A new report from the Veterans Administration shows two Alabama VA medical centers have made some improvements in its quality of services over the past year, while another remains stagnant.
As part of their efforts to remain transparent and hold VA facilities accountable, the U.S. Department of Veterans Affairs’ (VA) on Wednesday released end of fiscal year 2018 (FY2018) hospital Star ratings, which evaluate and benchmark quality of care delivery at VA medical centers (VAMCs) across the nation.
In Alabama, on a 1 through 5 star scale, they rated:
- Birmingham: 4-star (score went up)
- Montgomery: 1-star (trivial change, did not improve)
- Tuscaloosa: 3-star (score went up)
“With closer monitoring and increased medical center leadership and support we have seen solid improvements at most of our facilities,” said VA Secretary Robert Wilkie. “Even our highest performing facilities are getting better, and that is driving up our quality standards across the country.”
The Star rating designation is designed to help VA identify best practices of its top performing hospitals and share them across VA’s health care system to achieve system-wide improvements.
“There’s no doubt that there’s still plenty of work to do, but I’m proud of our employees, who work tirelessly to move VA in the right direction for Veterans and taxpayers,” Wilkie added.
Birmingham remains a bright spot for veterans within the Alabama care system. Over the past three years it has steadily improved having received a 3-star rating in 2016, going up to a 4-star in 2017 and now pulling another 4-star with additional signs of improvement.
“Providing high quality healthcare and benefits to our nations Veterans is one of our most fundamental obligations,” said Rep. Terri Sewell. “I’m proud of the tireless work that VA professionals are doing in Birmingham to save lives and improve healthcare quality standards for our Veterans and service members. Here in Congress, I have supported VA reforms like the Veterans’ Access, Choice and Accountability Act, a bill which allowed Veterans to receive care from private doctors when there’s a backlog and which increases accountability and transparency within the VA. I also introduced and helped pass a VA hiring amendment that encouraged the VA Secretary to select eligible employees for its fellowship program who represent rural areas. I’ve visited the Birmingham VA and met with the staff there, which is why I am not surprised to learn that they have maintained their 4-star rating. Our fight to provide Veterans across Alabama with timely and responsive access to quality care is far from over, and I applaud the Birmingham VA medical center on the strides it has made.”
In 2015, the director of the Central Alabama Veterans Healthcare System (CAVHCS), or Montgomery VA, was removed from his post when a pattern of gross mismanagement and systemic malfeasance was exposed. Weeks later he became the first VA official in the country fired under our new VA accountability law. Since that time the Montgomery VA has been under a federal microscope and was making many improvements.
However, after improving from 2015 to 2017 and receiving a 3-star rating for two years in a row, the state’s capital city VA hospital dropped to a 1-star, out of 5, in 2018.
Someone who has been working hard to hold the Montgomery VA accountable and improve their service is Alabama 2nd District Rep. Martha Roby. She calls the newly released rating “unacceptable.”
“The news that the Central Alabama VA has dropped from a 3-star rating to a 1-star rating is completely unacceptable,” Roby told Alabama Today. “Our veterans represent the very best of this country, and it is incumbent upon us to ensure they receive the best possible care we can provide. Significant work is needed to achieve this goal.
She continued, “I have been and will remain actively engaged with CAVHCS Director Dr. Linda Boyle and other VA leadership to improve care for our veterans so that it is easily accessible and of the highest quality. As always, I encourage veterans in Alabama’s Second District to contact my office with problems related to VA casework. I am deeply disappointed in this rating, and my top priority continues to be that we treat our veterans properly.”
The VA uses a comprehensive performance improvement tool called Strategic Analytics for Improvement and Learning (SAIL) that includes key metrics used by the private sector as well as additional metrics that are important for addressing access to care, quality of mental health care, employee perception about the organization, nursing turnover, efficiency and capacity.
The metrics are organized into 9 Quality domains and one Efficiency and Capacity domain. The Quality domains are combined to represent overall Quality. Each VA medical center is assessed for overall Quality from two perspectives:
- Relative Performance compared to other VA medical centers using a Star rating system from 1 to 5.
- Improvement compared to its own performance from the past year. Both relative performance and size of improvement are used to guide improve efforts.