{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:59:53Z","timestamp":1790175593288,"version":"4.1.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":85,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007181","name":"Quality Enhancement Research Initiative","doi-asserted-by":"publisher","award":["QIS 18-201"],"award-info":[{"award-number":["QIS 18-201"]}],"id":[{"id":"10.13039\/100007181","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Healthcare professionals often implement quality improvement (QI) initiatives but lack training to implement and sustain QI initiatives. Leading Healthcare Improvement (LHI) is a course that combines principles from change management, team science, and leadership effectiveness into an implementation strategy to enable clinicians to lead sustainable change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>LHI is a 6-session, 4-month interactive training. Learners work on an active QI project throughout the course. A Wilcoxon signed-rank test was conducted to evaluate pre- and post-course changes in learners\u2019 self-reported confidence across five QI competencies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Veterans Healthcare Administration clinicians and fellows completed the LHI pre- (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009111) and post-course (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200974) evaluations with 70 responding to both evaluations. The 70 learners self-reported significantly increased confidence after the training in each of the QI competencies: communicating urgency (W\u2009=\u200956,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), developing and leading interprofessional teams (W\u2009=\u200948,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), creating and communicating project vision (W\u2009=\u200954,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), developing strategies to remove barriers (W\u2009=\u200960,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and communicating project impacts to leadership (W\u2009=\u200962,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>LHI is an implementation strategy curriculum intended to support healthcare professionals in leading system-level changes. Its emphasis on key partner influence, interprofessional teamwork, and real-time project application may help address gaps in existing training and has the potential to strengthen capacity for sustained healthcare improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-026-15046-4","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:11:08Z","timestamp":1782846668000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Leading healthcare improvement: an implementation strategy"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6657-3379","authenticated-orcid":false,"given":"Kelley","family":"Arredondo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Ecker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Vaclavik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacquelene","family":"Shahin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Horstman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ramsey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyler M.","family":"Godwin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"issue":"3","key":"15046_CR1","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1007\/S40037-014-0119-Y","volume":"3","author":"JK Stoller","year":"2014","unstructured":"Stoller JK. 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The need for informed consent was deemed unnecessary by the Baylor College of Medicine IRB according to national regulations (45 CFR 46.104). This project adhered to the Declaration of Helsinki and was conducted as part of a routine QI initiative aimed at enhancing existing educational professional development programs and was funded by the VA Quality Enhancement Research Initiative (QUERI; QIS 18\u2013201).","order":1,"name":"Ethics","label":"Human ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1289"}}