Field of medicine: Quality improvement.

Format: Hardcover book.

Audience: Leaders and managers of the U.S. health care industry, especially those responsible for ensuring quality; federal workers; students; quality management personnel; and accreditation organizations.

Purpose: To describe the integration of quality improvement throughout the Department of Veterans Affairs and to share lessons learned during the process.

Content: In describing how the Department of Veterans Affairs implemented sweeping organizational changes to improve quality measurement, this book highlights such key areas as physician involvement, obstacles to change, and improvement of outcomes.

Highlights: Provides examples and technical data to show how the Department of Veterans Affairs measures and improves the quality of patient care. The author keeps the reader's attention by inserting anecdotal stories about fictional characters that describe aspects of care from the patient's perspective.

Limitations: Additional illustrations would help convey certain abstract concepts and highlight some of the dramatic improvements within the Veterans Health Administration.

Context: The purpose of the changes made at the Veterans Health Administration was to ensure quality health care, which is defined as "care that is needed and delivered in a manner that is competent, caring, cost-effective, and timely and that minimizes risk and achieves achievable benefits."

Reviewer: Laura J. Fiscus, BS, Department of Veterans Affairs, Milwaukee, Wisconsin.

Commentary: Pressures on the Veterans Health Administration to improve organization may be relevant to the health care industry as it undergoes massive reform. The author of this book brings depth to this experience by discussing why this type of change is important.