VA Psychology Leadership Conference y gy p PAST PRESENT & FUTURE FOR VHA: PAST, PRESENT & FUTURE FOR VHA: THE REALIGNMENT IN CENTRAL OFFICE May 18, 2011 y , George W. Arana, MD Acting Assistant Deputy Under Secretary for Health g p y y f Clinical Operations
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Expectations of Healthcare Industry Changing h • Moment of Truth: Healthcare Value, Economic Realities, f , , Outcomes • Patients participate as partners in their care • Care is convenient and local: Walk in clinics ZoomCare Care is convenient and local: Walk in clinics, ZoomCare, Walmart, Employer Embedded PC • Alternative care (non ‐ institutional, homelike, complementary) complementary) • Health care information is readily available (WebMD, etc) • Preventive health (Health clubs, Nutrition, Well ‐ being) • Public awareness of war and veterans issues • Younger veterans often have families and jobs 5
Secretary Shinseki’s Vision Secretary Shinseki s Vision • Veteran Centric • Veteran Centric • Results Oriented • Forward Looking 6
Universal Services Framework Universal Services Framework Veteran Centric – Results Oriented – Forward Looking Patient Centered – Team Based – Continuously Improved – Evidence Based P ti t C t d T B d C ti l I d E id B d 7
Secretary Shinseki’s Themes Secretary Shinseki s Themes • Access Access • Homelessness H l • Backlog 8
Dr. Petzel’s Priorities Dr. Petzel s Priorities • Create a Vision for the Organization Create a Vision for the Organization • Align/Reorganize the Organization li / i h O i i • Reduce Variation 9
VHA Mission VHA Mission Honor America’s Veterans by providing exceptional health care that improves their health and well ‐ being. 10
Key Elements of VHA Vision Key Elements of VHA Vision • Patient ‐ Centered Patient Centered • Team Care • Continuous Improvement C i • Data ‐ Driven • Evidence ‐ Based 11
Patient Centered • Patients in control of their health care Patients in control of their health care • System designed around the needs of the S t d i d d th d f th patient 12
Team Care Th N The New Health Care Work Place H l h C W k Pl • Work is done in teams Work is done in teams • Team members regard each other as peers • Teams are empowered • Teams are empowered • Teams have data about cost, quality, satisfaction and access satisfaction and access • Teams use a continuous improvement process • Teams have time T h ti • Teams work collaboratively 13
Continuous Improvement p • Data about: Quality, Cost, Access and S Satisfaction i f i • Time • A corporate operating principle • VHA System Redesign VHA System Redesign 14
Total Quality Management Total Quality Management 15
Continuous Improvement Continuous Improvement 16
Data Driven, Evidence Based , • Data about point of care performance • Data about point ‐ of ‐ care performance • Medical practice based on the evidence 17
VHA Transformation Initiatives VHA Transformation Initiatives • New Health Care Models New Health Care Models • Enhancing the Veteran Experience and Access to Healthcare to Healthcare • Improving Veteran Mental Health • Ending Veteran Homelessness • Improving Healthcare Efficiency p g y • Improving Healthcare Through Informatics 18
Targeted Waste Reduction Targeted Waste Reduction •Reduce length of stay •Reduce length of stay •Reduce indirect cost •Reduce readmissions d d i i •Reduce unnecessary admissions •Reduce ambulatory sensitive conditions admissions 19
Reorganization –Why? Reorganization Why? • Clinical presence in operations Clinical presence in operations • Consolidate informatics • Consolidate workforce group C lid kf • Consolidate compliance and oversight • Clarify roles of policy and operations 20
VHA: Central Office VHA: Central Office 21
VHA: Office of the DUSH for Operations and Management 22
VHA: Office of DUSH for Policy and Services 23
VHA: Office of the PDUSH VHA: Office of the PDUSH 24
VHA: ADUSH for Clinical Operations 25
Vision Vision • Alignment Alignment • Integration/Coordination • Standardization S d di i 26
Integration PACT PACT 3 3 2 2 2 2 Specialty Mental 3 3 4 Medicine Health 2 3 2 Geriatrics/Extended Care 27
In Patient Out Patient Coordination of Care of Care H Home L Long ‐ Term T 28
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Questions? Questions? George W. Arana, MD Acting Assistant Deputy Under Secretary for Health: Clinical Operations for Health: Clinical Operations 32
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