In a massive health care system, like VA’s Veterans Health Administration, how do you find the smart solutions people have already developed to solve problems and address challenges? And then, how do you share those innovations with others?
With more than 1,700 sites of care serving approximately 8.76 million Veterans each year, every VA medical facility has its own patient population, its own leadership and its own challenges—but some of these challenges are shared broadly by facilities from across the nation. Along with these unique 1,700 sites come thousands of dedicated, creative employees, whose mission is the same: to create positive care experiences for Veterans. Every day, these providers work with and for Veterans and are developing a treasure trove of innovative, resourceful solutions that improve quality, safety, experience and access to care.
Two weeks ago, Secretary Bob McDonald talked about how MyVA is modernizing VA “by combining functions, simplifying operations and providing Veterans care and services so that they see VA as MyVA—a world-class, customer-focused, Veteran-centered service organization.” He said, “We know that VA has significant issues that need to be addressed—so we’re listening to others’ perspectives and investing in our people.”
Enter VA’s very own rendition of “Shark Tank.”
VA Under Secretary for Health Dr. David Shulkin knew he needed to make this effort engaging enough to encourage broad participation, so he created an unusual approach: a competition to identify actual solutions developed by employees that can then be shared across the system to directly improve experiences for Veterans, driving a supportive culture of continuous improvement. More than 250 innovations and improvements were submitted in November 2015 from VA employees throughout the country, ranging from physicians to researchers to chaplains. These were narrowed to 20 finalists from 14 regional networks, who gave rapid-fire virtual pitches on Jan. 29 to VA medical center leaders, similar to the television show “Shark Tank.” The leaders committed resources to the innovations they wished to replicate or adapt at their medical center.
Dr. Shulkin kicked off the competition by thanking participants for their commitment to learning from one another by diffusing best practice innovations. He noted that “very few health systems across the world have done this. Other health systems will be able to learn from VA.” Participants pitched innovations and improvements they’ve had success implementing in their own facilities, ranging from code cart organization to increase efficiency, to improving same day access to urgent primary care, to improving access to care for rural Veterans, to anesthesia improvements that reduce nausea and pain while speeding recovery. These practices, along with the submissions that did not make it to the competition, will be featured in a publication later this year called “Best Care Everywhere,” by Dr. Shulkin with contributions from VA employees from across the nation.
The enthusiasm in for VA’s “Shark Tank” was palpable. Almost every pitch received multiple bids, which took the form of assigning staff to train or manage, dedicating funds to implement technology and offering up sites for implementation. Many medical center and network leaders combined forces, offering joint investments to participants, proposing community partnership connections and even offering collaboration with the Department of Defense for some bids.
Simply opening this new, creative venue that offers employees the opportunity to showcase their ingenuity and participate in friendly competition has revealed an abundance of good ideas that can be replicated across facilities with minimal impact to existing resources and work load. Staff on every level are eager to share information, to teach and learn from each other and most importantly, to figure out ways to provide Veterans and their supporters with the care they earned and deserve.
The finalists will be further narrowed to 10 “gold status” practices, which will be replicated in VA health care facilities across the system. The finalists whose practices are selected for the list of 10 will be named fellows and will play an instrumental role in supporting the replication and diffusion of their innovations and improvements.
One finalist, who pitched a method to archive Veteran’s life stories in their electronic medical record, summed up his experience: “I feel very good about the future direction of VA.”
About the authors: Shereef Elnahal, M.D., a White House Fellow appointed to the Office of the Under Secretary for Health; Patrick Littlefield, Ph.D., the executive director of VA’s Center for Innovation and Andrea Ippolito, the leader of the VA Innovators Network , contributed to this blog.