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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.


Enhancing quality of care by communicating health needs collaboratively

Created in June 2012 by the Jennifer Moreno Department of Veterans Affairs Medical Center (San Diego, California)

Fall Prevention System

Use smart socks to alert nurses when fall-risk patient get out of bed.

Created in January 2020 by the Palo Alto VA Medical Center (Palo Alto, California)

Falls Boot Camp

Preventing falls through team style activity sessions

Created in February 2017 by the Des Moines VA Medical Center (Des Moines, Iowa)

FLOW System (formerly FLOW3)

Delivery of prosthetic limbs in less than half the time

Created in January 2013 by the Seattle VA Medical Center

Healing Veteran Hearts with Virtual Home-Based Cardiac Rehabilitation (Smart HEART)

Reduce cardiovascular disease risk and improve quality of life

Created in May 2016 by the Atlanta VA Medical Center (Atlanta, Georgia)

Healthier Kidneys Through Your Kitchen (HKTYK)

Earlier Nutrition Intervention for Chronic Kidney Disease: Inspiring and supporting behavior change through nutrition, cooking, and movement.

Created in June 2017 by the Franklin R. Sousley Campus (Lexington-Leestown)

Hospital acquired pneumonia prevention by engaging nurses (HAPPEN)

Brushing teeth is saving Veteran lives

Created in October 2016 by the Salem VA Medical Center (Salem, Virginia)

Increasing Access to Primary Care Using Pharmacist Providers

Pharmacists open access by shifting appointments & saving time.

Created in September 2014 by the William S. Middleton Memorial Veterans' Hospital (Madison)

Intermediate Care Technician

To augment the VA workforce with former military combat medics, medical technicians, and corpsmen in a unique health care role that: Utilizes their vast array of clinical skill-sets for Veteran care; Decreases overall visit waiting times and improve access to healthcare to make the VHA the “treatment of choice;” and, Improves the transition of this highly trained and skilled work force from DoD to Veteran care with a career pathway for professional healthcare roles.

Created in January 2013 by the VA Northeast Ohio Healthcare System

Kicking CAUTI Campaign

Our intervention reduces unneeded urine tests & antibiotic treatment.

Created in April 2010 by the Michael E. DeBakey Department of Veterans Affairs Medical Center (Houston)

Mini-Cog Screening Tool: Early Identification of Patients with Cognitive Impairment

Early nursing cognitive screening leads to improved patient outcomes.

Created in July 2019 by the The Villages VA Clinic