Women’s Health Evidence Based Quality Improvement



Veterans Health Administration (VHA), Office of Women’s Health Services



More women are choosing VHA for their health care than ever before. Women account for over 30 percent of the increase in Veterans served over the past 5 years. Based on the upward trend of women in all military Services, the expected number of women Veterans using VHA health care will continue to rise. However, many VHA facilities lack adequate capacity to serve the growing women Veteran population. The VHA engaged our team to assist with evaluating current services and developing action plans to enhance services to ensure the best quality of care for women Veterans.



Women Veterans’ Achieving Comprehensive Health Innovation and Enhancement for Women Veterans through Evidence-Based Quality Improvement (WV-ACHIEVE) is a new program which combines successful strategies from prior health care facility assessments and evidence-based quality improvement (EBQI) initiatives at VHA Women’s Health Programs (WHP) across the nation. Our team is conducting an analysis of WHP service enhancement opportunities, working with Department of Veterans Affairs Medical Center (VAMC) and Veteran Integrated Service Network leaders to select areas of EBQI focus, and facilitating implementation of QI initiatives. The upfront data-driven analysis is not an assessment, but rather a collaboration in the design of a QI approach that fits the needs of each facility. The EBQI methodology, applied during WV-ACHIEVE, is a top-down/bottom-up methodology that integrates practice-, system-, and region-level priorities.



The team has assisted VHA with improving women Veteran healthcare by:

  • Developing the EBQI Methodology ― The team worked with the Office of Women’s Health Services to develop and refine an EBQI methodology that can be deployed across all VAMCs. The methodology identifies and prioritizes challenges/improvement areas based on evidence. For the quantitative analysis the team uses data from VHA’s Clinical Data Warehouse (CDW) —Women’s Assessment Tool for Comprehensive Health (WATCH), Quality Performance Measures, Healthcare Access Data, Enrollment Data, Patient Aligned Care Team (PACT) Panel Reports, and Survey of Healthcare Experiences of Patients (SHEP).
  • Developing and supporting action plan implementations that impact women Veterans care ― The team has completed EBQI initiatives at 21 VAMCs to date. The QI initiatives resulted in decreased wait times for services, increased women Veteran health screenings, increased provider knowledge of women Veteran health topics, and facility and equipment modifications to better care for women Veterans.
  • Implementing plans for further EBQI initiatives ― In 2022, the team will work with an additional 21 VAMCs to address areas of QI through WV-ACHIEVE.