Organisational health as the unifying framework: Integrating VHA’s transformational efforts
Abstract
The Veterans Health Administration (VHA), as exemplified by its mission statement, ‘Honor America’s Veterans by providing exceptional health care that improves their health and well-being’, has long recognised its moral obligation to provide the highest quality care for America’s heroes. In response to important healthcare industry trends — such as the shift to patient-centered models, integrated care and the rise of high reliability principles to reduce medical errors — the VHA has adapted its strategies to meet the evolving needs of Veterans. These trends have driven the VHA to commit to several important initiatives, including Whole Health, employee experience and patient experience programmes, while also adopting principles of high reliability organisations (HROs) to guide cultural transformation. Initially perceived as disparate efforts by managers and staff, the VHA shifted towards an organisational health framework to integrate these initiatives into a cohesive strategy. Organisational health serves as the unifying lens through which the VHA manages largescale transformations, ensuring that patient safety, holistic care and workforce well-being are consistently prioritised. This approach mirrors frameworks like the IHI Quadruple Aim and Quintuple Aim in broader healthcare, focusing on patient outcomes, employee engagement and care quality. The VHA’s success to date is demonstrated by important metrics, such as a 91.8 per cent trust level in VA healthcare, a 41 per cent improvement in the close-call-toadverse- event ratio since 2021, and the fact that 67 per cent of VA hospitals receive four or five-star Centers for Medicare & Medicaid Services (CMS) ratings. This paper explores how the VHA’s organisational health framework serves as a scalable model for aligning strategic efforts for optimum service delivery and employee satisfaction. This article is also included in The Business & Management Collection which can be accessed at https://hstalks.com/business/
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Author's Biography
L. Michaelle Guerrero , MA, CPHIMS, PMP, SAFe, Prosci, is the Principal Programme Manager with Cognosante for the Veterans Health Administration’s (VHA) High Reliability Organisation (HRO) transformation, where she oversees a US$99.8m contract supporting the Office of Quality and Patient Safety. In this role, she leads efforts to integrate HRO principles across VHA organisations, driving innovation and enhancing patient safety. A retired Senior U.S. Air Force Healthcare Administrator with over 26 years of service, Michaelle has held various leadership roles in enterprise information systems, data analytics and healthcare operations at multiple levels of command. She played an important role in the development of the Air Force’s teleradiology programme and the DoD’s first multi-patient infectious disease transport system. She also guided the initial roll-out of DoD’s US$11bn electronic health record, as Commander at the lead pilot site for MHS Genesis.
Maureen L. Marks , PhD, as Executive Director of NCOD, oversees all business lines within NCOD (Research, Consulting, Operations and Organisational Health Initiatives), comprising about 55 professional staff, which provides on-site and virtual organisation development services, workforce survey administration, 360-degree assessments, leadership coaching and data analytics. Maureen guides the development of services using principles, practices and techniques that foster employee engagement, including supporting leaders in building a positive organisational culture based on servant leadership principles, utilising effective change management strategies, supporting effective team functioning and using VA workforce data to inform improvement of the work environment. She oversees the formulation, implementation and evaluation of a range of programmes and consultation services that support leaders and leadership teams in adapting and thriving in the rapid-paced environment of healthcare and other Veteran services. Maureen is the co-author of a book chapter entitled ‘Civility, Respect, and Engagement in the Workplace (CREW): Creating Organisational Environments that Work for All’, published in Creating Healthy Workplaces (2014), edited by Caroline Biron, Ronald Burke and Cary Cooper.
Amjed S. Baghdadi , MHA, MBA, FACHE, CPHQ, CLSSBB, Prosci, currently serves as the Associate Director, High Reliability Infrastructure on the Veterans Health Administration (VHA) High Reliability Enterprise Support team under VHA’s Office of Quality and Patient Safety, where he is responsible for developing and executing enterprise implementation and resourcing strategies in support of VHA’s High Reliability Organisation (HRO) journey. Amjed began his VA career in 2003 at the South Texas Veterans Health Care, where he spent most of his VHA journey, including several years as Chief, Quality Management, followed by the role of Assistant Director for Operations in Austin for the Central Texas Veterans Health Care System. He has diversified experience in multiple care settings and has worked in consulting, private sector and public affairs.
Citation
Guerrero, L. Michaelle, Marks, Maureen L. and Baghdadi, Amjed S. (2025, June 1). Organisational health as the unifying framework: Integrating VHA’s transformational efforts. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 9, Issue 4. https://doi.org/10.69554/JBIW4943.
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