Medical centersand other facilities operatedrelatively independently of eachother, even competitively duplicatingservices. Until the mid-1990s, the VA operated largely as a hospitalsystem providing general medical and surgical services,specialized care in mental health and spinal cordinjury, and long-term care throughdirectly operated or indirectlysupported facilities. Structural and Organizational TransformationSince 1995 The Secretary of Veterans Affairsdirects the activities of the department, and the UnderSecretary for Health serves as the chief executive officerof VHA.
The Veterans Administrationwas elevated to Cabinet status and became theDepartment of Veterans Affairs in 1989, with financialsupport programs such as pensions administered underthe aegis of the Veterans Benefits Administration andhealth services consolidated in the Veterans HealthAdministration (VHA). Resourcesfor social services expanded rapidly followingWorld War II with the Servicemen's Readjustment Actof 1944 (better known as the GI Bill of Rights), and ahospital system that specialized in meeting the rehabilitativeneeds of more than 1 million returning troopswho had experienced physical and emotional traumaexpanded and evolved.
Origins of the Veterans Health AdministrationĪlthough health and social support for aged or disabledsoldiers has existed in the United States sinceColonial times, the spectrum of national programs forAmerican veterans was consolidated with the establishmentof the Veterans Administration in 1930.
HISTORY OF THE VETERANS HEALTHADMINISTRATION
Suffering deservedlyor not during the 1980s and early 1990s from a tarnishedreputation of bureaucracy, inefficiency, andmediocre care, the VA sought to reinvent itself beginningin 1995 as a model system characterized bypatient-centered, high-quality, high-value healthcare.This reinvention mandated structural and organizationalchanges, rationalization of resource allocation,measurement and active management of quality andvalue (and clear accountability for quality and value),and an information infrastructure that would increasinglysupport the needs of patients, clinicians, andadministrators.Īlthough predating the US Institute of Medicine'srecent recommendations for a more ideal health system, 1 the VA's improvement using strategies remarkablysimilar to those enunciated in the report providesincreasing evidence for the utility of the recommendationsin closing the "quality chasm." Through adoptionof evidence-based practices, proactive approaches topatient safety, and use of advanced technologies (eg, afully deployed electronic health record, bar-coded medicationadministration), the VA's success in improvingquality, safety, and value have allowed it to emerge asan increasingly recognized leader in healthcare. The Veterans Health Administration (VHA), oneof three administrations within the Departmentof Veterans Affairs (VA), is the largest integratedhealth system in the United States. Once disparaged as a bureaucracy providingmediocre care, the Department of Veterans Affairs (VA) reinventeditself during the past decade through a policy shiftmandating structural and organizational change, rationalization ofresource allocation, explicit measurement and accountability forquality and value, and development of an information infrastructuresupporting the needs of patients, clinicians, and administrators.Today, the VA is recognized for leadership in clinicalinformatics and performance improvement, cares for more patientswith proportionally fewer resources, and sets national benchmarksin patient satisfaction and for 18 indicators of quality in diseaseprevention and treatment. The Veterans Health Administration is the United States' largestintegrated health system.
0 kommentar(er)
