Health Services Research & Development

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In This Issue

Director's Letter

Director's Letter
by David Atkins, M.D., M.P.H., Director, HSR&D

Health care systems and researchers are increasingly paying attention to organizational culture in health care settings and how to improve it. Patient safety events often reveal local breakdowns in communication, teamwork, and leadership that enable problematic practices to develop...

Commentary

Practicing, Teaching, and Researching in an Era of Transformational Change
by Jeff Murawsky, M.D., Veterans Integrated Service Network 12, Westchester, Illinois

Within VHA, the culture shifts may be characterized as transformational. The shifts influence not only the larger VHA health care delivery system but also the changes required by individual providers in the delivery of health care, and in our medical education and research priorities...

Response to Commentary

The Individual, Research, and Transformational Change
by Saul J. Weiner, M.D., Jesse Brown VA Medical Center, Chicago, Illinois

Perhaps the most important message is that everyone in a health care organization is powerful and that, without a process for communicating its mission and obtaining everyone's buy-in, the results are potentially capricious and chaotic. This lesson is particularly applicable to periods of organizational change...

Research Highlights

The Critical Role of Leadership in Creating a Culture of Improvement
by Carol VanDeusen Lukas, Ed.D., Lauren Babich, Ph.D., Martin P. Charns, D.B.A., Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts

As VHA strives toward higher levels of Veteran-centered, data-driven, and team-based care, VA medical centers need to engage in continuous change and improvement...


Patient Engagement and Diabetes Self-Management
by LeChauncy D. Woodard, M.D., M.P.H., and Aanand D. Naik, M.D., Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas

At any given time, over 1 million Veterans receive health care services for diabetes, and many suffer adverse vascular outcomes, such as myocardial infarction, blindness, and peripheral artery disease...


Progress Toward Recovery Transformation in Mental Health
by Alexander S. Young, M.D., M.S.H.S., and Amy N. Cohen, Ph.D., VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles VA Healthcare Center, Los Angeles, California

A decade ago, the President's New Freedom Commission outlined a vision of recovery-oriented mental health services. As part of the "recovery transformation," the commission foresaw a future in which "everyone of all ages with a mental illness would have access to effective treatments and supports...


Dialogue

A Conversation with VHA National Center for Organization Development's Linda Belton

FORUM recently sat down with Linda Belton, Director, Organizational Health, VHA National Center for Organization Development, to discuss her views on culture change and organizational transformation in VHA...