A Learning Collaborative Model for Implementation of Smoking Cessation among Homeless Veterans

Abstract

We evaluated the feasibility of incorporating integrated care (IC) for smoking cessation into routine care for homeless veterans at seven Department of Veterans Affairs (VA) Medical Centers and the utility of the learning collaborative (LC) model in facilitating implementation. The goal of IC is for clinicians to provide smoking cessation concurrent with other clinical duties. The LC model utilises multidisciplinary teams and recognised field experts to develop methods for accelerating the use of evidence-based treatments. Multidisciplinary teams comprising 34 (of about 175) staff members from seven VA homeless provider teams participated. Via self-report questionnaires, we assessed providers’ perceptions of the LC and the number of providers delivering IC. Nineteen of thirty-four providers (54%) reported delivering IC at the end of training and at 10-months. Providers rated the face-to-face trainings and collaborative team trainings as the most helpful LC components. Barriers to the use of the LC included lack of leadership support and the lack of ability to electronically track progress through the electronic medical record. Additional research, quality improvement, and policy changes at higher administrative levels are needed to identify methods to sustain the use of LC among providers serving homeless veterans.