TY - JOUR
T1 - The role of the Veterans Affairs Medical Centers in patient care, surgical education, research and faculty development
AU - Longo, Walter E.
AU - Cheadle, William
AU - Fink, Aaron
AU - Kozol, Robert
AU - DePalma, Ralph
AU - Rege, Robert V
AU - Neumayer, Leigh
AU - Tarpley, John
AU - Tarpley, Margaret
AU - Joehl, Ray
AU - Miller, Thomas A.
AU - Rosendale, Douglas
AU - Itani, Kamal
N1 - Funding Information:
These preliminary results were limited by the selection of two surgical subspecialties from only three private sector institutions. Since that study, the VA and American College of Surgeons (ACS) began collaboration for further application of the NSQIP into the private sector. With support from a grant from the Agency for Healthcare Research and Quality (AHRQ) to the ACS, the NSQIP was introduced into 11 additional university hospitals. Data were subsequently included from four additional affiliated community hospitals.
PY - 2005/11
Y1 - 2005/11
N2 - Veterans Administration (VA) medical centers have had a long history of providing medical care to those who have served their country. Over time, the VA has evolved into a facility that has had a major role in graduate medical education. In surgery, this had provided experience in the medical and surgical management of complex surgical disease involving the head and neck, chest, and gastrointestinal tract, and in the fields of surgical oncology, peripheral vascular disease, and the subspecialties of urology, orthopedics, and neurosurgery. The VA provides a venue for the attending physician and resident to work in concert to allow the resident to shoulder increasing accountability in decision-making and delivery of care in the outpatient arena, the operating room, and the intensive care unit. Medical students assigned to a VA hospital are afforded a great opportunity to be exposed to preoperative planning, discussions leading to informed consent for surgery, the actual operation, and postoperative care. Numerous opportunities at the VA are available for novice and experienced medical faculty members to develop and/or enhance skills and abilities in patient care, medical education, and research. In addition, the VA offers unique opportunities for academic physicians and other healthcare professionals to administer its many programs, thereby developing leadership skills and experience in the process. The VA is uniquely situated to design and conduct multicenter clinical trials. The most important aspect of this is the infrastructure provided by the VA Cooperative Studies Program. Of the four missions of the Department of Veterans Affairs, research and education is essential to provide quality, state of the art clinical care to the veteran. The National Surgical Quality Improvement Program (NSQIP) is an example of how outcomes based research can favorably impact on patient outcome. Looking across the horizon of information solutions available to surgeons, the options are limited. This is not the case for the Department of Veterans Affairs. With the congressionally mandated charge for the VA to compare its quality to private clinicians, the advent of the "Surgery Package" became possible. The VA will continue its leadership position in the healthcare arena if it can successfully address the challenges facing it.
AB - Veterans Administration (VA) medical centers have had a long history of providing medical care to those who have served their country. Over time, the VA has evolved into a facility that has had a major role in graduate medical education. In surgery, this had provided experience in the medical and surgical management of complex surgical disease involving the head and neck, chest, and gastrointestinal tract, and in the fields of surgical oncology, peripheral vascular disease, and the subspecialties of urology, orthopedics, and neurosurgery. The VA provides a venue for the attending physician and resident to work in concert to allow the resident to shoulder increasing accountability in decision-making and delivery of care in the outpatient arena, the operating room, and the intensive care unit. Medical students assigned to a VA hospital are afforded a great opportunity to be exposed to preoperative planning, discussions leading to informed consent for surgery, the actual operation, and postoperative care. Numerous opportunities at the VA are available for novice and experienced medical faculty members to develop and/or enhance skills and abilities in patient care, medical education, and research. In addition, the VA offers unique opportunities for academic physicians and other healthcare professionals to administer its many programs, thereby developing leadership skills and experience in the process. The VA is uniquely situated to design and conduct multicenter clinical trials. The most important aspect of this is the infrastructure provided by the VA Cooperative Studies Program. Of the four missions of the Department of Veterans Affairs, research and education is essential to provide quality, state of the art clinical care to the veteran. The National Surgical Quality Improvement Program (NSQIP) is an example of how outcomes based research can favorably impact on patient outcome. Looking across the horizon of information solutions available to surgeons, the options are limited. This is not the case for the Department of Veterans Affairs. With the congressionally mandated charge for the VA to compare its quality to private clinicians, the advent of the "Surgery Package" became possible. The VA will continue its leadership position in the healthcare arena if it can successfully address the challenges facing it.
KW - Faculty development
KW - National Surgical Quality Improvement Program
KW - Research
KW - Surgical education
KW - Veterans Administration Medical Center
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U2 - 10.1016/j.amjsurg.2005.07.001
DO - 10.1016/j.amjsurg.2005.07.001
M3 - Article
C2 - 16226937
AN - SCOPUS:26844540483
SN - 0002-9610
VL - 190
SP - 662
EP - 675
JO - American journal of surgery
JF - American journal of surgery
IS - 5
ER -