Veteran, UAB VA National Quality Scholar improving care through research

Suzie Miltner, an assistant professor in the University of Alabama at Birmingham (UAB) School of Nursing is passionate about veteran’s health care, and she has a personal understanding of what veterans need. Miltner attended college on an ROTC scholarship, spent six years in the Army Nurse Corps and is married to a retired Army officer. 

In 2010, Miltner, Ph.D., RNC-OB, CNL, NEA-BC, came to UAB to do a postdoctoral fellowship as a VA National Quality Scholar (VAQS). Today she is researching quality improvement initiatives for America’s veterans.

The Veterans Health Administration (VA) National Quality Scholars Fellowship Program is a two-year, post-residency fellowship for physicians and pre-doctoral and post-doctoral fellowship for nurses. It promotes leadership in quality improvement research; participants learn to develop and apply knowledge for the ongoing improvement of healthcare services for the VA and the nation. 

“In 2003, the Institute of Medicine (IOM) issued a report that said the VA and military medicine should be exemplars of how to deliver quality health care,” Miltner said. “As a veteran and the wife of a veteran, this is personal to me, but I also think the VA gives us an amazing opportu­nity to be involved with a system that can really make great organizational change and inspire other organizations in the private sector to follow its lead.”

The Birmingham VA Medical Center (VAMC) is one of eight VAQS sites nationwide. While the program initially offered two-year fellowships only to physicians who had completed their residencies, VAQS began admitting pre-doctoral and post-doctoral nurses in 2009.

Pat Patrician, Ph.D., RN, FAAN, a retired Army colonel and Donna Brown Banton Endowed Professor at the UAB School of Nursing, along with Carlos Estrada, M.D., M.S., director of the Division of General Internal Medicine at the UAB School of Medicine, serve as senior scholars in Birmingham, directing the program for each school.

Miltner was familiar with Patrician’s work in research and quality improvement with military hospitals. That is what first sparked her interest in VAQS work at UAB.

With ties to the Quality and Safety Education in Nursing (QSEN) project funded by the Robert Wood Johnson Foundation, VAQS emphasizes interprofessional learning.

The program is modeled in a way that reduces professional territoriality; it brings to the forefront any issues that might stand in the way of collaboration and encourages learning across disciplinary lines. The goal is to produce “change champions” to lead quality improvement wherever they serve, but particularly in VA medical centers.

VAQS curriculum is delivered through local academic programs, biweekly video teleconferences that foster discussion among scholars both within individual sites and across sites, three educational confer­ences aimed at helping scholars network in person and learn together, and mentored quality improvement projects carried out at fellows’ local VA hospitals.

“Nurses and our physician colleagues are now collaborating to publish and present best practices aimed at improving care outcomes,” Pa­trician added. “As we continue to build relationships and teams, the quality of health care we deliver — not just to veterans, but to everyone in this country — will only get better.”

Now a member of the Birmingham VAMC’s Nursing Shared Governance Council, Miltner is helping implement quality improvement initiatives at the hospital, many that VAQS fellows initiated.

 “I have the perfect job,” Miltner said.  “Improving the quality of care for veterans through local improvement teams and research projects is very important to me.”

Estrada credits Greg Eagerton, former chief nurse executive of the Birmingham VAMC, in large part for the suc­cess of the nursing Quality Scholars program in Birming­ham.

“Without his support, the nursing program could not have started,” Estrada said. “He and his leadership team prepared the Birmingham VAMC for the future from a nursing perspective. Now we have the opportunity to create nursing leaders with the specific tools and skills to study, measure and improve quality.”

The U.S. Department of Veterans Affairs is celebrating National VA Research Week May 13-17, 2013. It is designed to call attention to the achievements of VA researchers and the role they play in providing high quality care for veterans and advancing medical science. Throughout the week, UAB’s VAQS Fellows are participating in research presentations at the Birmingham VAMC on topics that include incontinence and skin care, vital sign monitoring, palliative care for advanced cancer patients and catheter-associated urinary tract infections.