# Spreading Healthcare Access, Activities, Research and Knowledge (SHAARK) PEC

> **NIH VA I50** · DURHAM VA MEDICAL CENTER · 2021 · —

## Abstract

Anticipated Impacts on Veteran’s Healthcare: The Spreading Healthcare Access, Activities, Research and
Knowledge (SHAARK) Partnered Evaluation Center (PEC) is designed to provide rapid and frequent feedback
to VHA Diffusion of Excellence (DEI) partners by 1) addressing factors aimed at increasing participation in the
DEI; 2) helping increase organizational readiness for change within VA facilities to successfully implement
promising practices; and 3) addressing key contextual factors that are associated with successful
implementation of gold status practices at VA facilities. An anticipated evaluation outcome is the increased
ability of DEI partners to provide effective “personalized implementation” (organizational-level and person-level
human centered design) of promising practices.
Project Background: The objectives of the DEI are to: 1) empower employees to develop innovations in care
and administrative processes, 2) institutionalize the process for implementing and spreading promising
practices; and 3) minimize negative variation in practices across the VA. The DEI began with solicitation of
“promising practices” from front-line VA staff designed to address key priorities of the Under Secretary for
Health. In December 2015, 260 “promising practices” were submitted followed by subject matter expert
selection of 40 semifinalists and 20 finalists. Finalists were then presented to facility and Veterans Integrated
Service Network (VISN) directors through a “shark tank,” during which the participating directors (i.e., sharks)
“bid” resources for implementation of the finalist “promising practices” they chose. The 13 chosen promising
practices were designated as “gold status” best practices. Support to develop implementation materials has
been provided to the sites that initiated the practice (“gold status facilities”) and facilitated support has been
provided to the 17 sites selected to implement “gold status” practices (“implementation facilities”). The process
of implementing these practices across the VA has subsequently begun with 385 implementations across >100
facilities. The DEI has since been institutionalized within the Office of Strategic Integration, which reports to the
Deputy Under Secretary for Health for Organizational Excellence.
Project Objectives: The overall goal of the SHAARK PEC is to understand the impact of the DEI’s process,
which provides a national infrastructure to support a bottom-up approach eliciting promising practices from
frontline staff which are then implemented with central support. Aims 1 and 2 are focused on DEI participation
and adoption decisions for promising practices. Specifically, aim 1 is to identify factors associated with
participation in the DEI. Aim 2 is to examine shark decision making processes when choosing to bid resources
for implementation of gold status practices and relate processes to perceived organizational readiness for
change (ORC). Aim 3 is focused on the process of implementing gold st...

## Key facts

- **NIH application ID:** 9396645
- **Project number:** 1I50HX002451-01
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Laura J. Damschroder
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2017-04-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9396645

## Citation

> US National Institutes of Health, RePORTER application 9396645, Spreading Healthcare Access, Activities, Research and Knowledge (SHAARK) PEC (1I50HX002451-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9396645. Licensed CC0.

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