Restructuring VA Ambulatory Care and Medical Education

The PACE Model of Primary Care

Published in: Academic Medicine, v. 71, no. 7, July 1996, p. 761-771

Posted on RAND.org on December 31, 1995

by Dennis W. Cope, Scott E. Sherman, Alan S. Robbins

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The Veterans Health Administration (VHA) Western Region and associated medical schools formulated a set of recommendations for an improved ambulatory health care delivery system during a 1988 strategic planning conference. As a result, the Department of Veterans Affairs (VA) Medical Center in Sepulveda, Calif., initiated the Pilot (now Primary) Ambulatory Care and Education (PACE) program in 1990 to implement and evaluate a model program. The PACE program represents a significant departure from traditional VA and non-VA academic medical center care, shifting the focus of care from the inpatient to the outpatient setting. This paper describes the transitional phases of the PACE program (strategic planning, reorganization, and quality improvement) that are relevant for other institutions that are shifting to training programs emphasizing primary and ambulatory care.

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