VA Transparency and Quality Initiatives: An Update
Diffusion of Excellence
Federal Practitioner. How has the Diffusion of Excellence (DoE) program grown from its inception?
Dr. Elnahal. Since 2015, when we launched the initiative, the program has grown considerably both in size as well as in the diversity of best practices put forward.
Federal Practitioner. Does this initiative play into the larger efforts to improve transparency and quality of care?
Dr. Elnahal. Absolutely. Every cycle, categories of best practices are aligned seamlessly with the priorities of the moment. For example, suicide prevention and controlling the opioid epidemic were just some of the priorities we focused on this past year, because they are what the organization has been focused on at large. Quality and patient safety—perennial priorities of VHA—are always reflected in our solicitation of best practices.
Federal Practitioner. Can you identify/describe a few successful DoE programs that exemplify VA employees’ commitment to improving quality of care?
Dr. Elnahal. One example that springs to mind is the Home-based Mental Health Evaluation, or HOME, a program that bridges the gap in mental health care recently discharged rural veterans’ experience. In VISN 16, the program reduced psychiatric rehospitalizations by nearly 50% and the average length of a hospital stay by 41% by having staff meet with hospitalized veterans; complete a home visit within 1 week after the patient is discharged; and maintain weekly phone contact until the veteran starts outpatient mental health services.
