Synopses & Reviews
Redefining a Public Health System is a remarkable story, as told by Galen L. Barbour, M.D., a top-level Veterans Health Administration (VHA) executive. The book reveals how the VHA met the daunting challenge of improving health care quality measurement throughout its enormous system. Barbour tells of the projects that overcame myriad obstacles, including internal apathy and resistance from administrators and physicians. He and his associates rolled out new and innovative methods and tools for measuring quality health care. This achievement has striking implications for health care executives who are charged with quality improvement within their own organizations.Since the capitated and vertically integrated Veterans Health Administration is representative of the type of structure many private health delivery systems are adopting, the transformation of the VHA can serve as a model for measuring and improving quality in other complex health care organizations. Redefining a Public Health System is written by an executive for executives. This book offers health care leaders compelling information on:** The development of a state-of-the-art patient feedback program, including comparison to similar measurements in the private sector** The VHA's Decentralized Hospital-Based Computer Program (DHCP) which serves as a successful model for handling data and as a systems approach to information collection** A specific tool--collection of risk data on patients about to undergo surgery--which is becoming the standard by which surgical care will be measured everywhere** How the VHA provided the equipment, direction, and resources to enhance the capability of hospitals at the local level to make necessary improvements** The successful shift from a punitive-based quality assurance model to a process-focused quality improvement approach** Key methods used to obtain and maintain physician involvement in programs, from the development stage through evaluation and impro
Review
?As healthcare networks expand, they are likely to be subjected to widespread public attention given to any claimed quality problems that are similar to the scrutiny currently experienced by VHA and other public healthcare institutions. Redefining a Public Health System provides several useful approaches, methods, and tools that are applicable to quality improvement in any healthcare organization.? —Richard J. Coffey, director, Program and Operations Analysis, University of Michigan Hospitals, and co-author of Transforming Healthcare Organizations and Total Quality in Healthcare
?This book goes beyond the bland platitudes, it lays out in comprehensive detail the evolution and refinement of a working quality management system. The author is candid in describing not only successes but some of the failures and the insights they provide.? —Kerry E. Kilpatrick, professor and chairman, Department of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill
?The VHA story is a major contribution to the literature. Managers can use it as a model of how to do the right things and of how to do things right. Scholars and theorists can--and should--use it as an important and provocative case study.? —N. Lamar Reinsch Jr., associate dean for graduate programs, Georgetown School of Business, Georgetown University, Washington, D.C.
?This book presents why traditional methods of quality assurance have not been successful and how the philosophies of continuous quality improvement have been used to reengineer such processes as utilization management, risk management, and patient feedback systems. Barbour presents valuable lessons that can shape improvement efforts in other health care systems.? —Vinod K. Sahney, senior vice president, Henry Ford Health System, Detroit, Michigan
Synopsis
Telling the story from one executive to another, this book provides readers with an insider's view of how the VHA -- a huge, bureaucratic system -- pushed the boundaries of its traditional processes to become a leader in health care delivery. The author, a VHA physician for over 25 years, looks at the whole process -- from the beginning stages where the need for a different way of doing things forced change, to the predictable resistance and myriad of obstacles at all organizational levels, to the day-to-day individual and collective successes and failures.
By adding to this mix a running story line in which we follow two patients -- one who navigates through a traditional system and one who navigates through a progressive system -- the author puts a human face on health care, reminds us of the "other" reasons why the difficult process of implementing quality improvement is so crucial, and offers an often-neglected perspective on the issue: the patient's experience.
Synopsis
Redefining a Public Health System is a remarkable story, as told by Galen L. Barbour, M.D., a top-level Veterans Health Administration (VHA) executive. The book reveals how the VHA met the daunting challenge of improving health care quality measurement throughout its enormous system. Barbour tells of the projects that overcame myriad obstacles, including internal apathy and resistance from administrators and physicians. He and his associates rolled out new and innovative methods and tools for measuring quality health care. This achievement has striking implications for health care executives who are charged with quality improvement within their own organizations.
Synopsis
[share header with other Barbour book, since they are sold as a set]A remarkable story, told by Galen L. Barbour, M.D., a top-level Veterans Health Administration (VHA) executive. This book reveals how the VHA met the challenge of improving health care quality measurement throughout its enormous system. Barbour tells of overcoming myriad obstacles, including internal apathy and resistance from administrators and physicians.This achievement has striking implications for health care executives who are charged with quality improvement within their own organizations.
About the Author
GALEN L. BARBOUR M.D., is the director of planning, education and performance improvement at the Washington, D.C. Veterans Administration medical center. He is a clinical professor in the Department of Internal Medicine at The George Washington University School of Medicine. From 1990 to 1995, he served as the associate chief medical director for quality management for the Veterans Health Administration and was responsible for designing, developing, and overseeing the quality assessment and improvement programs for VHA's hospitals, clinics, and nursing homes throughout the country.
Table of Contents
Foreword, Paul Batalden
1. A Brief Look Back: Quality, Health Care, and the VA
2. The Diagnosis: Sorting Fact from Fiction
3. Building a Reliable Data Collection System
4. The QUIC Checklist: A Quality Improvement Tool
5. Implementing Change at the Core: Designing an Appropriate Infrastructure
6. The Local Angle: Bringing Quality to the Point of Patient Contact
7. Securing Physician Involvement
8. Managing Risks
9. Monitoring Quality from Outside the System
10. Reviewing Utilization of Resources
11. Through the Customer's Eyes: The Patient Feedback Program
12. The National Surgical Risk Program(Shurkir F. Khuri, M.D., and Jennifer Daley, M.D.)
13. A Brief Look Forward: Facing the 21st Century