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2023 HSR&D/QUERI National Conference Abstract

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4101 — Evaluating VHA’s Shark Tank Competition: A Typology of Engagement in Innovation Across VHA Medical Centers

Lead/Presenter: Gemmae Fix ,  COIN - Bedford/Boston
All Authors: Kaitz J (Center for Healthcare Organization and Implementation Research, VA Bedford), Deeney C (Center for Healthcare Organization and Implementation Research, VA Bedford) DeLaughter K (Center for Healthcare Organization and Implementation Research, VA Bedford) Cutrona S (Center for Healthcare Organization and Implementation Research, VA Bedford; University of Massachusetts Medical School) Damschroder L (Ann Arbor VA CCMR) Hogan T (Center for Healthcare Organization and Implementation Research, VA Bedford; University of Texas) Gifford AL (Center for Healthcare Organization and Implementation Research, VA Boston; Boston University) Jackson GL (Durham VA ADAPT, Duke University) King H (Durham VA ADAPT, Duke University) Nevedal A (VA Palo Alto Center for Innovation to Implementation) Reardon C (Ann Arbor VA CCMR) White B (Durham VA ADAPT) Fix GM (Center for Healthcare Organization and Implementation Research, VA Bedford; Boston University)

Objectives:
Learning healthcare systems seek to identify, implement, and spread innovations. The Veterans Health Administration (VHA) developed a “Shark Tank” competition as part of the Diffusion of Excellence, a national program to spur innovation. Frontline staff submit innovations to Shark Tank; winners receive facility support (e.g., money, staff) to spread their innovations. However, facility engagement in Shark Tank may vary across VHA facilities, thus limiting the development and spread of innovation. We sought to (1) assess engagement in VHA’s Shark Tank competition and (2) identify the nature of engagement and explore organizational conditions for innovation across VHA facilities.

Methods:
We used a multiple case study design to understand medical center (facility) Shark Tank engagement, and the relationship between engagement and organizational conditions that have been shown to impact innovation. We compiled a database of administrative data from 141 VHA medical centers across seven Shark Tanks (2015-2021). Facility-level Shark Tank engagement was measured through the number of innovations submitted, winning innovations, and bids on innovations from other facilities. Organizational characteristics of each facility included: VHA complexity designation, presence of research center(s), and presence of a local innovation specialist (iNET). The analysis was based on Kluge’s (2000) typology method including: developing type dimensions using a qualitative iterative process, grouping cases along dimensions, analyzing meaningful relationships to create types, and characterizing types.

Results:
A total of 1646 applications were submitted to Shark Tank between 2015 and 2021. Of 141 VHA facilities, 138 submitted at least one innovation to Shark Tank. Of those, 39 facilities have had winning innovations, adopted by 74 facilities. We identified a typology of seven types of engagement based on facility engagement in Shark Tank and facility organizational conditions for innovation. “Connected Creators” were the most typical of facilities with winning innovations: they were high complexity facilities with research centers and/or local innovation coordinators. “Independent Innovators” also had winning innovations but were lower complexity facilities without research centers and/or local innovation coordinators. “Daring Diffusers” were engaged in Shark Tank by submitting and bidding on innovations. “Ambitious Adopters” focused on bidding on innovations from other facilities. “Persistent Pioneers” were engaged in Shark Tank only through submitting innovations. Finally, the less engaged facilities were primarily “Remote Recruits”: low complexity facilities without a research or innovation presence. “Future Flourishers” made up a smaller group of less engaged facilities that were high complexity facilities with some research or innovation presence.

Implications:
Across 141 VHA facilities we found high engagement in Shark Tank. Overall, there are diverse ways for facilities to be engaged in innovation that can capitalize on their organizational conditions. While facilities with established conditions for innovation were highly engaged in innovation, facilities with less established conditions for innovation were still engaged in Shark Tank, especially through bidding.

Impacts:
In the future, Diffusion of Excellence can use this information to tailor how they work with different facilities based on engagement and organizational conditions. Remote Recruits may be facilities where added innovation support is particularly needed.