Table 1 Core components of evidence-based quality improvement (EBQI) implementation strategy

Conduct of VISN-level interdisciplinary stakeholder planning meetings to develop “QI roadmaps”

Modified Delphi panel meetings with materials on PACT and panel ratings in advance of an in-person presentation of aggregated pre-panel ratings for review and moderated discussion and consensus development on top priorities for QI in context of feasibility of implementation and local resources

Panel materials

• Panel rating form

• Summary of women Veterans’ research

• VISN-level gender differences in patient ratings of care

• Local practice and patient population characteristics

VISN-level QI roadmaps

• Brief panel presentation summary

• Brief summary of top VISN priorities for QI for PACT for women Veterans

• Brief summary of top-rated topics requiring technical support (e.g., care coordination between VA and non-VA providers)

• Oversight and communication plans

Development, training, and support of local QI champions and QI team members

In-person training of 1–2 local QI champions at the parent study site in Los Angeles

• National PC and WH leadership endorsement

• Review VISN QI roadmaps and planned QI projects across intervention sites

• Review approaches to QI

• Breakout groups on applying QI methods/tools to project plans

• Across-team debriefing

• Formative feedback from key stakeholder interviews

• Breakout groups on applying EBQI principles to WH-PACT QI projects

• Training on EBQI formative feedback reports and Technical Work Groups

• Exemplar session on using EBQI to improve PACT team functioning

• Q&A panel with EBQI experts on lessons learned from prior projects

• Training on local QI project documentation

Training materials (reader, slidesets, breakout exercises, in-person expert EBQI project consultations)

Follow-up technical consults on local QI plans (with QI/system redesign consultant by email/phone)

Formative feedback of local QI data

• Feedback of baseline and 12-month survey data from women Veterans seen in participating VAMC primary care clinics

• Feedback of baseline PACT provider and staff survey findings

• Feedback of key themes from baseline interviews of VISN, VAMC and practice-level key stakeholders

• Feedback of key themes from baseline interviews of PACT teamlet members in participating VAMCs

• Feedback of VA quality measures and patient survey data by gender for participating VAMCs

Site-level formative feedback reports with comparisons to VISN and all participating VAMCs

Ongoing practice facilitation and expert review/feedback on local QI proposals and progress

• Regular EBQI team contacts with local QI teams by telephone and email

• Troubleshooting of local problems using VISN oversight/communication plans

• Intermittent policy contacts (e.g., identify/disseminate key policy documents, obtain national guidance)

Structured local QI project proposals (templated)

Structured expert feedback (email and telephone summaries)

Facilitation or across-site collaboration and spread of effective QI innovations

EBQI team-moderated monthly calls with 1+ representative per intervention VAMC

Verbal summaries of local QI project progress (including shared materials across sites)

Aggregated across-site formative feedback (from multiple data sources, e.g., patient surveys)

Technical work groups designed to provide additional evidence-based support in priority areas

VISN-level stakeholder panel meeting (above) used to also rate priority areas in which expert evidence-based consultation and support would be useful—work groups will be convened among national experts in clinical care and research in selected priority areas

Mini-systematic reviews in priority area(s)

Practice scans of WH-PBRN site leads to identify best practices at other VAMCs