In 2016, the Veterans Health Administration (VHA) Diffusion of Excellence began a journey to
develop repeatable, inclusive frameworks that enable Promising Practices developed by our
frontline employees to obtain recognition and broader impact. Like most startups, we’ve
encountered plenty of unexpected bumps in the road. We’ve also discovered unique ways to
empower our workforce, make their combined efforts more readily understandable to peers and
leadership, and unlock broader impact across our health care enterprise for the most promising
of emerging practices.

After five years, six national competitions, 69 Promising Practice designations, 10 National
Diffusion Practices, over 800 practice replications, and too many relationships formed to count,
it’s finally time to share some of the knowledge we’ve accrued along the way. This Diffusion
Playbook is intended as a practical overview and guide. It’s a “bread-crumb trail,” rather than
formal manual.

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