Characteristics of Successful Quality Improvement Teams: Lessons from Five Collaborative Projects in the VHA

Background

A pre–post observational design was used to study the aggregate results of five national
Breakthrough Series (BTS) collaboratives run within Veterans Health Administration
(VHA) to identify the organizational, interpersonal, and systemic characteristics
of successful improvement teams.

Methods

One hundred thirty-four medical quality improvement teams participated in five BTS
collaboratives in the VHA between 1999 and 2002. Team characteristics were assessed
using a team questionnaire before and after the BTS collaboratives.

Results

Fifty-seven percent of participating teams were rated as successful (a $ 20% improvement
from baseline for at least two months before the collaboratives’ end). More high-performing
medical quality improvement teams perceived their work to be part of their organization’s
key strategic goals. By the end of the BTS collaboratives, high-performing teams had
more front-line staff support and stronger team leadership.

Discussion

Strong organizational support, strong team leadership, and high levels of interpersonal
team skills help medical quality improvement teams go further to improve clinical
care. It is recommended that quality improvement teams become integrated with their
organization’s key strategic goals, that improvement teams stay together, and that
leadership and team training be provided to improve clinical outcomes.