Abstract
This review describes the development, implementation, and current status of programs that promote and maintain surgical quality performance within the Department of Veterans Affairs, Veterans Health Administration (VHA). It also considers evolving initiatives to improve surgical outcomes and enhance patient safety. The VHA is a nationwide health care system operated and funded by the federal government. It consists of 154 federal hospitals and 875 clinics staffed by 16,000 nurses, 33,000 other health care professionals, 15,000 doctors, and 25,000 university-affiliated faculty physicians. The VHA trains 90,000 health care professionals, and additionally its activities are supported by 140,000 dedicated volunteers. More than 1000 surgeons in all specialties serve in its facilities. Since these programs began more than 19 years ago, there has been a steady decrease in both risk-adjusted and actual mortality rates tracked annually.
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