Online Toolkits for Metric-Driven Quality Improvement: The Veterans Health Administration Managed Grassroots Approach

摘要

The Veterans Health Administration (VHA) manages the largest integrated care system in the United States, serving more than eight million veterans annually across its 21 regional networks. During the past 20 years, the VHA has made compelling and appreciable improvements in the quality of health care by acting on opportunities for improvement identified by clinical care quality indicators and performance measures. In recent comparisons, the quality of medical care provided to veterans has been shown to typically exceed that of a national sample. The VHA is committed to improving and redesigning systems when necessary to advance the quality of care provided. It monitors facility performance against data-driven quality and access metrics and holds facility leadership accountable for measurable improvements. For example, facilities are measured on more than two dozen indicators for timely diagnosis and treatment of lung cancer patients. In general, metrics are constructed in line with evidence-based clinical guidelines or other recommendations, while others are "veteran-centric."