The "New VA": A National Laboratory for Health Care Quality Management

In 1995, the Veterans Health Administration (VHA) initiated the most radica l redesign of the veterans health care system since the system was formally created in 1946, One of the goals of this reengineering effort has been to ensure the consistent and predictable provision of high quality care every where in the system. To accomplish this goal, the VHA has organized more th an 100 different quality improvement activities according to a structure, p rocess, and outcomes focused quality management accountability framework (Q MAF) that targets 10 interrelated dimensions of quality management (QM). Ea ch of these dimensions utilizes a defined strategy and employs a menu of qu ality assessment and assurance tactics. Organizing these many different qua lity improvement activities into an accountability framework. should facili tate the development of policies and procedures that will systematize the V HA'S QM. The VHA's new operational structure and its approach to quality im provement provide a unique national laboratory for health care QM.