CcoEihHW8AAgDrC.jpg largeLast Thursday, VA employees and leaders arrived from all across the country to team up in an intense two-day working session. The goal: to co-create plans to adapt “Gold Status” innovations and practices with demonstrated results in other facilities so that they can be spread – or diffused – throughout VA to more rapidly serve Veterans and their families in the quest to transform VA into one of the best customer service organizations in the country.

(Learn how these Gold Status Fellows were selected.)

Day One

A group of people listen to Dr. Shulkin speak.

Dr. Richard Stone, Principal Deputy Under secretary of Health, opened up the first day on a positive and encouraging note: “The people of this system are great…What we are doing here is that creativity that is so important. It is an incredible concept to match innovators with those who can implement their practices.”

Prior to the Summit, Andrea Ippolito, Innovator’s Network Lead, trained VA Gold Status Fellows, Implementation Facility Fellows, and facilitators in human centered design, a best practice customer experience approach to designing solutions that involves putting the customer – in this case, Veterans and employees, at the center. During the Thursday working session, 12 Implementation Teams put those human centered design principles to work by co- creating Action Plans. Each team had a facilitator who guided their discussion. Members from the Diffusion Council, a governance group of VHA leaders, and the Senior Medical Advisory Board (SMAG) Best Practices Identification and Diffusion Work Group, a group of industry leaders and luminaries, joined their conversations to help think through issues, lessons learned, and the best approach for that facility. Teams collaborated to identify strategies for adapting each practice to serve the unique needs of Veteran populations served by the facilities to which each practice would be replicated.

Each Implementing Facility will be charged with the challenge of implementing its plan by August. They will be supported every step of the way by their Gold Status Fellow, VHA Action Team Lead, Atlas Research and ERPi support team members, and the Diffusion Council to help provide guidance, remove barriers, and enable success.

Day Two

Two women speak to a crowd.

The already high energy at the summit was elevated even more when VA Secretary Bob McDonald joined on Friday to share his passion and encouragement with the crowed. As he spoke about VA’s myVA initiative, he stressed the importance of leadership in an uncertain and constantly evolving world: “The only way we escape not adapting is by leading change. You have to embrace things you don’t understand…We must have an inspiring mission, great values, principle based management, and trained people.” Secretary McDonald further iterated the need to apply human centered designed principles to solving VA’s toughest challenges, just as many of the leading companies in America have done to improve customer experience.

Dr. Peter Pronovost, Director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, presented on the “Fractal Framework for Quality Management,” emphasizes the creation of local enabling infrastructure, clear communication of goals, engagement of clinicians in peer learning communities, and transparent reporting and accountability systems. In a simple statement, Dr. Pronovost demonstrated the passion for quality and patient safety that VA employees feel every day: “Through micromoments of love you can build a system that connects and can build better Vet care.”

A panel of healthcare industry leaders and luminaries with the SMAG Best Practices Identification Work Group engaged with the Planning Summit attendees around lessons learned in diffusing best practices. They all stressed the importance of communication, trust, and employee engagement.

Dr. Nirav Shah, Senior Vice President of Kaiser Permanente Southern California Region, stated, “We should reward failure in addition to success so we encourage people to try.”

All of the Implementation Teams’ hard work culminated on Friday afternoon. Each Implementation Team gave a 5-minute presentation of their Action Plans to a panel of VHA leaders. In return, the panel had 5 minutes to ask questions and provide helpful feedback on the spot to help the Teams refine their plans.

“We are totally going to implement this before August 2016. We know we can do it.” — Darren Sundman, W. G. (Bill) Hefner VA Medical CenterImplementing Facility for WAKE Score for Recovery from Anesthesia / Sedation

Dr. Henry Elzinga, Section Chief for Primary Care at Boise VA Medical Center and one of the Gold Status Fellows, stated, “There are loads of bright spots everywhere in our organization. While it’s nice to be recognized for our work, it’s even better to see others who want those same things in their facility or clinic.”

We are eager to follow our Fellows and Implementing Facilities as they transform those bright spots into a nationwide floodlight of innovation and improved care for our nation’s Veterans.

Want to feel like you were at the VA Diffusion of Excellence Planning Summit? Visit and join the conversation.


About the authors: Shereef Elnahal, M.D., a White House Fellow appointed to the Office of the Under Secretary for Health; and Andrea Ippolito, the leader of the VA Innovators Network, contributed to this blog.

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Published on Mar. 8, 2016

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