Term Paper on "Quality Improvement in Health Care"

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The rehabilitation services component of the VA provides many services for veterans while contributing in the management of health care resources. This is due to the fact that recent research indicates that the availability of federal, state and local government funds to subsidize the care of persons left without services varies by state and community and may not match community need (Wilson & Kizer, 1997). In this way, the VA health care delivery system contributes in managing health care resources because it takes on the strains of existing alternatives. Within this patchwork, the VA health delivery system stands out as a significant, coordinated, nationwide safety net for veterans (Wilson & Kizer, 1997). The VA also cares for small vulnerable populations for whom care is expensive but generally unprofitable in the private sector (Wilson & Kizer, 1997). In addition to veterans with service connected injuries, illness and exposures and former prisoners of war, the VA is legislated to treat veterans with special disabilities of spinal cord dysfunction, blindness, amputation, traumatic brain injury, substance abuse and homelessness resulting from mental illness (Wilson & Kizer, 1997).

Efficiency, Effectiveness and Efficacy

The VA rehabilitation services structure attempts to fulfill the concepts of efficiency, effectiveness and efficacy through a number of measures. First, the VA's headquarters manages its networks by setting goals and defining strategies to maximize health care value throughout the nation. Efficiency, or value, is defined as balanced performance of five factors: cost, access, technical quality, patient functional ability, and patient satisfaction (Wilson & Kizer, 1997). The VA headquarters also focuses on developing a standardized management and monitoring system that supports risk adjusted comparative analysis among networks (Wilson & Kizer, 1997). These efforts are designed to assure that high quality care is consistently delivered. The VA rehabilitation system also plays an important role in transitioning patients from one level to another level of care in the health care continuum; this can be described as the role of the construct of effectiveness. This transitional role can be illustrated through the VA's treatment of serious health problems such as Parkinson's disease, which currently affects about 1.5 million Americans who are diagnosed with the disease (Department of Veterans Affairs, 2001).

The role of efficacy can be illustrated through the VA's role in the treatment of Parkinson's disease, a progressive degenerative disorder of the central nervous system, with physical symptoms of tremor, rigidity and bradykinesia. It can usually be diagnosed based on the medical history and physical findings. To better address the needs of veterans with Parkinson's disease, in February 2001 the VA announced the creation of six centers specializing in Parkinson's disease (Department of Veterans Affairs, 2001). The VA Parkinson's centers also develop training programs for patients, families, students and health care professionals. Additionally, each site conducts… READ MORE