When the Veterans Health Administration Innovation Ecosystem’s (VHA IE’s) Diffusion of Excellence (Diffusion) portfolio launched in 2015, it was built to discover, support and spread innovative projects throughout the country’s largest health care system, forging the future of Veteran health care. It has been incredibly successful, bringing multiple health care innovations from frontline employees to scale across VHA. Since then, VHA IE has grown dramatically, but its goal of spreading innovation has never changed. The catalyst for this goal is providing more frontline workers with the knowledge and experience to innovate, and from this challenge the VHA Diffusion Academy (Diffusion Academy) was born.

The Diffusion Academy brings employees with mature practices together from across VHA IE portfolios to train and support them in taking the next step in spreading their work across VHA. This year, Diffusion Academy also supported researchers from the Quality Enhancement Research Initiative (QUERI), providing them with the same training and tools during the three-day intensive collaboration.

The 2021 VHA Diffusion Academy – the second to occur – took place virtually from April 20–22 with 54 representatives from 10 Promising Practices participating. During the three days, attendees heard from VHA leaders and subject matter experts as they worked to build 1–2-year business plans for their innovations while they build the groundwork for sustaining and scaling their practices. Panels and presentations focused on identifying resources, reporting metrics, developing enterprise-wide business cases and much more.

With the chance to brainstorm, connect with like-minded innovators and bring in diverse perspectives, Diffusion Academy provided these employee innovators with the tools to go out and positively impact even more Veteran lives. Attendees also walk away with a network of supportive peers to help them scale their work and deliver exemplary service to Veterans.

“The group participation is overwhelming,” said Blaine Fitzgerald, a diffusion specialist and the Diffusion Marketplace community manager. “They are transparent with their challenges or barriers, but in return, gain solutions and support to mitigate them. They genuinely and unconditionally celebrate each other’s successes, too. They are the most determined, passionate, hardworking group of individuals I’ve come across in the enterprise. It’s my privilege to be surrounded by such inspiring humans.”

Moving an innovation from a few facilities to a systemwide standard is a challenge that requires not only different skills, but also continued support and connectivity. By addressing knowledge and project management gaps, connecting innovators with each other and leadership, and providing in-depth planning, Diffusion Academy allows VA employees to continue to diffuse, mature and/or progress their work independently.

Learn more about this Diffusion Academy’s 10 incredible innovations below.

[accordion][accordion_section title=”Dedicated Environmental Management Services (EMS) Training Specialist “]Dedicated EMS Training Specialist increases standardization of work and highlights that environmental care in a health care setting is at its best when process-driven. This Promising Practice establishes clear expectations for new employees while providing a platform for ongoing training and education for established employees. The training specialist networks with facility subject matter experts on a variety of topics to augment in-service training needs, acts as a service-level Talent Management System (TMS) administrator, performs literature review research, as well as develops appropriate curriculum as needed. The practice also embeds components of Whole Health to better support a Veteran-majority staff.[/accordion_section][accordion_section title=”A Whole Health Approach for Reducing Opioid Reliance and Utilization “]Opioid reliance in chronic conditions can be mediated through Whole Health approaches and interventions within a shared medical appointment. Developing a Shared Medical Appointment (SMA) clinical pathway using the Whole Health conceptual framework curriculum can equip Veterans to make meaningful changes in their lives, improve self-care modalities for better pain management, and reduce opioid reliance.[/accordion_section][accordion_section title=”TeleSleep Home Sleep Apnea Testing Program “]Utilization of home sleep apnea testing (HSAT) diagnostics is rapidly increasing to better meet demand for Veteran evaluation of suspected obstructive sleep apnea (OSA). HSAT is considered a best practice and is supported by the Office of Specialty Care Services, Telehealth Services, and Office of Veteran Access to Care. HSAT is sharply increasing to meet Veteran demands. Implementation of a home sleep apnea testing program has become an integral part of the Sleep Medicine Program Office as a way to address access issues. Implementation of a home sleep testing program bring many benefits to sleep programs such as reduced costs over community care and Veteran travel. [/accordion_section][accordion_section title=”Falls Boot Camp”]Falls Boot Camp is an activity program designed to reduce the risk of falls among susceptible Veterans. It is an interdisciplinary approach, involving occupational, physical, and music therapy. The program consists of several training sessions designed to improve Veterans’ power, gait, balance, and cognition. They also receive an at-home program so they can continue to work towards personal goals.[/accordion_section][accordion_section title=”GERI-VET “]Geriatric Emergency Room Interventions for Veterans (GERI-VET)—an evidence-based multidisciplinary program performing geriatric screens and care coordination for at-risk older Veterans treated in the emergency department (ED)—was implemented based on established best practices for geriatric ED care. ED staff receive multimodal geriatric emergency medicine training and champion the care of the most frail, older Veterans during their ED visit. GERI-VET serves as a platform for Geriatric ED Accreditation through the American College of Emergency Physicians.[/accordion_section][accordion_section title=”One Consult Pathway “]One Consult Pathway is a Whole Health and Pain Management service that helps streamline the consultation process for providers and ensures that Veterans receive appropriate care. With the help of a provider or designated coach, patients complete a Personal Health Inventory (PHI) and Personal Health Plan (PHP), answering important questions about what they want for their health and choosing a self-care area to improve. Once complete, the PHI and PHP are embedded in the wireless access device (WAD) postings tab, so any provider can easily access them. Since its inception, One Consult Pathway has led to significant increases in Primary Care consults and has improved access to comprehensive Pain Management and Whole Health services for Veterans.[/accordion_section][accordion_section title=”TeleRehab Wheeled Mobility Clinic to Community Nursing Homes “]TeleRehabilitation wheeled mobility clinic completes complex wheelchair seating assessments and delivers equipment to Veterans without the need for travel to a VA facility. Using telehealth technology, rehab clinicians work together with community therapists to evaluate, measure, fit, train, and deliver a specialized wheelchair over the course of multiple visits. Vendors are used to assist with delivery of the equipment and provide hands-on assistance with set up of the wheelchair. Using telerehabilitation has enabled Veterans to get the care they need, eliminating hardships with travel to VA facilities.[/accordion_section][accordion_section title=”Spinal Cord Injury (SCI) Sexual Health and Fertility: An Interdisciplinary Approach “]Research shows sexual function is a “top 5” priority, yet sexual health education and services are lacking in the spinal cord injury (SCI) service at the VA St. Louis Health Care System and their spoke sites. This practice provides an assessment tool and standardized education and resources to create an interdisciplinary approach to sex education and services for Veterans with SCI.[/accordion_section][accordion_section title=”Therapeutic Design for Dementia “]Therapeutic Design for Dementia uses a multisensory approach to address anxiety, agitation, and aimless wandering using murals, music, aromatherapy, robotic pets, interactive busy boards, and more. The approach seeks to remedy the absence of a homelike and sensory-stimulating environment for Veterans with dementia.[/accordion_section][accordion_section title=”Kicking Catheter-Associated Urinary Tract Infection (CAUTI) Campaign “]The purpose of the Kicking CAUTI Campaign is to reduce knee-jerk, reflexive prescription of antibiotics in patients who have asymptomatic bacteriuria (bladder colonization without urinary symptoms). The focus is on diagnostic stewardship, or judicious use of diagnostic testing. Specifically, the campaign discourages sending urine cultures in patients without urinary-specific symptoms. Decreasing unnecessary urine cultures in turn decreases unnecessary antibiotic use. Decreased CAUTI) rates are another beneficial outcome.[/accordion_section][/accordion]

Blake Henderson is the director of the Diffusion Excellence. 

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