Table 1 Evaluation data sources, samples, and measures

Purposive sample of 130 or more facility-level key stakeholders across the 21 participating sites and corresponding regions

Baseline interview domains

• Structure and delivery of usual care for women veterans

• Barriers and facilitators to achieving delivery of comprehensive women’s health care

• Improvements underway in women’s health and/or for women veterans (if any)

• Familiarity with performance metrics

• Access to metrics by gender

• Experience with quality improvement

• Local culture

• Perceptions of the care environment

• Women veteran engagement

12- and 24-month interview domains

• Changes in care for women veterans

• Details of completed/in progress QI projects

• Perspectives on critical components of EBQI

• Anticipated sustainability of local improvements and QI methods

Key informant organizational surveys, in addition to annual administered WATCH surveys from WHS

Surveys include measures of:

• Leadership support

• Local resources (e.g., sufficiency of time, personnel, equipment)

• Practice structure (e.g., women’s health care model, staff mix, referral arrangements)

• Service availability

• Care coordination arrangements (within and outside VA)

• Ability to engage in QI (e.g., barriers to QI, data access by gender)

• Gender-sensitivity of environment (e.g., privacy)

• Local challenges (e.g., provider shortages, hiring difficulties, practice chaos)

• Facility type (e.g., size, academic affiliation, urban/rural)

• EBQI activities

Census of PC and women’s health providers using Primary Care Management Module data

• EBQI exposure/participation (e.g., awareness, hours spent, local buy-in)

• QI orientation/culture (e.g., perceived cooperation among managers/providers/staff, communication effectiveness, culture fostering flexibility, participative decision-making)

• Gender sensitivity (e.g., awareness, knowledge, attitudes, self-assessment of women’s health proficiency)

• Practice context (e.g., leadership norms, organizational readiness to change, job satisfaction, burnout)

• Provider/staff characteristics (e.g., age, gender, race, ethnicity, staff type, clinician type, women’s health provider, proportion of women veterans in panel/clinic, board certification, years in VA)

Secondary data on women veteran-specific VA quality of care and patient experience, utilization patterns, and other administrative data

• Quality of care measures from VA performance measures (chart-based and patient survey-based measures by gender), including prevention and chronic disease metrics (e.g., immunizations, cancer screening, diabetes process measures) and patient ratings of access, continuity, and coordination

• Utilization measures (e.g., primary care visit rates)

• Organizational measures (e.g., facility complexity)

• Provider characteristics (e.g., primary care and women’s health provider types, staffing levels)