• Goetz Goldberg Debora D From the George Mason University, Department of Health Administration and Policy, Peterson Family Hall, MS IJ3, 4400 University Drive, Fairfax, VA, Sahar Haghighat, Sneha Kavalloor, and Len M Nichols.
• From the George Mason University, Department of Health Administration and Policy, Peterson Family Hall, MS IJ3, 4400 University Drive, Fairfax, VA 22030 (DGG, SK); George Mason University, Department of Sociology Fairfax, VA 22030 (SH); George Mason University, Center for Health Policy Research and Ethics Fairfax, VA 22030 (LMN). dgoldbe4@gmu.edu.
• J Am Board Fam Med. 2019 Sep 1; 32 (5): 705-714.

PurposeThe Heart of Virginia Health care (HVH) was a regional cooperative under the EvidenceNOW initiative to assist primary care practices in implementing evidence-based cardiovascular care and building capacity for quality improvement. The HVH implementation team included individuals from multiple universities, quality improvement organizations, and consulting firms. The goal of this study was to understand HVH team member viewpoints on the challenges, strengths, and lessons learned in each phase of the project.MethodsQualitative methods were used to facilitate reflection on the implementation and dissemination of the EvidenceNOW initiative in Virginia. In-depth interviews were conducted at the end of the project with 22 HVH team members. A nonparticipant, multidisciplinary research team completed thematic analysis of interview transcripts.ResultsPositive attributes of the HVH initiative included diverse team member skills and areas of expertise, a well-received kick-off event, and a comprehensive set of practice improvement resources. Major challenges included recruiting primary care practices, varying types and capabilities of electronic health records, and working with practices at different transformation stages, with different objectives for participating and involvement in other government initiatives.ConclusionsStudy findings provide insights for future dissemination research and implementation of evidence-based practices in primary care. Challenges experienced in project development can result in a domino effect that could change the project timeline, type of practices recruited for study participation, resource allocation, and planned activities for quality improvement. Effectiveness of external quality improvement support may depend on practice engagement, preexisting organizational structures and processes, availability of resources, and length and continuity of practice facilitation.© Copyright 2019 by the American Board of Family Medicine.

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