Streamline Training & Documentation: Quality Healthcare from the VA

Wednesday, July 12, 2006

Quality Healthcare from the VA

The goal: Make the healthcare system of the Department of Veteran Affairs work for the patient.

According to an article by Catherine Arnst in the July 17 issue of Business Week, this goal became the lodestar for a complete makeover of the VA system that began in the mid-1990s. The makeover was spearheaded by Ken Kizer, Health Under Secretary at the VA during the period in question.

Arnst is clear about a key enabling condition: "A nationwide health-care network that gets its funding from a single payer..." Arnst explains:

Not having to rely on piecemeal insurance payments means the VA can finance large-scale improvements such as [its] electronic medical-records system, up and running in all of its facilities since 2000.¹ In contrast, only some 20% of civilian hospitals have computerized their patient records. ... When hospitals were evacuated from New Orleans during Hurricane Katrina, the VA's patients were the only ones whose medical records could be accessed immediately anywhere in the country.

Furthermore:

The VA's charter also confers some unique advantages. Because it treats patients throughout their lives, it can invest in prevention and primary care, knowing it will reap the benefits of lower long-term costs. ...

The VA uses the data gathered in its computers to pinpoint problem areas, such as medication errors. The network also allows it to track how closely the medical staff is following evidence-based treatment and monitor deficiencies.

Though Kizer left the VA in 1999, his culture of quality lives on:

Practices and outcomes are evaluated constantly, and staffers throughout the system meet regularly to discuss ways to improve patient care.

There are change management lessons here not only for civilian hospitals, but also for any type of organization willing to make the effort to investigate where its circumstances and environment overlap those of the VA.
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¹ The VA has just been awarded an Innovations in American Government Award by Harvard's Kennedy School of Government. The award honors the VA's model electronic medical-records system. You can read the Kennedy School press release here (pdf).

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