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Since 2018, VHA’s Diffusion of Excellence Initiative (DOEI)—part of the VHA Innovation Ecosystem—has been sponsoring an annual Shark Tank competition, which focuses on identifying field-developed practices that promote positive outcomes and improved experiences for Veterans and employees. The program facilitates the standardization of those practices across the VA healthcare system, fostering a culture of continuous improvement. Any VA employee can submit a practice for consideration, and after two rounds of evaluation by VA subject matter experts, 16 finalists emerge. Finalists pitch their practices during a live roundtable, with “sharks” (directors from VA Medical Centers and VISNs) bidding to support the implementation of the chosen practice at their site. The 2021 VHA Shark Tank Competition was held in a live, virtual event on October 27, 2021 and several HSR&D investigators were among this year’s 16 finalists.
Colorectal Cancer Screening with Programmatic Mailed FIT - Screening is proven to reduce mortality from colorectal cancer (CRC), the second leading cause of cancer death in the United States. Unfortunately, hundreds of thousands of Veterans are unscreened, and the COVID-19 pandemic has exacerbated this problem, with approximately 1.6 million Veterans due for screening in 2021. To address this growing backlog, the CRC Fecal Immunochemical Test (FIT) team, including HSR&D affiliate investigator and Executive Director of VA’s National Gastroenterology and Hepatology Program, Jason Dominitz, MD, MHS, initiated a program to mail FIT kits for CRC screening directly to Veterans to use in their homes and mail back for analysis. Thus far, Veteran and provider acceptance have been very positive. The team believes that this FIT-first approach will increase CRC screening adherence, reduce overall costs, increase colonoscopy access for Veterans with the highest risk for CRC, and ultimately save lives.
Fall Prevention System (FPS) - In 2015, the cost of fatal and non-fatal falls in the US was approximately $50 billion—and since falls disproportionally impact older adults, it is a particularly important issue for VA to address. The FPS team, including investigator Thomas Osborne, MD, of HSR&D’s Center for Innovation to Implementation and Director for VA’s National Center for Collaborative Healthcare Innovation (NCCHI), has been developing innovative ways to prevent falls. The NCCHI is collaborating with a medical company on a project that utilizes a smart integrated sock sensor system to alert nurses when a fall-risk patient attempts to get out of bed.
Healing Veteran Hearts with Virtual Home-Based Cardiac Rehabilitation (Smart HEART) - Smart Health Education and Rehab Technology (HEART) Virtual Home-Based Cardiac Rehabilitation helps at-risk Veterans who have had hospitalizations for heart disease. The Smart HEART team, including HSR&D affiliate investigator Amit Shah, MD, are using connected technology such as fitness trackers and a smartphone app to remotely connect Veterans from home with their VA cardiology team.
Implementation of Syringe Services Programs (SSP) within the VA - Using non-sterile syringes can result in transmission of viral hepatitis, HIV, and other conditions, including injection site infections. The Syringe Services Programs (SSPs) seeks to reduce transmission of these diseases as well as reduce overall harm for Veterans. The program provides:
HSR&D investigators contributing to the program include Elizabeth Oliva, PhD, with HSR&D’s Center for Innovation to Implementation; and Justeen Hyde, PhD and Westyn Branch-Elliman, MD, MS, both with HSR&D’s Center for Healthcare Organization & Implementation Research.
Team-supported, EHR-leveraged, Active Management for Hypertension (TEAM) - TEAM is a proven adaptable, effective, economically sustainable, and telehealth-delivered program that improves high-blood pressure management for Veterans—particularly among under-represented minorities—through the use and adaptation of existing VA tools and resources. TEAM's implementation, adaptations, and linkages to effective VA resources achieve improved blood pressure control while simultaneously reducing barriers to care and increasing Veteran engagement with the VA healthcare system. TEAM is being led by HSR&D investigators Hayden B. Bosworth, PhD, and Karen Goldstein, MD, both with HSR&D’s Center of Innovation to Accelerate Discovery and Practice Transformation.
