Women's Health VA Stakeholders Discuss "Ideal" Care
BACKGROUND:
National VA policies have led to important advancements in providing comprehensive, gender-sensitive care for women, and local leadership plays a vital role in implementing these national priorities. As part of a multisite implementation trial of evidence-based quality improvement for tailoring PACT to women Veterans' healthcare needs, investigators conducted semi-structured interviews with 86 local leaders from May through December 2014. Participants spanned 12 VAMCs and 4 VISNs, and included VAMC and VISN leadership, women's health medical directors, women's health program managers, and other relevant roles (e.g., leaders in quality measurement/improvement, informatics). At the conclusion of interviews about women's primary care, participants were asked to describe their conceptualizations of "ideal care" for women Veterans.
FINDINGS:
In describing ideal care, study participants commonly discussed:
- Whether women Veterans should have separate primary care services from men;
- The need for childcare, expanded reproductive health services, resources, and staffing;
- Geographic accessibility;
- The value of input from women Veterans;
- The physical appearance of facilities;
- Fostering active interest in women's health across providers and staff; and
- The relative priority of women's health at VA.
IMPLICATIONS:
Paths toward ideal care could include:
- Projecting and anticipating growth in women's health programs;
- Building on VA's pilot program to provide childcare for patients' children during visits;
- Designing a hiring process to more consistently recruit providers with a strong interest in caring for women; and
- Conducting listening sessions and creating other opportunities that allow senior VA leadership to hear women Veterans' perspectives and preferences directly.
LIMITATIONS:
- Other studies have focused on the important perspectives of women Veterans and frontline providers. Those perspectives were not the focus of this study.
- This analysis is based on responses to the final question in interviews that emphasized primary care, the organization of women's health, and quality improvement efforts. These topics may have primed participants to focus on primary care and give less consideration to specialty services.
AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (CRE 12-026). Drs. Brunner, Yano (Director), and Hamilton are part of HSR&D's Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Los Angeles, CA.
Brunner J, Cain C, Yano E, and Hamilton A. Local Leaders’ Perspectives on Women Veterans’ Health Care: What Would Ideal Look Like? Women’s Health Issues. Jan-Feb, 2019;29(1):64-71.
