The staff at Harry S. Truman Memorial Veterans’ Hospital in Columbia, Missouri, is committed to excellent patient care, education, and research.
Truman VA offers a full range of inpatient and outpatient health services to veterans from 43 counties in Missouri, as well as Pike County, Illinois. Each year, approximately 40,000 veterans access services from Truman VA providers who specialize in primary care, women’s health, medical and surgical specialty care, behavioral health, physical and occupational therapy, pharmacy, and more. In addition to the main hospital in Columbia, Truman VA also offers health services to veterans who live in rural areas. The medical center’s eight community-based outpatient clinics are located in Camdenton, Jefferson City, Kirksville, Marshfield, Mexico, St. James, Sedalia, and Waynesville.
Truman VA was the first veteran’s hospital in the country to collaborate with the National Center for Patient Safety as part of the “Hospital of the Future Project” and continues to lead the way to an improved patient and employee experience by working toward becoming a high reliability organization (HRO).
“Our goal when we committed to becoming an HRO was to create a shared philosophy that led to exceptional, highly reliable care,” said Lana Zerrer, MD, Chief of Staff and Interim Director of Truman VA. “Effective HROs continuously evaluate, design, and implement procedures that eliminate emerging threats through awareness. Issues almost never are identical. That’s why we felt it was so important to create an environment of high reliability, to enable us to anticipate concerns and mitigate consequences before they occur.”
“Our team is committed not only to the Veterans we serve, but also to each other. It’s in an environment of trust and self-worth that we have the greatest ability to provide excellent, meaningful care for our nation’s heroes.”
— Lana Zerrer, MD, Chief of Staff and Interim Director of Truman VA
The three main initiatives Truman VA has focused on are leadership engagement, widespread staff participation, and implementation of “Just Culture” principles.
“To be a true HRO, the strategies you develop to prevent an issue from occurring must be governed by Just Culture values,” Lana said. “The key to practicing Just Culture is to create an environment where staff understand they should continuously analyze and report issues without fear of retaliation. That doesn’t mean our culture is blame-free. It means we work to balance the cause of each issue with an appropriate response that eliminates recurrence.”
Some examples of high reliability processes initiated by Truman VA include physician-led daily briefings, discussions that incorporate the voice of frontline staff, leadership’s commitment to clinical team training, and dedicated staff huddles. Additionally, simulation-based risk assessments are made prior to the activation of new patient care services.
Another key component of innovation and reliability is modernization. Truman VA is committed to modernizing care for Veterans — a concept of continual improvement to infrastructure, equipment, and services.
“We are building high reliability into everything we do to include performance plans, job announcements, policies, construction projects, and standardized initiatives,” Lana said. “It’s now a common thread throughout all the services and activities we perform. As part of this process, we continuously listen to our veterans for opportunities to better meet their needs and expectations.”
Truman VA’s initiatives are paying off. From the moment a Veteran enrolls in VA health care, satisfaction is a priority. However, compliments directly from the veterans themselves offer real-world feedback. A few recent examples include:
“This VA has saved my life, my brothers, and my father-in-law’s. It has saved our financial lives too and provided peace of mind. This VA is how the nation has repaid my service in Vietnam. I can’t thank the taxpayers enough. It is quality people like those who work so very hard at this VA that make it happen,” says one veteran.
Another veteran shares, “I choose to be seen at the VA in Columbia, MO. I have options but the care has been top notch. More importantly, the attitude of the staff is amazing. There is something special about what is being done for our vets and I make a point to tell a staff member that very thing, every visit.”
“I have always been pleased with the care I’ve received at HSTVA. Something that has always impressed me is how many employees, nurses, technicians, doctors everyone is willing to assist you regardless of your need. An example is when you’re lost, someone not only tells you where you need to go, they take you,” another veteran explains.
In addition to Veteran care, employee satisfaction is an important measure of Truman VA’s success on its journey to high reliability. The medical center was ranked No. 1 in the nation for employee satisfaction for three consecutive years (2017, 2018 and 2019) through VA’s All Employee Survey.