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VA Health Systems Research

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FORUM - Translating research into quality health care for Veterans


In This Issue

Director's Letter

Director's Letter
by David Atkins, MD, MPH, Director, HSR&D

Everyone seems to agree that American health care costs too much and delivers too little. An estimated 30 percent of health care spending is wasted on therapies that are unnecessary, ineffective, or poorly targeted...

Commentary

Lean Enterprise Transformation within VHA
by Heather Woodward-Hagg, PhD, Veterans Engineering Resource Program Office Washington, DC, VA Center for Applied Systems Engineering, Indianapolis, Indiana and Robin Hemphill, MD, MPH, VA Office of Quality, Safety and Value, Washington, DC, VA National Center for Patient Safety, Ann Arbor, Michigan

Researchers have found that the application of Lean in the health care sector often fails when implementation focuses on limited application of Lean tools and methods with little or no emphasis on the cultural transformation necessary to sustain results over time...

Response to Commentary

Evidence-Based Implementation: Towards a Scientific Agenda for the Learning Healthcare System
by Amy Kilbourne, PhD, MPH, Director, QUERI Program, Washington, DC

A close complement to Lean techniques, implementation science provides a systematized approach to identifying barriers and facilitators to system change, and uses this information to refine and test implementation strategies. Many of these strategies focus on methods to support providers in the use of a clinical treatment across different practice settings...

Research Highlights

Measuring Value
by Todd Wagner, PhD, Steven Asch, MD, MPH, both from HSR&D's Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, California

How do you measure value? That question was tackled by a panel as part of a recent State of the Art (SOTA) conference on performance measurement. In our panel, experts from a range of backgrounds met virtually on three occasions to define value and help focus priority areas for further VA research on measurement strategies ...


Does Better Quality Cost More?
by Eileen Moran, MS, VHA Office of Productivity, Efficiency & Staffing (OPES); Peter Almenoff, MD, FCCP, VHA Office of Analytics and Business Intelligence; Jian Gao, PhD, VHA OPES, all located in Washington, DC

Within the health care industry, there is a belief that better quality must cost more, or that reducing costs will come at the expense of quality. However, in the Veterans Health Administration (VHA) we have found the opposite—high quality is associated with high efficiency or low cost across the medical centers ...


Value and Efficiency in the Context of Dual Use
by Walid F. Gellad, MD, MPH, HSR&D Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania

The issues of value and efficiency have become central to every conversation about health care since the passage of the Affordable Care Act (ACA). In a much publicized perspective piece in the New England Journal of Medicine in March 2015, the Secretary of the Department of Health and Human Services (HHS), Sylvia Burwell, emphasized the growing role of value-based payment systems under which health care providers are accountable for the quality and cost (i.e., value) of care they deliver ...




Berlowitz Receives 2015 Under Secretary's Award for Outstanding Achievement in Health Services Research

Dr. Berlowitz is a leading health services researcher with strong methodological expertise in the areas of quality assessment, risk adjustment, and the use of large databases. His work focuses on assessing and improving the quality of health care for Veterans ...



HSR&D Holds National Conference
"Health Services Research for a Veteran-Centered Learning Organization" was the theme of the 30th HSR&D/QUERI National Conference held July 8-10 in Philadelphia. This year's theme emphasized a robust commitment to forward-looking system change oriented around Veterans' needs, helping to meet the goals of VHA's Blueprint for Excellence. See www.hsrd.research.va.gov/meetings/2015/ for more information and conference abstracts.

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