ArticleImplementation science communications2020
Implementation and sustainment of diverse practices in a large integrated health system: a mixed methods study.
Article in Implementation science communications, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed.
- Implementation of Direct-to-Patient Mobile Teledermatology in VA.Journal of general internal medicine · 2024Trial
- IMPACT: A Structured Human-Centered Design Process for Integrating Community Health Worker Insights Into Program Policy in Pakistan.Global health, science and practice · 2026Article
- Beyond implementation: what drives long-term sustainment of life-sustaining treatment documentation in VA home based primary care.BMC health services research · 2026Article
- Implementing multidomain non-pharmaceutical interventions for preventing cognitive decline in community-dwelling older adults in China: An embedded mixed-methods implementation study of determinants and strategies.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Implementation of a national aging-in-place reform: a qualitative study exploring facilitators and barriers from the perspectives of employees in six Norwegian municipalities.Implementation science communications · 2025Article
- Implementation of the framework for disability and rehabilitation in Gauteng, South Africa.African journal of primary health care & family medicine · 2025Article
- The Consolidated Framework for Implementation Research (CFIR) User Guide: a five-step guide for conducting implementation research using the framework.Implementation science : IS · 2025Article
- How senior leaders support innovations in large learning health systems: Insights from United States Veterans Health Administration national program office leaders.Learning health systems · 2025Article
- Leveraging data to support health equity in an integrated delivery and finance system.Learning health systems · 2024Article
- Understanding pathways from implementation to sustainment: a longitudinal, mixed methods analysis of promising practices implemented in the Veterans Health Administration.Implementation science : IS · 2024Article
- Supporting Veteran's Administration Medical Center Directors' Decisions When Adopting Innovative Practices: Development and Implementation of the "QuickView" and "WishList" Tools.The Permanente journal · 2023Article
- Hurdles of innovation-insights from a new healthcare delivery innovation program.Learning health systems · 2023Article
- Leveraging Organizational Conditions for Innovation: A Typology of Facility Engagement in the Veterans Health Administration Shark Tank-Style Competition.The Permanente journal · 2023Article
- Sustainment of diverse evidence-informed practices disseminated in the Veterans Health Administration (VHA): initial development and piloting of a pragmatic survey tool.Implementation science communications · 2023Article
- Diffusion of excellence: evaluating a system to identify, replicate, and spread promising innovative practices across the Veterans health administration.Frontiers in health services · 2023Article
- The updated Consolidated Framework for Implementation Research based on user feedback.Implementation science : IS · 2022Review
- Implementation of an Intensive Telehealth Intervention for Rural Patients with Clinic-Refractory Diabetes.Journal of general internal medicine · 2022Article
- The Perils of a "My Work Here is Done" perspective: a mixed methods evaluation of sustainment of an evidence-based intervention for transient ischemic attack.BMC health services research · 2022Article
- Realist evaluation of the impact of the research translation process on health system sustainability: a study protocol.BMJ open · 2022Article
- Using qualitative comparative analysis to uncover multiple pathways to program sustainment: implications for community-based youth substance misuse prevention.Implementation science communications · 2022Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOne goal of health systems seeking to evolve into learning health systems is to accelerate the implementation and sustainment of evidence-based practices (EBPs). As part of this evolution, the Veterans Health Administration (VHA) developed the Innovation Ecosystem, which includes the Diffusion of Excellence (DoE), a program that identifies and diffuses Gold Status Practices (GSPs) across facilities. The DoE hosts an annual "Shark Tank" competition in which leaders bid on the opportunity to implement a GSP with 6 months of implementation support. Over 750 diverse practices were submitted in cohorts 2 and 3 of Shark Tank; 23 were designated GSPs and were implemented in 31 VA networks or facilities. As part of a national evaluation of the DoE, we identified factors contributing to GSP implementation and sustainment.
methodsOur sequential mixed methods evaluation of cohorts 2 and 3 of Shark Tank included semi-structured interviews with at least one representative from 30/31 implementing teams (
resultsOver 50% of teams (17/30) successfully implemented their GSP within the 6-month implementation period. Despite extensive implementation support, significant barriers related to centralized decision-making, staffing, and resources led to partial (
conclusionsMost teams implemented within 6 months and/or sustained their GSP 1.5 years later. High levels of implementation and sustainment across diverse practices and teams suggest that VHA's DoE is a successful large-scale model of diffusion. Team predictions about sustainability after the first 6 months of implementation provide a promising early assessment and point of intervention to increase sustainability.
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