New Deputy Director Enhances High Reliability - VA Sierra Nevada Health Care System
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VA Sierra Nevada Health Care System


New Deputy Director Enhances High Reliability

Lisa Hamilton standing in front of a Humvee.

Lisa Hamilton standing in front of a Humvee at Harrah Military Museum Tour.

By Michael Brogan
Thursday, November 12, 2020

In 2019, VA Sierra Nevada Health Care System’s (VASNHCS) embarked on a journey to high reliability to eliminate preventable patient harm. Through applying high-reliability practices currently used in the commercial aviation and nuclear power industries, VASNHCS aims to produce predictable and desirable quality and safety outcomes for its Veterans. Now, VASNHCS has a newly arrived high reliability organization (HRO) proponent.

Lisa Hamilton, VASNHCS’ new Deputy Director, intends to use lessons learned from previous assignments to keep VASNHCS focused on its HRO journey. Ms. Hamilton assumed the newly created Deputy Director position in early October after having served as the Associate Director of Alexandria VA Health Care System in Pineville, Louisiana. While there, she developed process improvements and operational efficiencies as she helped develop a culture of high reliability within the Operational Services Teams. 

Ms. Hamilton is excited to help VASNHCS continue its journey towards HRO, particularly because it’s an ongoing and empowering process. “The journey of high reliability is not something we say we reached – there is no end point – but rather a continual process,” said Ms. Hamilton. “We look for ways to eliminate errors by engaging our staff to speak up, demonstrate their commitment to excellence, and help VASNHCS be the health care provider of choice, and the health care employer of choice.”

The Director of VASNHCS, Lisa Howard, has overseen the health care system’s journey towards high reliability and created the position of deputy director to further that goal. She sees in Ms. Hamilton an experienced leader ready to take the health care system to the next level, noting Ms. Hamilton, “has experience at multiple VAs and many services and programs, bringing technical acumen, energy and enthusiasm that equals the pace of our environment to help us build our future.”

Ms. Hamilton is acutely aware of the challenges facing her. The coronavirus has added to that list. “We currently have a number of staff still teleworking, and face-to-face meetings are not being held. Teamwork is a big part of the HRO journey, so these small impediments create challenges to creating a collaborative workforce,” she shared. To deal with these COVID-19 barriers, Ms. Hamilton looks to engagement, “Although separated by computer screens and remote locations, high engagement helps keep us all focused on the bigger picture day in and day out.”

Engagement will continue to prove crucial on VASNHCS’ journey towards high reliability. The health care system must analyze errors and close calls to determine root causes and adapt processes and policies to mitigate future vulnerabilities. Staff must share a preoccupation with failure and a reluctance to oversimplify situations and solutions. Engagement and collaboration are key, and Ms. Hamilton is not a fan of business as usual, “I focus on strategic thinking and identifying efficiencies and effective changes that break the mold from this is the way it’s always been done.” 

With a new Deputy Director in place, the path required for VASNHCS to produce predictable and desirable quality and safety outcomes for its Veterans is more clearly defined. Ms. Hamilton’s role in the health care system’s high reliability journey is critical, but that doesn’t mean it isn’t enjoyable. “I like to have fun, and I want my team to enjoy coming to work. I believe in taking care of my team who in turn I entrust to take care of our Veterans.” 


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