Merging Implementation Practice and Science to Scale Up Promising Practices: The Veterans Health Administration (VHA) Diffusion of Excellence (DoE) Program.
The Veterans Health Administration (VHA) Diffusion of Excellence (DoE) program developed and manages a framework for identification, replication, and diffusion of promising practices throughout the nation's largest integrated health care system. DoE identifies promising practices through a "Shark Ta...
| Publicado en: | Joint Commission Journal on Quality & Patient Safety Vol. 47; no. 4; pp. 217 - 228 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Apr2021
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149394861&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149394861 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15537250 17W5 jtl: Joint Commission Journal on Quality & Patient Safety issn: 15537250 maglogo: N pubinfo: dt: Apr2021 vid: 47 iid: 4 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 149394861 149394861 149394861 10.1016/j.jcjq.2020.11.014 149394861 ppf: 217 ppct: 11 formats: tig: atl: Merging Implementation Practice and Science to Scale Up Promising Practices: The Veterans Health Administration (VHA) Diffusion of Excellence (DoE) Program. aug: au: Jackson, George L. Cutrona, Sarah L. White, Brandolyn S. Reardon, Caitlin M. Orvek, Elizabeth Nevedal, Andrea L. Lindquist, Jennifer Gifford, Allen L. White, Lindsay King, Heather A. DeLaughter, Kathryn Houston, Thomas K. Henderson, Blake Vega, Ryan Kilbourne, Amy M. Damschroder, Laura J. sug: subj: Implementation Science United States Department of Veterans Affairs Excellence Human Multimethod Studies Adoption Decision Making Surveys Semi-Structured Interview Descriptive Statistics Motivation ab: The Veterans Health Administration (VHA) Diffusion of Excellence (DoE) program developed and manages a framework for identification, replication, and diffusion of promising practices throughout the nation's largest integrated health care system. DoE identifies promising practices through a "Shark Tank" competition with winning bidders receiving external implementation facilitation. DoE further supports diffusion of successful practices across the VHA. This article presents results of a mixed methods implementation evaluation of DoE, focusing on program reach, program participation and decisions to adopt innovative practices, implementation processes, and practice sustainment. Data sources include practice adoption metrics, focus groups with bidders (two focus groups), observations of DoE events (seven events), surveys of stakeholders (five separate surveys), and semistructured interviews of facility directors, practice developers, implementation teams, and facilitators (133 participants). In the first four Shark Tank cohorts (2016–2018), 1,676 practices were submitted; 47 were designated Gold Status Practices (practices with facilitated implementation). Motivation for participation varied. Generally, staff led projects targeting problems they felt passionate about, facility directors focused on big-picture quality metrics and getting middle manager support, and frontline staff displayed variable motivation to implement new projects. Approximately half of facilitated implementation efforts were successful; barriers included insufficient infrastructure, staff, and resources. At the facility level, 73.3% of facilities originating or receiving facilitated implementation support have maintained the practice. VHA-wide, 834 decisions to adopt these practices were made. DoE has resulted in the identification of many candidate practices, promoted adoption of promising practices by facility directors, and supported practice implementation and diffusion across the VHA. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|