DePalma Ralph G
Patient Care Services, Department of Veteran Affairs, Washington, DC, USA.
Am Surg. 2006 Nov;72(11):999-1004; discussion 1021-30, 1133-48.
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.
本综述描述了美国退伍军人事务部退伍军人健康管理局（VHA）内促进和维持手术质量绩效的项目的发展、实施情况及现状。它还探讨了为改善手术结果和提高患者安全而不断推进的举措。VHA是一个由联邦政府运营并提供资金的全国性医疗保健系统。它由154家联邦医院和875家诊所组成，配备有16000名护士、33000名其他医疗保健专业人员、15000名医生以及25000名大学附属教职医生。VHA培训90000名医疗保健专业人员，此外，其活动还得到140000名志愿者的支持。其机构中有1000多名各专业的外科医生。自这些项目于19多年前启动以来，每年跟踪的风险调整死亡率和实际死亡率都在稳步下降。
