Journal of Medical Systems

, 43:27 | Cite as

How to do a Virtual Breakthrough Series Collaborative

  • Lisa ZubkoffEmail author
  • Julia Neily
  • Peter D. Mills
Systems-Level Quality Improvement
Part of the following topical collections:
  1. Systems-Level Quality Improvement


Despite widespread use of the breakthrough series (BTS) collaborative in healthcare, there is limited literature on how to operationalize the method in healthcare settings. A recent modification to the model is the virtual breakthrough series (VBTS), in which all work is done remotely via telephone and web-based platforms. With virtual methods gaining popularity, this manuscript presents guidance on methods to conduct a virtual breakthrough series collaborative to assist clinical teams in implementing evidence-based practices. Manuscript describes planning activities and implementation steps for individuals interested in conducting a VBTS collaborative. Topics presented include planning/preparation activities (e.g., developing a planning committee and change package of the evidence-based interventions), estimated resources required (i.e., personnel, percent effort), activities to prepare participants for the project (e.g., orientation calls), specific actions during the virtual collaborative, and evaluation approaches. The manuscript also presents examples from our work and templates for end users. This paper is a first attempt to describe the infrastructure and processes of a VBTS collaborative and offer reproducible methods currently employed in the U.S. Veterans Health Administration.


Quality improvement collaborative Quality improvement Patient safety Virtual Learning collaborative 



Breakthrough series


Catheter associated urinary tract infections


Hospital acquired pressure ulcers


Institute for healthcare improvement


National center for patient safety


Plan do study act


Pressure injury prevention


Quality improvement


Randomized controlled trial


Specific, measurable, attainable, relevant, and time-bound


State veteran homes


Virtual breakthrough series


Veterans health administration


Author contributions

All authors (LZ, JN, PM) contributed to the development and writing of the manuscript. All authors read and approved the final manuscript.

Compliance with ethical standards

Disclosure of potential conflicts of interest

Dr. Zubkoff declares that she has no conflict of interest. Ms. Neily declares that she has no conflict of interest. Dr. Mills declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Not applicable.

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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  1. 1.White River Junction VA Medical CenterWhite River JunctionUSA
  2. 2.Department of PsychiatryGeisel School of Medicine at DartmouthHanoverUSA
  3. 3.National Center for Patient Safety Field Office (10E2E)White River Junction VA Medical CenterWhite River JunctionUSA

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