Diffusion of Excellence
Scaling Best Practices Across the Country
Diffusion of Excellence specializes in scaling emergent, high-impact health care practices across the nation’s largest integrated health care system consisting of more than 300,000 employees, and serving over 8.9 million Veterans at roughly 1,700 facilities annually. The 2015 Veterans Choice Act studies uncovered that, on average, Veterans Health Administration outperformed the private sector on many measures, but variation between facilities resulted in poor outcomes for some Veterans. VHA took a unique approach to solving this issue by designing and deploying a model to identify, test, and diffuse best practices across VHA, naming it the Diffusion of Excellence.
Diffusion of Excellence puts the Department of Veterans Affairs (VA) talented clinical and administrative workforce at the helm of enterprise-wide health care improvement initiatives. VHA has held four "Shark Tank" style competitions since 2015, each followed by Diffusion of Excellence Base Camp which guide the winners, known as Gold Status Fellows, in building implementation plans for practice replication. VHA consults the champions on adapting the practices to meet the unique needs of local Veteran populations and employees. Once the practices deliver consistent impact and prove to be replicable, Diffusion of Excellence works with national stakeholders to collaboratively develop strategies for national diffusion throughout the VHA system.
Diffusion of Excellence currently supports five Gold Status Practices undergoing National Implementation from Cohorts 1-3 of the VHA Shark Tank Competition. These practices include FLOW3, Project HAPPEN, the Rapid Naloxone Initiative, TeleWound, and VIONE. The practices selected for National Implementation show content maturity, national stakeholder engagement, and alignment with VA priorities. In Fiscal Year 2019 (FY19), Practices undergoing National Implementation have spread to 167 new sites and impacted approximately 34,000 Veterans, saving 170 Veteran lives and saving an annualized estimate of $12.62 million dollars.
Cohort 4 Practices
Diffusion of Excellence sustainably replicated nine Gold Status Practices at 24 new sites. Topics of Cohort 4 ranged from improving Veteran satisfaction by improving communication opportunities between patients and Environmental Management Services (EMS) to offering virtual visits to Veterans who receive hypertension management on a recurring basis.
Diffusion Marketplace supports a high-reliability and learning organization by diffusing best practices. The site is designed to help spread important and life-saving best practices throughout the VA health care system.