# Virtual Quality Improvement Training for VHA Teams: The Learn. Engage. Act. Process. (LEAP) Program

> **NIH VA I50** · VETERANS HEALTH ADMINISTRATION · 2021 · —

## Abstract

Background Our team has conducted and published multiple implementation evaluations in VA; the same
core set of barriers are repeatedly identified that negatively impact implementation success. Key gaps
associated with poor or failed implementation are related to the Process domain described by the Consolidated
Framework for Implementation Research (CFIR): lack of planning, engaging, and reflecting on and evaluating
progress of implementation. Methods used by quality improvement (QI) collaboratives are successful in helping
local teams implement change. Yet, this approach tends to be resource-intensive, requiring travel and time off
for multi-day sessions and site visits by expert facilitators. A structured scalable, cost-effective approach for
building skills to implement change is needed among frontline clinicians and staff. Our QUERI program
developed the “Learn. Engage. Act. Process.” (LEAP) Program to address this need.
Significance/Impact Dr. Stone, the Executive in Charge for VHA has made becoming a High Reliability
Organization (HRO) a top priority for VHA. One of three pillars of HRO and a foundational capability necessary
for learning health systems is Continuous Process Improvement, where all employees routinely work together
using QI methods make improvements in clinical processes and practices. Employees must have the
necessary skills and feel empowered to innovate and implement QI initiatives to ultimately impact Veterans’
health and well-being. These same skills are critical for implementing evidence-based innovations. However, in
baseline surveys administered to 109 employees from 20 VHA medical centers, respondents rated their QI
skills below three on a six-point scale in five of six categories of QI methods. Hands-on learning of QI methods
for employees within everyday clinical work is essential for achieving HRO goals and to become a learning
health system.
Innovation Our team developed LEAP specifically to help teams implement effective changes within busy
clinical settings. LEAP is unique in providing small “bites” of new content which teams immediately apply
within their own clinical setting to achieve aims that are their highest priority. LEAP draws on curriculum
developed by HarvardX and the Institute for Healthcare Improvement (IHI) and comprises four evidence-based
implementation strategies: 1) create a learning collaborative, 2) assess for readiness and identify barriers and
facilitators, 3) audit and provide feedback, and 4) conduct cyclical small tests of change. LEAP is cost-saving
because coaching is provided using a webinar platform with support of an online collaboration platform. LEAP
is fully developed and packaged for delivery to more teams.
Specific Aims We have two aims: Aim 1) Provide LEAP training in quality improvement methods to VHA
clinical teams, helping clinics achieve VHA’s HRO goal of Zero Preventable Harms to Veterans; and Aim 2)
Train additional LEAP coaches using a train-the-trainer model to expan...

## Key facts

- **NIH application ID:** 10181070
- **Project number:** 5I50HX003140-02
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Laura J. Damschroder
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-10-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10181070

## Citation

> US National Institutes of Health, RePORTER application 10181070, Virtual Quality Improvement Training for VHA Teams: The Learn. Engage. Act. Process. (LEAP) Program (5I50HX003140-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10181070. Licensed CC0.

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