HSR&D Finalists Achieve VA Shark Tank Gold Status
September 26, 2018
Takeaway: HSR&D researchers excel at developing innovations that change Veterans’ lives. Four research innovations were selected as Gold Status by the 2018 Shark Tank, allowing for continued implementation of Advanced Comprehensive Diabetes Care (ACDC), in-hospital daily supervised walking (STRIDE), community health worker social support to high-risk patients (IMPaCT), and tailored exercise programs for older Veterans (Gerofit).
As part of VHA’s Diffusion of Excellence Initiative, the VHA Shark Tank Competition identifies field-developed promising practices and facilitates the standardization of those practices across the VA healthcare system. Submitted practices undergo evaluation by VA subject matter experts. During the virtual competition, the leadership teams bid resources—such as money, staff, or time—to implement the practices they want in their facilities. VA senior leaders then select approximately 10 finalists and 10 network directors as winners. In 2018, the following HSR&D projects were chosen:
- The “Advanced Comprehensive Diabetes Care (ACDC)” program is a nurse-administered telehealth intervention for Veterans with persistently poor diabetes control. ACDC augments standard home telehealth services with diabetes self-management support and clinician-guided medication management. ACDC’s effectiveness in the “real world” has been confirmed in a randomized trial and in clinical practice across five VA sites where the intervention is being implemented. After selection as a Gold Status Practice through the 2018 Shark Tank competition, the ACDC intervention is being implemented within the VISN 19 Rocky Mountain Network, Montana VA Health Care System.
- “Getting Hospitalized Veterans Back on Their Feet: The STRIDE Program” consists of a one-time gait and balance assessment conducted by a physical therapist, followed by daily supervised walks by a therapy or nursing assistant for the duration of the hospital stay. Program evaluation has demonstrated high satisfaction among Veteran participants and reduced need for post-acute institutional care. Outcome measures include reduced discharges to skilled nursing facilities, reduced length of hospital stay, and improved Veteran experience. The intervention will be implemented within the Jennings Bryan Dorn VA Medical Center in South Carolina and the Martinsburg VA Medical Center in West Virginia.
- “Better Health, Lower Cost: How IMPaCT Community Health Workers Can Support Veterans” was developed to help Veterans struggling with real-life challenges such as hunger, housing insecurity, or trauma. IMPaCT consists of a standardized, evidence-based program in which community health workers are hired and trained to join healthcare teams and provide social support to high-risk patients. IMPaCT has been tested in three randomized controlled trials. These trials demonstrated consistent improvements in chronic disease control, mental health, and quality of care, and reductions in hospitalizations by 65%. IMPaCT has been delivered to nearly 7,000 patients in the Philadelphia region and continues as a clinical program at the Michael J. Crescenz VA Medical Center.
- “Gerofit – Managing Diseases and Lowering Care Costs with Exercise” is an exercise and health promotion program that provides personally-tailored exercise programs for older Veterans. Gerofit supports facility-based programs, home-based counseling programs, and various modalities of hybrid outreach programs. Thus far, the Gerofit program has resulted in a 25%, 10-year reduced mortality rate and a reduced risk of institutionalization. Gerofit also resulted in a significant reduction in Veterans’ cardio-metabolic risk profiles. In addition, Gerofit has reduced the numbers of prescribed medications, and for patients with PTSD, 86% of participants reported improved symptoms. With support from the VA Offices of Geriatrics and Extended Care and Rural Health, Gerofit has been disseminated to 12 other medical care systems. More than 7,000 Veterans have been reached by one of the many Gerofit programs. One or two new programs are added each year. (repetitive with earlier sentence)