Transparency and accountability are 2 recurring components of efforts to improve the quality and value of US health care. In the June 2017 issue of JAMA Internal Medicine, Blay et al1 compared the performance of US Department of Veterans Affairs (VA) hospitals with non-VA hospitals using Centers for Medicare & Medicaid Services (CMS) Hospital Compare data. VA hospitals (n = 129) were compared with both academic and community hospitals (n = 4010) on a range of clinical outcomes and patient experience measures. VA hospitals performed better than non-VA hospitals for most outcome measures—including lower rates of inpatient safety events such as pressure ulcer, iatrogenic pneumothorax, and central line–associated bloodstream infection—and lower 30-day mortality and readmission rates for acute myocardial infarction (MI), pneumonia, heart failure, and chronic obstructive pulmonary disease. At the same time, VA hospitals scored lower for patient experience and behavioral health. Given the unique mission and heightened visibility of VA as a public-sector institution, these findings raise 2 questions: how does VA ensure the best health care possible for veterans in all aspects of care, and what is the VA doing to address areas that may need further improvement?
David Atkins, Carolyn M. Clancy. Advancing High Performance in Veterans Affairs Health Care. JAMA. 2017;318(19):1927–1928. doi:10.1001/jama.2017.17667