Creating a Culture of Quality: The Remarkable Transformation of the Department of Veterans Affairs Health Care System
Authors: Sheldon Greenfield, Sherrie H. Kaplan
Journal: Annals of Internal Medicine (2004)

Editorials17 August 2004Creating a Culture of Quality: The Remarkable Transformation of the Department of Veterans Affairs Health Care SystemSheldon Greenfield, MD and Sherrie H. Kaplan, PhD, MPHSheldon Greenfield, MDFrom University of California, Irvine, Irvine, CA 92697. and Sherrie H. Kaplan, PhD, MPHFrom University of California, Irvine, Irvine, CA 92697.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-4-200408170-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail For decades, fairly or unfairly, the Department of Veterans Affairs (VA) health care system had a suboptimal image in the quality of care it provided and in the evaluation of that care. About 10 years ago, the VA leadership began a major national reorganization that has transformed the VA health care system. What was largely an inpatient, subspecialty-based system became a "full-service," integrated delivery system committed to a new model of health promotion, disease prevention, and coordination of care. The VA's transformation was 2-part. First, it implemented a sweeping overhaul of service delivery. Second, it created a "culture of quality," ...References1. Kizer KW, Demakis JG, Feussner JR. Reinventing VA health care: systematizing quality improvement and quality innovation. Med Care. 2000;38:I7-16. [PMID: 10843266] CrossrefMedlineGoogle Scholar2. Jha AK, Perlin JB, Kizer KW, Dudley RA. Effect of the transformation of the Veterans Affairs Health Care System on the quality of care. N Engl J Med. 2003;348:2218-27. [PMID: 12773650] CrossrefMedlineGoogle Scholar3. Kerr EA, Gerzoff RB, Krein SL, Selby JV, Piette JD, Curb JD, et al . Diabetes care quality in the Veterans Affairs health care system and commercial managed care: the TRIAD study. Ann Intern Med. 2004;141:272-81. 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Diabetes Physician Recognition Program, National Committee for Quality Assurance. Accessed at www.ncqa.org/dprp on 7 July 2004. Google Scholar17. Heart/Stroke Recognition Program, National Committee for Quality Assurance. Accessed at www.ncqa.org/hsrp on 7 July 2004. Google Scholar18. Eisenberg JM. Measuring quality: are we ready to compare the quality of care among physician groups? [Editorial]. Ann Intern Med. 2002;136:153-4. [PMID: 11790069] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Sheldon Greenfield, MD; Sherrie H. Kaplan, PhD, MPHAffiliations: From University of California, Irvine, Irvine, CA 92697.Disclosures: None disclosed.Corresponding Author: Sheldon Greenfield, MD, Center for Health Policy and Research, University of California, Irvine, 111 Academy Way, Suite 220, Irvine, CA 92697.Current Author Addresses: Drs. Greenfield and Kaplan: Center for Health Policy and Research, University of California, Irvine, 111 Academy Way, Suite 220, Irvine, CA 92697. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiabetes Care Quality in the Veterans Affairs Health Care System and Commercial Managed Care: The TRIAD Study Eve A. Kerr , Robert B. Gerzoff , Sarah L. Krein , Joseph V. Selby , John D. Piette , J. David Curb , William H. Herman , David G. Marrero , K.M. Venkat Narayan , Monika M. Safford , Theodore Thompson , and Carol M. Mangione Metrics Cited byTraining leaders for a culture of quality and safetyDo associations between employee self-reported organizational assessments and attitudinal outcomes change over time? An analysis of four Veterans Health Administration surveys using structural equation modellingAn Overview of Evidence-Based Mental HealthReconsidering the Veterans Health Administration: A Model and a Moment for Publicly Funded Health Care DeliveryJoan J. 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