Bagian went on to fly two shuttle missions. Gaffney, who worked with him on the second, in 1991, recalls Bagian summoning him excitedly to see the Great Lakes and other sights passing below. Bagian's most lasting contribution to the space program was developing a treatment for motion sickness in space. The space program had avoided the issue, but "I rallied the doctors and crew and got them to agree" to advocate for the change, Bagian recalls. Now, astronauts routinely get anti-nausea injections.
Making headway on patient safety was tough at the start. Initially, Bagian recalls, some VA administrators and senior physicians assumed "it's not my problem." The biggest challenge, he says, was ending a "blame game" mentality that made staff reluctant to discuss problems. "If the first question the supervisor asks is, 'Whose fault is it?,' then you're in a bad place," he says. "The question is…what do we do to prevent it from happening again?"
At first, only two out of twenty-two VA networks (there are six to ten hospitals per network) signed on to Bagian's reforms. That quickly changed once the center's work began to show results.