: Lieutenant Colonel Charles S. Kettles VA Medical Center (Ann Arbor) MI: Saginaw VA Clinic (Saginaw Barnard Road) MO: St. Louis VA Medical Center-Jefferson Barracks (St. Louis Jefferson Barracks) MS: Biloxi VA Medical Center (Biloxi) MT: Fort Harrison VA Medical Center (Fort Harrison) NC: Charles George Department of Veterans Affairs Medical Center (Asheville) NC: Durham VA Medical Center (Durham) NV: North Las Vegas VA Medical Center (North Las Vegas) NV: Northwest Las Vegas VA Clinic (Northwest Las Vegas)
  • Started adoption on 09/2022.
NY: Margaret Cochran Corbin VA Campus (Manhattan) NY: Samuel S. Stratton Department of Veterans Affairs Medical Center (Albany, New York) NY: Syracuse VA Medical Center (Syracuse) OH: Cincinnati VA Medical Center (Cincinnati, Ohio)
  • Started adoption on 09/2021, ended on 03/2022.
OH: Clermont County VA Clinic (Clermont County)
  • Started adoption on 09/2021, ended on 03/2022.
OH: Columbus VA Clinic (Columbus Airport Drive) OH: Hamilton VA Clinic (Hamilton, Ohio)
  • Started adoption on 09/2021, ended on 03/2022.
OH: Louis Stokes Cleveland Department of Veterans Affairs Medical Center (Cleveland, Ohio) OK: Jack C. Montgomery Department of Veterans Affairs Medical Center (Muskogee, Oklahoma) OR: Eugene VA Clinic (Eugene) OR: Portland VA Medical Center (Portland, Oregon) PA: Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center (Philadelphia, Pennsylvania) SD: Fort Meade VA Medical Center (Fort Meade, South Dakota) TN: James H. Quillen Department of Veterans Affairs Medical Center (Mountain Home, Tennessee) TN: Lt. Col. Luke Weathers, Jr. VA Medical Center (Memphis) TN: Nashville VA Medical Center (Nashville) TX: George H. O'Brien, Jr., Department of Veterans Affairs Medical Center (Big Spring) TX: Michael E. DeBakey Department of Veterans Affairs Medical Center (Houston) TX: Temple VA Clinic (Temple South General Bruce Drive) UT: George E. Wahlen Department of Veterans Affairs Medical Center (Salt Lake City) VA: Hampton VA Medical Center (Hampton) VT: White River Junction VA Medical Center (White River Junction) WI: William S. Middleton Memorial Veterans' Hospital (Madison) WV: Martinsburg VA Medical Center (Martinsburg) WY: Cheyenne VA Medical Center (Cheyenne) WY: Sheridan VA Medical Center (Sheridan)

There are no in-progress adoptions for this innovation.

There are no unsuccessful adoptions for this innovation.

Multimedia

Videos

Laura Damschroder at the Ann Arbor VA provides an overview of the LEAP program

Testimonial from a LEAP Participant - Simona

Testimonial from a LEAP Participant - Crystal

Implementation

Timeline

  • Weeks 1-5
    By Week 5, teams have engaged new members, reviewed current data, and brainstormed project ideas.
    Assignments: Team Member Roles Table, Affinity Diagram, and Matrix Diagram or Impact/Effort Matrix
  • Weeks 6-14
    By Week 14, teams have explored root causes, set an aim, and begun a Project Charter.
    Assignments: Fishbone Diagram, Project Charter draft, and Process Map
  • Weeks 15-21
    By Week 21, teams have finished the Project Charter, implemented change, and collected process data.
    Assignments: Project Charter and Run Chart
  • Weeks 22-26
    By Week 26, teams have presented progress, planned next steps, and reflected on the LEAP experience.
    Assignment: Final Project Presentation

Departments

  • None

Core Resources

Resource type Resource description
PEOPLE
  • Typically, Team Leaders can expect to dedicate 3-5 hours per week. Team members often expend much less time ranging from 1 to 5 hours, depending on the week (stage of the project), the nature of the project selected, and their role.

Files

Links

Risks and mitigations

Risk Mitigation
Lack of time to participate in LEAP and lack of time to plan and execute improvements. Obtain local leadership support for dedicating time to QI initiatives. Communicate successes and lessons learned to build support over time.
Inability to sustain improvements. Communicate positive effects with leaders and colleagues to gain their support for designing processes that are sustainable.
Employees may have inadequate access to needed data, meaning they are unable to reliably identify problems and track the effects of improvements. Coaches work with teams, local systems redesign, and/or quality management to design meaningful reports that can be easily produced for the long-term.

Contact

Comment

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Email

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About

Origin story

Employees are incredibly dedicated to improving care for Veterans but work in busy clinical settings. QI skills are needed, yet most training requires time outside of clinic and provides little coaching support. We designed LEAP to be accessible by using an incremental learning approach with hands-on application. LEAP draws on the Institute for Healthcare Im ... Employees are incredibly dedicated to improving care for Veterans but work in busy clinical settings. QI skills are needed, yet most training requires time outside of clinic and provides little coaching support. We designed LEAP to be accessible by using an incremental learning approach with hands-on application. LEAP draws on the Institute for Healthcare Improvement (IHI) and HarvardX curriculum.

Original team

Jeremy Sussman

Principal Investigator

Ariel Domlyn

Principal Investigator

Michelle Freitag

Improvement Coach

Claire Robinson

Improvement Coach

Madison Stewart

Research Assistant

Laura Damschroder

Founding Principal Investigator (Retired)