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Durham Center of Innovation to ADAPT

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Dynamic Diffusion Network (DDN) QUERI Program

Overview

The Dynamic Diffusion Network (DDN) QUERI Program initially launched in 2021. The overarching goal of the DDN QUERI Program is to expand utilization of evidence-based practices among later adopter sites, with a specific focus on innovations in diabetes, moral injury, and safe medication prescribing for affected Veterans.  DDN QUERI leverages the use of practical implementation strategies and frameworks to successfully spread and sustain complex clinical evidence-based practices beyond early adopters of innovation. DDN QUERI’s work aligns with the national VA priorities of optimizing Veteran access, quality, efficiency, and experience of care.

Project Components

DDN QUERI involves the implementation and evaluation of three distinct evidence-based practices:

DDN QUERI Cores

Methodology

Guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, the DDN QUERI will carry out hybrid type 3 randomized trials of Moral Injury Groups, ACDC, and EQUiPPED. Each trial will compare the implementation strategy of “dynamic diffusion network” for operationalizing EPIS to community of practice among participating VA facilities and implementing teams.

Across the 3 EBPs, the primary outcome is the receipt of the EBP, difference in receipt of appropriate dose/adherence to the EBP intervention.  Secondary clinical/intervention effectiveness outcomes consist of differences in moral injury and depression symptoms for Moral Injury Groups; differences in hemoglobin A1c for ACDC; and differences in potentially inappropriate medications for older patients for EQUiPPED.

DDN QUERI will also carry out a mixed-methods evaluation using the Consolidated Framework for Implementation Research (CFIR) to examine factors influencing  outcomes at each EPIS stage; and a cost impact analysis to establish the business case for the practices.

The practices will be implemented and evaluated across VA Medical Centers nation-wide.

Program Summary

Read program summary here

Partners
  • VHA Innovation Ecosystem
  • VHA Office of Rural Health
  • VA Mid-Atlantic Health Care Network
  • VHA Office of Mental Health & Suicide Prevention
  • VHA Integrative Mental Health
  • VHA National Chaplain Service
  • VHA Office of Connected Care
  • Office of Specialty Care (Endocrinology and Diabetes)
  • Office of Geriatrics and Extended Care
  • National Emergency Medicine Program
  • Center for Healthcare Organization and Implementation Research (CHOIR)
  • Center for Clinical Management Research (CCMR)
  • Birmingham/Atlanta Geriatric Research Education and Clinical Center

For More Information:

George Jackson, Ph.D., MHA (Corresponding PI)

Email: george.jackson3@va.gov

Brandolyn White, MPH (Program Adminstrator)

Email: brandolyn.white@va.gov
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