JHQ 317: Community of Practice Implementation: Leveraging VA/DOD Diabetes Clinical Practice Guidelines and Data Insights-JHQ 317: Article

JHQ 317: Article

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This article describes how the Veterans Health Administration and Department of Defense sought to improve implementation of evidence-based diabetes clinical practice guidelines (CPGs) by creating a national, multidisciplinary, virtual Community of Practice (CoP). Diabetes care is complex and outcomes are inconsistent; despite many treatments, only about one-third of patients receive recommended standards of care. The VA/DOD Type 2 Diabetes Mellitus CPGs offer structured, GRADE-based recommendations derived from a systematic evidence review, but adoption is challenged by the VA’s large, geographically dispersed, and sometimes siloed system.<br /><br />The authors developed a bimonthly CoP using Microsoft Teams, built on quality-improvement principles and the National Association for Healthcare Quality competency framework. A key design feature was integrating data-driven insights from VA performance tools—Strategic Analytics for Improvement and Learning (SAIL) and Electronic Quality Measures (eQM) dashboards—along with operational realities of Patient Aligned Care Teams (PACTs). Subject matter experts (SMEs) were selected using a data-driven approach, prioritizing high-performing facilities (upper quintile on a diabetes composite measure including HbA1c poor control, retinal exam timeliness, and kidney health evaluation). Sessions featured brief SME presentations plus interactive Q&A and live polls to assess awareness and perceived ability to apply practices.<br /><br />Early results showed strong growth and engagement: 92 attendees in the first session and 228 in the second, with many participants hearing about VA/DOD CPGs for the first time (51% and 61%, respectively). After sessions, most attendees reported they could apply best practices locally (76% and 78%). Post-session satisfaction (limited responses, mostly nurses) averaged 4.71/5.<br /><br />The authors note limitations such as technology access, time zones, sustaining engagement virtually, and dissemination barriers across organizational layers. Overall, they conclude that a virtual, data-informed CoP can accelerate CPG dissemination and practical implementation, and the model is expanding beyond diabetes (e.g., a mental health series drawing 500+ attendees).

Keywords

Veterans Health Administration (VHA)

Department of Defense (DoD)

Type 2 diabetes clinical practice guidelines (CPGs)

evidence-based guideline implementation

virtual Community of Practice (CoP)

Microsoft Teams healthcare education

quality improvement (QI) framework

SAIL performance dashboard

electronic Quality Measures (eQM)

Patient Aligned Care Teams (PACT)