Measure review · Veterans Health Administration
VA quality measures can describe defined outcomes, patient experience and improvement processes. They cannot by themselves show how quickly a veteran can obtain a specific operation, whether that procedure is offered locally or why one facility’s result differs from another.
Draft status: no author or reviewer is assigned. Confirmed-profile candidates Jodi Segal, MD, MPH and Lisa Cooper, MD, MPH may be considered by the owner.
VA sources checked August 26, 2026
Quality and access are separate axes
Quality question
What did a defined measure report for eligible care in a stated period?
Access question
Could a veteran obtain the needed service at an appropriate place and time?
Both questions matter, but their data sources differ. A facility can perform well on a reported measure while a patient faces travel or scheduling barriers. A facility can also have missing public values for a measure without the missingness proving poor care.
What VA publishes for comparison
VA’s Medical Center Performance Search states that the department posts patient quality, safety and outcome measures on its own site and through federal Care Compare reporting. The page also identifies measures that are unavailable or still under development, an important signal that absence should not be reclassified as a result.
A comparison should name the exact measure, time period and facility. Composite ratings and single measures answer different questions. The measure definition must remain visible, especially where case eligibility, adjustment or small numbers affect interpretation.
VASQIP is an improvement system
The VA National Surgery Office directive describes the Veterans Affairs Surgical Quality Improvement Program as part of a quality-assurance system for surgical morbidity and mortality. The program collects clinical data and supports risk-adjusted outcome monitoring and improvement within VA surgical programs.
A 2024 VA privacy impact assessment for the National Surgery Office system explains that VASQIP data are used to monitor and report risk-adjusted surgical outcomes and unadjusted mortality for procedures at VA medical centers. These internal improvement functions are broader than the public measures available for a patient-facing facility comparison.
Read every measure through four fields
| Field | Question | Risk if omitted |
|---|---|---|
| Population | Which patients or cases? | Unlike groups compared |
| Outcome | What event and time window? | Measure renamed broadly |
| Adjustment | How is patient risk handled? | Raw differences misread |
| Period | When did care occur? | Historical value called current |
Why a facility ranking can mislead
Surgical case mix differs across facilities, and a center that treats more complex patients may not be comparable to a lower-complexity site without appropriate adjustment. Public measures can also cover selected conditions or experiences rather than the full surgical program. A single rank strips away these boundaries.
Quality data should inform questions, not provide a diagnosis or select an operation. Clinical appropriateness depends on the patient’s condition, alternatives, risks and the treating team’s assessment.
Common mistakes
- Calling an unavailable measure a zero score.
- Using a quality result as a wait-time measure.
- Comparing facilities without case-mix context.
- Extending one measure to all surgery.
What a veteran can verify next
Use the VA facility page to identify the measure and reporting period, then ask the care team about the relevant service, referral, location and expected scheduling pathway. Urgent symptoms require direct clinical assessment; a public quality page is not an emergency or treatment tool.