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Diffusion of Excellence

The Diffusion of Excellence Initiative helps to identify and disseminate clinical and administrative best practices through a learning environment that empowers its top performers to apply their innovative ideas throughout the system. All practices featured on this page are winners of the national VHA Shark Tank Competition.


Reduce Veteran wait times for eyeglasses by up to 53%

Created in August 2017 by the Tibor Rubin VA Medical Center (Long Beach)

Advance Care Planning via Group Visits Program

Engaging Veterans in group discussions to develop an advance care plan

Created in January 2012 by the Eugene J. Towbin Healthcare Center (North Little Rock)

Advanced Comprehensive Diabetes Care (ACDC)

Leveraging Home Telehealth and other VA resources to control diabetes

Created in December 2013 by the Durham VA Medical Center

Age-Friendly Health Systems

Age-Friendly Health Systems reliably provide high-quality care to older Veterans using the 4Ms framework – What Matters, Medication, Mentation, and Mobility.

Created in April 2017 by the Institute for Healthcare Improvement

Allergy to Beta Lactam Evaluation (ABLE)

Improving outcomes by clarifying & clearing penicillin allergies.

Created in November 2016 by the Memphis VA Medical Center

Building and Sustaining effective Veterans Family Advisory Councils- Workshop (VFAC)

Veteran and family perspective integrated into VA services at all levels

Created in October 2009 by the Palo Alto VA Medical Center (Palo Alto, California)

Building Spiritual Strength (BSS)

Building Spiritual Strength is a group approach for moral injury that can be led by chaplains, mental health providers, or both as a team.

Created in December 2005 by the Minneapolis VA Medical Center (Minneapolis, Minnesota), Edith Nourse Rogers Memorial Veterans' Hospital (Bedford), Lewiston VA Clinic (Lewiston, Maine)

Chronic Obstructive Pulmonary Disease Coordinated Access to Reduce Exacerbations (COPD CARE)

Empowering interprofessional care teams to optimize COPD management.

Created in October 2015 by the William S. Middleton Memorial Veterans' Hospital (Madison)

Continuous Cleaning of Hightouch Surfaces for Veteran and Employee Safety

Self-cleaning mats continuously disinfect providing extra protection

Created in April 2021 by the H. John Heinz III Department of Veterans Affairs Medical Center


Ensuring Veterans receive needed care after emergency department visits

Created in November 2015 by the West Los Angeles VA Medical Center


This EMS Initiative enhances the cleanliness of Medical Equipment & Beds

Created in July 2019 by the Louis Stokes Cleveland Department of Veterans Affairs Medical Center (Cleveland, Ohio)

Environmental Management Services Training Specialist

Improving infection control with consistent training of healthcare facility housekeepers

Created in August 2016 by the William S. Middleton Memorial Veterans' Hospital (Madison)