Client Story: Veterans Health Administration

Veterans Health Administration (VHA) Profile:

US-DeptOfVeteransAffairs-Seal-LargeThe Department of Veterans Affairs (VA) was established on March 15, 1989, succeeding the Veterans Administration.  It is responsible for providing federal benefits to veterans and their families. From 54 hospitals in 1930, VA’s health care system now includes 144 hospitals, with at least one in each state, Puerto Rico and the District of Columbia.  The VA operates more than 1,400 sites of care, including 1203 outpatient sites.  VA health care facilities provide a broad spectrum of medical, surgical and rehabilitative care.



The VA has experienced unprecedented growth in the medical system workload over the past several years.  The number of patients treated increased by 29 percent from 4.2 million in 2001 to nearly 5.5 million in 2008 (to 6.6 million in 2014). In an effort to provide the highest quality and most efficient delivery of care, the VHA began a national initiative towards improving processes, projects and implementing a culture of continuous performance improvement.


Pivotal Services and Solutions:

  • Utilizing proven methodologies and tools such as Lean Six Sigma and CPI, a model for organizational transformation was developed that is specific to the VA needs and experience, called VA~TAMMCS.
  • As part of the national Systems Redesign initiative, the VAMCs and VISNs requested expert change management and process improvement help from contractors.
  • Pivotal Resources continues to be selected by different VAMCs around the US to provide consulting and training to VAMC Systems Redesign leaders and team members.
  • Through educating VA Medical Center teams to understand VA~TAMMCS and the foundational LSS concepts, tools and methodologies from which it was developed; and consulting with leaders to define and implement projects and processes that support the VA’s Systems Redesign overall efforts, Pivotal has helped VAMCs to enhance performance on specific projects, develop program metrics for prioritizing and tracking project performance, analyze and improve processes that support general hospital administration and delivery of care.



Working closely with leaders and Systems Redesign Coordinators at various VAMCS, accomplishments and progress to-date include:

  • Development and delivery to several hundred VA Medical Center staff of the Core Concepts of Systems Redesign and Lean Six Sigma training program.
  • Creating in-house capacity and expertise for project identification, prioritization and implementation with development of dashboards, metrics and other LSS tools and methodologies.
  • Advanced leadership coaching on mission critical projects and programs to ensure effective communication, cross-functional collaboration and overall results were achieved.

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