To improve standards of care for COPD, the Institute
for Healthcare Improvement’s ‘‘Breakthrough Series’’ (BTS)
model was used to guide the partnerships’ collaborative
efforts, educate providers, and empower clinical staff with
ideas and techniques for implementing and sustaining desired
practice changes.15 The BTS model was chosen as a
transformation mechanism because it has previously been
shown to be effective in improving care management strategies
for patients with other chronic diseases, including
congestive heart failure, depression, and asthma.16,17,18
This paper describes the IMI’s use of the BTS model to
implement evidence-based changes for COPD care in primary
care practices in rural areas of northeastern Maine, the
practice improvements that were achieved using this model,
the challenges faced, and the lessons learned.