Table 5.

Description of the MOVIT Quality Improvement Collaborative.

Brief Name	The MOVIT Programme
Why	The aim was to reduce fragmentation of medical care and ensure care meets the increasing complex medical needs of residents.
Where	Leiden, the Netherlands. Regional meetings were held at a university location and teams also met locally in their care home locations.
Who provided	The MOVIT collaborative was led by a local general practitioner and team members included a professor of primary care at Leiden University Medical Centre, a project manager, a postdoctoral researcher with experience in geriatrics, and a liaison member of staff from a local GP organisation. The project was funded by the Dutch Ministry of Health via the National Programme on Elderly care.
Recipient	29 local teams were formed (serving 33 residential homes). Each comprised general practitioners, community pharmacists, elderly care physicians, and nursing home staff.
How	Face to face meetings.
When and how much	42 months (2009–2013) with 10 regional educational meetings that took place 2–3 times per year, and in between, regional teams met in their locations and received QI coaching.
What (materials and procedures)	Forming communities of practice: the regional project team actively identified and approached care providers of local residential homes (general practitioners, nursing staff, elderly care physicians, and pharmacists) and formed teams. Once formed, each team agreed a focus which reflected local needs around improving integrated care and translating this into an improvement plan. Collaborative shared learning events: Teams shared project ideas, progress, and experiences of the improvement journey, describing challenges, successes, and lessons learnt around how to overcome barriers. Allocated time for education sessions (described below). Networking opportunities. Educational sessions: Education sessions aimed to inspire teams and provide relevant clinical evidence-based knowledge. Sessions target improvement project topics and activities. Consensus and guideline development: the teams developed and implemented regional guidelines on a variety of topics: geriatric assessment, patient-based interdisciplinary meetings, medication management and distribution, wound treatment, and advanced care planning. Implementation and sustainability: Managers and governors of the organisations and financial and regulatory institutions were involved to consider future sustainability. Promoting sustainability by developing financial constructions for the participating professionals and organisations within regional and national frameworks. Newsletter: team success stories were shared using a project newsletter, shared through email, approximately every 6 months. Evaluation: the MOVIT project team included a research nurse who helped (to a limited degree) with collecting data to monitor and evaluate improvement project outcomes and study the QI process. QI coaching: each team received coaching from a GP trained in QI and with special interest in elderly care. There were approximately seven GPs providing coaching to teams. Coaches met regularly (every 6 months) to coordinate and exchange experiences.
Tailoring	The project team took a flexible approach, adapting and tailoring implementation activities to respond to the obstacles encountered.
Modifications to the programme	Government policy moved towards phasing out residential care during the project; as a result, collaborative teams adapted and worked on transporting care from the institutional context to that in the community. As a result, teams were expanded to include domestic and social care providers and related stakeholders.
How well	Collaborative shared learning event attendance was not assessed.
Project evaluation	A structured process description and analyses were performed to better understand the relation between the project activities, identify relevant contextual factors, and examine the fidelity and quality of the implementation [22]. General satisfaction and satisfaction with GP care were compared pre and post MOVIT implementation using a repeated cross-sectional study [23].