What is a Collaborative

A Learning Collaborative is way to accelerate improvement in health care settings. It brings together quality improvement teams from different practices to learn with and from each other in four 2-day learning sessions over a 12 – 15 month period. Using a methodology that promotes rapid change, these sessions teach practical approaches on how to improve the management of commonly encountered problems. The methodology is based upon three components:

This equips participants to return to their practices, test out these new approaches and see the benefits in short time frames, while receiving on-site, telephone and email support. The collaborative approach is effective because it is systematic, easy to implement, includes ongoing support, and engages practices in working together to introduce rapid sequential changes and measure their impact.

The merit of the learning collaboratives has been documented in a comprehensive report published in the 2008 British Medical Journal. summary of article

The Saskatchewan Health Quality Council has produced an information guide for patients of participating practices.

There are a number of components to a successful Collaborative. These include:

1. A charter which also includes the goals of the collaborative and the measures and targets to be used. The charter of the QIIP collaborative provides an example.

2. The creation of interdisciplinary quality improvement teams that represent their practices at the learning sessions and guide the processes of change on their return.

3. The breakthrough series model which includes...

a. Pre-learning session preparatory activities where teams will examine current processes in their practices and gather baseline data.

b. Four 2-day learning sessions where the team learns about new approaches to managing clinical problems, quality improvement methods, and ways to apply these on their return to their practice. As the sessions progress, participants share their experiences and learn from each other as “everybody learns, everybody teaches”.

c. Action periods between learning sessions, during which the team uses PDSA cycles to test and implement their chosen improvements. Results are measured and reported monthly, and the data are used to identify successes and plan further improvements.
4. The (Chronic) Care Model as a framework for identifying areas where changes can be made in a system of care.

5. The Improvement Model and Plan Do Study Act (PDSA) cycles as a way to introduce rapid improvements and apply lessons learned to further improve care.

6. Through on-site visits, phone consultation, e-mail and regular telephone conferences, trained improvement facilitators support practices as they implement changes.

7. Using a virtual office, which links Collaborative participants and their facilitators, to help report data and share resources.

8. Monthly phone calls where all participating teams report and discuss their progress.

9. Finding way to “spread” change, taking the concepts presented in a learning session and disseminating them to other members of the practice team and FHT / CHC.