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Friday, December 21, 2018

Happy Holidays from the Ken Larson Free Q&A Reference Library





Quora Questions with Answers by Ken that have undergone over  1 Million Views on Small Business Government Contracting and the U.S. Military Industrial Complex Ken Larson Reference Library on Quora

Saturday, December 01, 2018

U.S. Veterans Hospitals Quality Ratings FY 2018


"U.S. DEPARTMENT OF VETERANS AFFAIRS"

"The Veterans Health Administration uses a comprehensive performance improvement tool called Strategic Analytics for Improvement and Learning (SAIL). SAIL is developed for the VA to drive internal system-wide improvement.

Many of the metrics on SAIL are not publicly reported by non-VA hospitals and health systems.  Therefore, it is not appropriate to directly compare evaluation findings derived from SAIL with results from public and private sector hospitals. "

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: (1) Relative Performance compared to other VA medical centers using a Star rating system from 1 to 5 and (2) Improvement compared to its own performance from the past year.  Both relative performance and size of improvement are used to guide improve efforts.

In 2018 66% (96 out of 146) of VA Medical Centers Reported on SAIL Showed Improvement Compared to Their Baseline One Year Earlier.

The table below displays relative performance in star rating in the third column and size of improvement in arrows in the fourth column that indicate whether medical center performance has improved, stayed the same or declined over the past year.
VISNMedical CenterRelative Performance
Star Rating (1 to 5)
Improvement From
Baseline Scores 2017
2Albany3 ↑↑
22Albuquerque2 ↑
16Alexandria2
4Altoona4
17Amarillo4↑↑
20Anchorage3
10Ann Arbor3
6Asheville5↑↑
7Atlanta 1
7Augusta 2
5Baltimore3
2Bath5
10Battle Creek2↑↑
8Bay Pines3
5Beckley2
1Bedford5
17Big Spring1↑↑
7Birmingham4
20Boise3
1Boston4
2Bronx4
2Brooklyn3
2Buffalo4↑↑
4Butler5
2Canandaigua4↑↑
23Central Iowa4
7Charleston4
19Cheyenne2
12Chicago3
10Chillicothe4
10Cincinnati5
5Clarksburg4↑↑
10Cleveland5
4Coatesville5
15Columbia MO3
7Columbia SC2
10Columbus4
1Connecticut5
17Dallas2↑ 
12Danville3
10Dayton3
19Denver2
10Detroit3
7Dublin3↑↑
6Durham3
2East Orange2
17El Paso1↑↑
4Erie5
23Fargo4
16Fayetteville AR3
6Fayetteville NC2
23Fort Meade3
10Fort Wayne2
21Fresno2
8Gainesville3
19Grand Junction4
16Gulf Coast HCS2
6Hampton2
17Harlingen2↑↑ 
12Hines3
21Honolulu2
23Hot Springs5↑↑
16Houston3
2Hudson Valley3
5Huntington4↑↑
10Indianapolis3↑ 
23Iowa City3
12Iron Mountain5
16Jackson2↑↑
15Kansas City2
8Lake City2
21Las Vegas2↑↑
15Leavenworth4
4Lebanon5
9Lexington4
16Little Rock3↑↑
22Loma Linda1
22Long Beach2
22Los Angeles3
9Louisville3
12Madison5
1Manchester3
15Marion IL2
5Martinsburg2
9Memphis1
8Miami3
12Milwaukee3
23Minneapolis4
19Montana2
7Montgomery1
9Mountain Home4
9Murfreesboro2
19Muskogee2
9Nashville2
16New Orleans3
2New York4
12North Chicago4
1Northampton5↑↑
2Northport3
19Oklahoma City2
23Omaha4
8Orlando3
21Palo Alto2
5Perry Point3↑↑ 
4Philadelphia3
22Phoenix1
4Pittsburgh4
15Poplar Bluff3
20Portland3↑↑ 
22Prescott2
1Providence3
20Puget Sound2↑ 
21Reno3
6Richmond4
20Roseburg2
21Sacramento3↑↑
10Saginaw5↑↑
6Salem5
6Salisbury3
19Salt Lake City3
17San Antonio3↑↑
22San Diego3
21San Francisco3↑ 
8San Juan2
19Sheridan4↑↑
16Shreveport3
23Sioux Falls4
20Spokane3↑↑ 
23St Cloud5
15St Louis3
2Syracuse3
8Tampa4
17Temple3
1Togus5↑↑
12Tomah3
15Topeka3
22Tucson1
7Tuscaloosa3↑ 
20Walla Walla2↑↑
5Washington1
8West Palm3↑↑
20White City3↑↑ 
1White River3↑ 
15Wichita4
4Wilkes Barre3
4Wilmington3↑↑
*Note: Improvement From Baseline: ↑↑ - Large Improvement; ↑ - Small Improvement; →: Trivial Change; ↓: Large Decline

VA Hospital End of Year Ratings

"MILITARY TIMES"


 Veterans Affairs officials claimed improvements at 66 percent of their medical centers across the country last fiscal year, with 18 earning the highest level of excellence in the department’s internal ratings system.

But nine others remain on the VA’s list of underperforming facilities after getting the lowest possible rating. They include the embattled Washington VA Medical Center, which sits just a few miles from the White House and has seen a series of leadership shake-ups in recent years.

The VA ratings — made public in 2016 after a USA Today report on the internal scorecards — grade each of the locations on metrics like patient mortality, patient length of stay, reported accidents and patient satisfaction. Officials have said the system is used to collect best practices from high-performing facilities to use in underperforming ones.

In a statement, VA Secretary Robert Wilkie touted improvements across the 146 medical centers.
“With closer monitoring and increased medical center leadership and support, we have seen solid improvements at most of our facilities,” he said. “Even our highest performing facilities are getting better, and that is driving up our quality standards across the country.”

The number of one-star facilities dropped by six from the start of fiscal 2018 to the end. Of the nine medical centers still at that level, four were cited for significant improvements: El Paso and Big Spring in Texas, Memphis in Tennessee, and Loma Linda in California.

The five others — Washington, Phoenix and Tucson in Arizona, Montgomery in Alabama, and Atlanta in Georgia — saw no overall change.

Earlier this year, VA placed 12 medical centers on a high-risk list for “aggressive” management intervention. Of those, eight were removed from the program after showing sufficient improvement by the end of last month.

Wilkie said while he is pleased with the results thus far “there’s no doubt that there’s still plenty of work to do.”
Here are the Best and Worst VA Medical Centers