Over the past year, VA’s Under Secretary for Health, Dr. David Shulkin, has focused on developing a method to identify and spread innovations and best practices that improve access to care, care coordination, employee engagement, quality and safety, and the Veteran experience. In response, the Veterans Health Administration (VHA) launched the Diffusion of Excellence Initiative.

The goal of the Diffusion of Excellence Initiative is to identify best practices, and adapt and replicate them at other sites of care to improve the experiences of Veterans and their families, as well as those who serve them. The initiative helps empower front-line employees to share best practices to effectively use existing resources and skills to make improvements.

The VA “Shark Tank” competition, inspired by the ABC television show Shark Tank, offers a unique opportunity to recognize top performers who are solving some of our toughest challenges across VHA.

The first Under Secretary for Health (USH) Shark Tank, held in January, provided VHA employees with the opportunity to share their best practices with other VHA facility and Veterans Integrated Service Network (VISN) leadership. This resulted in more than 12 facilitated and 200 organic implementations across the United States. The success of the first USH Shark Tank, and subsequent implementations, showed the impact of the Diffusion of Excellence Initiative and paved the way for the second USH Shark Tank.

Through two rounds of evaluation, subject matter experts selected 20 finalists out of more than 400 applications to present their practices at the second Shark Tank competition, Nov. 16. The finalists came from a wide range of areas, including chaplains, physicians, nurses, pharmacists and performance improvement coordinators. During the virtual event, finalists presented a two-minute live pitch of their practice to VA medical center (VAMC) and VISN director “Sharks.” Sharks had two minutes to ask the finalists questions and one minute to bid resources on practices they wished to implement within their facility.

The presentations ranged from a home-based mental health evaluation program to the organization of chaplain groups, as well as innovations to improve Veterans’ access to care, and enhance employee engagement with an emphasis on rural facilities.

Other presentations related to quality and safety, including a practice to create a virtual women’s health mini-residency, to answer the need for more Designated Women’s Health Providers (DWHPs).

The initiative to cultivate ideas is already benefiting Veterans. In October 2015, Mona Baharestani of the James H. Quillen VAMC (Mountain Home, Tenn.) submitted a plan titled “Increasing Wound Care Access for Rural Veterans Through Telehealth.” Her idea provides wound diagnosis and treatment via e-consults and clinical video telehealth. The program eliminates the travel burden and reduces the risk of infection, as well as hospitalization. Since the program’s inception, approximately 450 Veterans have participated, with around 60 percent demonstrating wound improvement or complete closure.

The Diffusion of Excellence Initiative will announce the USH designated “Gold Status” practices and fellows by Dec. 12. “Gold Status” fellows will attend the Diffusion of Excellence Summit with the implementing facility fellows in January 2017 to create an action plan to implement their ideas at their facilities. Following implementation, some practices will be chosen for national rollout, and continue to empower VA employees to better serve Veterans.

Check out the Twitter Moment featuring live tweets from the second USH Shark Tank.

Authors: Andrea Ippolito is the leader of the VA Innovators Network; Shereef Elnahal, M.D., is the assistant deputy under secretary for health for quality, safety, and value; and Sankalpa Subbu is a project manager for the Office of Strategic Integration.


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Published on Dec. 3, 2016

Estimated reading time is 2.9 min.

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  1. Lillian Michele Gibson December 11, 2016 at 7:07 am

    I am both a retired VAMC SALEM, Va and disabled veteran who has opted to be cared for exclusively by VA Healthcare providers. I am also among the female veterans who seek care at our VAs across our great nation. Although government spending is now under the scrutiny of our future commander and chief, namely , Donald Trump, we as both nurses as well as the veterans, must all work together. In working together, all of our nation’s veterans .Our dedicated VA healthcare providers must meet the Standards of Care in achieving healthy patient outcomes which substantiate that the care provided continues to show evidence that our mission and vision meets the needs of both employees and the veteran population.

  2. Alexander Bazos December 9, 2016 at 1:58 pm

    It would be inclusive and a benefit to Veterans if the Doctor or Hospital has a prescription to call it in to VA Pharmacy.

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