QI Spotlight: ALS Coordinator Community of Practice

The February QI Project Spotlight was submitted by Ileana Howard, MD.

Dr. Howard attended Harvard Medical School and completed her residency at the University of Washington. She is the Medical Co-Director of the ALS Center of Excellence at the VA Puget Sound in Seattle, Washington, where she established and now oversees one of the busiest ALS programs in the Veterans Health Administration. Dr. Howard practices at the VA Puget Sound in Seattle, Washington and is an Associate Professor of Rehabilitation Medicine at the University of Washington. In addition to educating PM&R residents, she is a fellowship director for the VA’s first Chief Resident in Quality and Safety for rehabilitation medicine.

Thank you for submitting your project, Dr. Howard!

The QI Project Spotlight is a periodic feature on the ABPMR News Center to highlight exemplary Quality Improvement projects submitted by your fellow diplomates (or residents) for continuing certification (CC) credit. Diplomates can use the QI Project Spotlight as a tool to plan their own QIs or as a way to connect with other diplomates doing similar work.

What is the problem you are trying to solve?

The Veterans Health Administration published a new directive for ALS (amyotrophic lateral sclerosis) care in 2021. One of the new requirements was that each of the 170 facilities name a specific point of contact to serve as an ALS coordinator. Enforcement began in November 2022. Over 50% of the ALS coordinators at VA facilities were new to the care of ALS. Therefore, we needed to create a solution to help provide education and support for these coordinators through creation of a community of practice.

What data (objective measurements) do you have that supports this as a problem?

  1. Low engagement with the ALS internal sharepoint webpage
  2. Low engagement of ALS coordinators through email listservs
  3. Low engagement of ALS coordinators through video conferences

What is your opportunity statement? State the goal you hope to achieve.

Through creation of an ALS Coordinator Community of Practice, we can increase engagement of front-line ALS coordinators nationally which will create opportunities to improve access to education and resources to enhance the care for Veterans with ALS and their families.

What is the underlying cause of the performance/quality problem?

Lack of formal infrastructure for coordinators.

What change(s) did you implement?

Sought volunteers from seasoned ALS coordinators to lead a Community of Practice, established monthly calls, curated new content to SharePoint and advertised the SharePoint through monthly calls and email signature line.

Did you achieve your goal or target from your opportunity statement? What data do you have to support your conclusion?



  1. Increase VHA ALS Coordinator listserv to 75 members
  2. Increase monthly traffic to SharePoint: 30/30 days
  3. Launch bi-monthly Community of Practice Call for ALS Coordinators

IMPORTANCE: Enhanced patient care and staff expertise.

DATA DEFINITIONS: As listed above.


Baseline measures (11/29/22) VHA ALS Coordinator listserv: 54 members ALS Coordinators Teams grouper: 33 members Web traffic to the ALS Sharepoint: 15 in past 30 days

Final measures (10/17/2023) VHA ALS Coordinator listserv: 172 members ALS Coordinators Teams grouper: 186 members Web traffic to the ALS SharePoint: 150 in past 30 days

How will you maintain the success of your project going forward?

The ALS Coordinator Community of Practice leadership is comprised of 6 volunteers and was formalized through written invitations to their supervisors. The group is now self-sustaining, and I serve in advisory capacity.

Originally Published: February 05, 2024