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Quality Management and Federal Workers' Compensation: The Veterans Health Administration Workers' Compensation Program Model

Hodgson, Michael J. MD, MPH; Mohr, David C. PhD; Lipkowitz-Eaton, Jennifer MD, MPH; Rodrigues, Dianne MSN, RN; Moreau, Sarah BS; McPhaul, Kate PhD, RN

Journal of Occupational and Environmental Medicine: March 2015 - Volume 57 - Issue - p S36–S42
doi: 10.1097/JOM.0000000000000375
Federal Workers' Compensation Supplement

Objective: The federal workers' compensation program includes under a single employer five commonly encountered roles and responsibilities—injured patient, clinical provider, third-party administrator, adjudicator, and insurer. Data within the Veterans Health Administration (VHA) provide a unique opportunity to apply a simple model of health care quality improvement, exploring interactions between structures, processes, and outcomes.

Methods: A facility survey identified reporting structures, levels of education and training, policies and processes, tool availability and use, and perceptions of role adherence. Administrative data included process and outcome metrics, including short-term disability, long-term disability, and lost time cases.

Results: Improved collaboration between clinical and administrative staff within VHA and with the Department of Labor was associated with improved performance.

Conclusions: Applying a clinical quality improvement model clarifies roles, expectations, and likely relationships for improved program management.

From the Occupational Health Strategic Health Care Group, Office of Public Health (Drs Hodgson, Lipkowitz-Eaton, and McPhaul, Ms Rodrigues, Ms Moreau), War-Related Illness and Injury Study Center, Office of Public Health (Dr Hodgson), Center for Organizational Learning and Management Research, VA Boston HealthCare System (Dr Mohr); Veterans Integrated Service Network 21 (Dr Rodrigues), and Veterans Integrated Service Network 22 (Dr Moreau), Veterans Health Administration, Washington, DC.

Address correspondence to: Michael J. Hodgson, MD, MPH, War-Related Illness and Injury Study Center, Office of Public Health, Veterans Health Administration (

This projected relied on operations funding from the Office of Public Health, Veterans Health Administration.

The authors declare no conflicts of interest.

The views expressed in this article are those of the authors and do not necessarily reflect the official policy, position or views of the Uniformed Services University, the Department of the Army, the Department of the Navy, the Department of Defense, the Veterans Health Administration or the US Government.

Copyright © 2015 by the American College of Occupational and Environmental Medicine