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VA Announces Aggressive New Approach for Low-Performing Medical Centers

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Today the U.S. Department of Veterans Affairs (VA) announced steps that it is taking as part of an aggressive new approach to produce rapid improvements at VA’s low-performing medical facilities nationwide.

VA defines its low-performing facilities as those medical centers that receive the lowest score in its SAIL star rating system, or a one-star rating out of five.  VA currently has 15 such one-star facilities:

Hampton (Virginia); Harlingen (Texas); Roseburg (Oregon); Washington (DC); Big Spring (Texas); Denver (Colorado); Dublin (Georgia); El Paso (Texas); Jackson, (Mississippi); Loma Linda (California); Memphis (Tennessee); Murfreesboro (Tennessee); Nashville (Tennessee); Phoenix (Arizona); and Walla Walla (Washington).

The steps VA is taking to produce rapid improvements at its low-performing facilities include:

  1. Central, national accountable leadership – VA has designated Dr. Peter Almenoff, Director of VA’s Office of Reporting, Analytics, Performance, Improvement and Deployment (RAPID) Healthcare Improvement Center, to oversee improvement at each of the centers.  Dr. Almenoff reports directly to Dr. Carolyn Clancy, Executive in Charge of the Veterans Health Administration (VHA).
  2. Comprehensive analysis and identification of improvement targets – VA is employing a new initiative, known as Strategic Action Transformation (STAT), that uses a rigorous and formal approach based on clinical performance indicators to identify vulnerabilities in each low-performing facility and set specific targets for improvement.
  3. Provision of national resources for improvement – VA’s RAPID team of experts will use sophisticated statistical tools to track the progress of improvement against these targets, and, where warranted, will dispatch a team of expert improvement coaches quickly to the medical centers to assist them in meeting the goals.
  4. Accountability for results –VA’s Central Office will review each of the facilities quarterly, and if the facilities fail to make rapid substantial progress in their improvement plan, VA leadership will take prompt action, including changing the leadership of the medical center.

“President Trump has made it clear that our Veterans deserve only the best when it comes to their healthcare, and that’s why we are focusing on improving our lowest performing facilities nationwide,” said VA Secretary David Shulkin. “We will employ tight timelines for facilities to demonstrate improvement, and if low performance persists, we will make swift changes — including replacing facility leaders — until we achieve the rapid improvements that Veterans and taxpayers expect from VA.”

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