A brief summary of workers' compensation performance improvement projects 2008 to 2012 in the Veterans Health Administration.

Background: The Veterans Health Administration undertook a series of performance improvement projects (PIP) using local initiatives identified through a national committee of regional workers' compensation representatives.

Methods: A steering committee identified five types of risks and interventions that were considered worthwhile. They defined performance metrics as outcome measures and distinguished short-term from long-term disability management success.

Results: Eight specific PIPs were implemented. No statistically significant differences in the planned outcome metrics were identified, although cost-benefit evaluations did identify a benefit.

Conclusions: Conducting quantitative PIPs in a large system requires top management commitment, sequestration of funds, and mature systems.