Fooks Cathy, Decter Michael
Health Council of Canada.
Healthc Pap. 2005;5(4):60-4. doi: 10.12927/hcpap..17388.
Over the past few years, there has been a steady stream of visitors to Canada from the US Veterans Health Administration (VA). Led by the former Under Secretary for Health in the Department of Veterans Affairs, Dr. Ken Kizer, they come to tell the remarkable story of how the VA transformed itself from a hospital-based bureaucracy described as "dangerous, dirty and scandal-ridden" to a healthcare system for veterans recognized for its high-quality, patient-centred care. It is a fascinating story of how a publicly funded healthcare service changed its entire approach to patient care with a quality improvement lens at its core. Fifteen years ago, critics of the VA called for its complete privatization as the only solution to fixing its problems. A team of quality champions set out to prove otherwise. Canada has some lessons to learn. The VA is a compelling role model for Canadian reformers, in large measure, due to its public sector character.
在过去几年里,美国退伍军人健康管理局(VA)的访客源源不断地前往加拿大。在前退伍军人事务部负责卫生事务的副部长肯·凯泽博士的带领下,他们前来讲述VA如何实现自我转变的非凡故事,即从一个被形容为“危险、肮脏且丑闻缠身”的医院式官僚机构,转变为一个以高质量、以患者为中心的护理而闻名的退伍军人医疗保健系统。这是一个关于公共资助的医疗服务如何以质量改进为核心,彻底改变其患者护理方式的引人入胜的故事。十五年前,VA的批评者呼吁将其完全私有化,认为这是解决其问题的唯一办法。一群质量倡导者着手证明事实并非如此。加拿大可以从中吸取一些经验教训。VA在很大程度上因其公共部门的性质,成为加拿大改革者极具说服力的榜样。