QUERI – Quality Enhancement Research Initiative

Go to the HSRD website

Virtual Quality Improvement Training for VHA Teams: The Learn. Engage. Act. Process.

Ann Arbor, MI

Principal Investigator: Laura Damschroder, MS, MPH; contact at Laura.Damschroder@va.gov


The VA healthcare system is leading the cultural transformations to high reliability (through becoming a High Reliability Organization) and as a learning health system. A key foundation for both high reliability organizations (HRO) and learning health systems is that all employees, especially frontline clinicians and staff who directly provide care for Veterans, routinely engage in improving care processes and programs. Investigators with the Virtual Quality Improvement Training for VHA Teams QUERI Training Hub developed the Learn. Engage. Act. Process. (LEAP) program to empower frontline employees to improve clinical programs. LEAP is an effective quality improvement training program and can be delivered at low cost. LEAP is a structured program with hands-on learning within everyday clinical work; there is no need for travel, and time away from clinical work is minimized. LEAP coaches work with teams individually and through online group collaborative sessions. More information about LEAP is available on VHA’s Online Marketplace: marketplace.vaftl.us


  • Provide LEAP training in quality improvement methods to VA clinical teams, helping to improve clinical care and achieve VA’s HRO goal of Zero Preventable Harms to Veterans
  • Train additional LEAP coaches using a train-the-trainer model to expand reach to more teams

Quality Improvement/Implementation Strategy

LEAP packages multiple implementation strategies into a single program. With coaches trained by the Institute for Healthcare Improvement (IHI), the QUERI Virtual Quality Improvement Training Hub will lead VA clinical teams through a hands-on, virtually-delivered structured curriculum in which employees:

  • Form a team and develop an improvement aim
  • Build a project charter
  • Test planned change(s) and monitor progress
  • Present results
  • Plan for subsequent cycles of change

Coaching is delivered via webinar and online collaboration platforms; new learning content is provided in small doses with immediate hands-on application.

Expected Impacts

So far, 48 teams, comprising over 200 frontline employees and Veterans, have completed LEAP and reported significant improvements in quality improvement skills, high satisfaction with LEAP, and plans to continue making improvements to care processes and programs that will improve the health and care of Veterans.  Building these skills is a necessary foundational step to achieve HRO status and is at the core of a learning health system.

LEAP Components and Timeline

Operations Partners

The National Center for Health Promotion and Disease Prevention (NCP) supported LEAP’s development and evaluation with teams from VA’s MOVE! Weight Management Program for Veterans®. The QUERI Virtual Quality Improvement Training Hub welcomes additional partners as new teams engage in LEAP.