VA: A History of Turning Challenges in to Opportunities

Dr. Carolyn Clancy, VA’s Interim Under Secretary for Health, recently penned an inspiring note to VA employees. Her memo underlines one of the main goals we have at VA Careers, which is to focus on the important work VA does to advance health care in the U.S., and how vital our employees are to that mission. Read her message below:

We have a long history in the VA health care system of turning our challenges into opportunities to improve the care and services we provide to our nation’s Veterans. Many of our improvements have even benefited health care as a whole. Back in the 1980s, the VA health care system was under a great deal of scrutiny from Congress and the media over the quality of surgical care in our hospitals. The perception was that surgical mortality rates in our hospitals were much higher than the rates in private sector hospitals. Congress passed a law requiring VA to report surgical outcomes annually and compare them to the national averages. But there was a problem: those national averages didn’t exist.

Our surgeons turned this challenge into an opportunity to develop ways to measure and compare the quality of surgical care within our system. Their success led VA to establish an ongoing program to monitor and improve the quality of surgical care across our system. The more we focused on outcomes, the more outcomes improved. Eventually, our surgical quality improvement program spread to private sector hospitals, where it achieved similar success.

The story of how VA became a national leader in surgical quality illustrates the value of being a “learning organization.” Learning is all about asking questions. In a learning organization, everyone is empowered to join the journey to continuous improvement by asking questions like: What do the men and women we serve really want and need? How are we doing at meeting those needs? How do we know? What could we do differently that would better meet those needs? Who is doing it better and how can we use their ideas here?

You—the men and women who carry out our sacred mission every day—are our organization’s greatest strength, and each of you has a vital role to play in improving our system. I encourage all of you to take advantage of the opportunities you have, including participating in our employee surveys, to tell us what you think about the work environment. If you have concerns, you should feel safe about speaking up without fear of reprisal. We must view our current challenges as an opportunity to learn—only then can we emerge as a better, stronger health care system.

CAROLYN M. CLANCY, MD

Carolyn Clancy, M.D., was named Interim Under Secretary for Health for the Department of Veterans Affairs, on July 2, 2014. As Interim Under Secretary for Health, Dr. Clancy oversees the health care needs of millions of Veterans enrolled in VHA, the United States’ largest integrated health care system, with more than 1700 sites, including hospitals, clinics, long-term care facilities, and Readjustment Counseling Centers. Dr. Clancy, a general internist and health services researcher, is a graduate of Boston College and the University of Massachusetts Medical School.