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6. Measuring Organizational Features of Health Care Systems

C VanDeusen Lukas, HSR&D Management Decision and Research Center; G Young, HSR&D Management Decision and Research Center; MP Charns, HSR&D Management Decision and Research Center

Workshop Objectives: Over the last five years, the VA health care system has undergone major changes at all levels. The department continues to change as it strives to provide higher quality care to veterans more efficiently. To monitor its performance during this continuing transformation, VA uses extensive measures of outcome and clinical processes. It does not, however, consistently measure its organizational features. Yet those features are often key determinants of the health systemís performance. The objective of this workshop is to increase participantsí understanding of the value of organizational measures and to offer strategies for using them in research and practice. The workshop will address three questions: 1) What organizational features are most important to measure? 2) What organizational measures are currently available in VA? 3) What methodological issues must be addressed in measuring organizational features?

Workshop Activities: The workshop will use three ongoing projects being conducted by researchers in HSR&Dís Management Decision and Research Center to illustrate these questions: 1) the national TQI survey administered for the past three years to staff in all VAMCs across the country; the TQI survey includes measures of organizational culture and employee commitment to customer service quality; 2) the integration scorecard designed for VISN 13 and also being administered in VISNs 1 and 14; the scorecard documents the progress of VISN efforts to create an integrated delivery system by surveying staff at all levels of the organization; 3) the national service line survey administered to directors of all VAMCs across the country; the survey includes measures of the organizational structure, reporting relationships and budget authority of facility-level service lines. Through presentation, discussion and exercises, the workshop will examine the organizational features measured in each project, the methodological challenges faced in collecting these data, and the actual and potential applications for the measures.

Target Audience: The workshop is designed for researchers, managers and clinicians who are interested in tracking the progress of organizational change in their networks or medical centers, and/or in analyzing the impact of organizational features on management initiatives or clinical practices.

Audience Familiarity: The workshop assumes a familiarity with the structure and mission of the VA health care system. No in-depth technical knowledge is required.