QUALITY IMPROVEMENT IN THE US-VETERANS-HEALTH-ADMINISTRATION

The Veterans Health Administration, the largest government-operated he alth-care system in the United States, has been actively engaged in qu ality improvement activities since 1990. These activities have been im plemented on both a system-wide and facility-specific basis. Some qual ity improvement efforts have been targeted to specific clinical servic es; others relate to the overall process of providing patient care. Th is paper provides an overview of three quality improvement activities in the Veterans Health Administration and considers the research and m anagerial issues they raise. (C) Elsevier Science Ltd.