White City VA gets 1 star rating

White City, Ore. — For years the Department of Veterans Affairs has given star ratings for each of it’s medical centers based on quality of care and service. Those ratings are now being released for the first time. And while the rating for Southern Oregon’s VA facility is disappointing for some, it’s staff says the rating only tells half the story.

“A 1 star rating is at best, terrible,” Vietnam veteran Jim Herndon says.

Jim Herndon is familiar with the issues that face today’s veterans trying to seek care, he’s one of them.

“It’s an all day process in a lot of cases,” Herndon says, “most of us have another life other than going out to sit at the VA.”

And long waits are only half the battle, in the last year the White City VA has lost two-thirds of it’s Primary Care Providers.

Herndon says that suggests to him that something’s wrong. The VA says they’ve made improvements, but there’s still more work to do.

In a statement leadership says, “in the past year, VA SORCC also made absolute performance improvements in wait times for both mental health and specialty care appointments and in access to routine specialty care appointments.”

They continue, saying “but the rating shows veteran’s continued frustrations with difficulty in navigating the system and with coordination of care.”

And while Herndon agrees with the reports ratings, he hopes bringing the issue to light will encourage changes.

“All I can do is hope that our new head of the VA understands our situation.”

“We’re not asking for more,” Herndon says, “we’re just asking for what we were guaranteed, and it doesn’t seem like we’re getting it.”

The VA facilities in Roseburg and Portland both received 2 star ratings. Of the 146 facilities that were rated in the U.S., 16 received 1 star ratings. Only 21 received 5 stars.

Here is the statement in full from the Southern Oregon Rehabilitation Center and Clinics:

The VA Southern Oregon Rehabilitation Center and Clinics earns only one of a possible five stars on a rating system that compares it to VA medical facilities across the nation, but facility leadership points out that that is only half the story.

The model that creates the rating is called SAIL, which stands for Strategic Analytics for Improvement and Learning. It is the VA internal learning tool which allows VA leaders and personnel to pinpoint and learn from VA medical facilities that have high quality and efficiency scores, both within specific measures and overall.

The SAIL model includes measures of technical quality that make up 64 percent of the overall star rating. The section on veterans’ perceptions accounts for 36 percent.

The model, which considers dozens of factors, shows that compared to other VA medical facilities, VA SORCC is a top performer in the Care Transitions domain and performs particularly well in the care transition measure Ambulatory Care Sensitive Condition (ACSC) hospitalizations. For this measure VA SORCC consistently performed in the top 20% of all VHA facilities throughout 2016.

In the past year, VA SORCC also made absolute performance improvements in wait times for both mental health and specialty care appointments and in access to routine specialty care appointments.

But the rating also shows Veterans’ continued frustrations with difficulty in navigating the system and with coordination of care. These frustrations impact Veterans’ experience at the facility, leading to lower scores.

Not helping matters is a chronic primary care and mental health provider shortage at the facility.

VA SORCC is currently a 1-star facility but fully expects to move to a 2-star facility in the next quarter.

A significant contributor to the current rating is the loss of approximately 2/3rds of our Primary Care Providers (PCP) in the last year to retirements, resignations and interdepartmental moves. In order to address this shortage and to improve the working conditions for our PCPs, VA SORCC has taken the following steps:

VA SORCC has substantially increased the PCP salary and offering recruitment and relocation incentives to new providers.

VA SORCC is recruiting through job postings and mailing of postcards to practicing physicians in the area.

VA SORCC is using more telehealth (5 teams) and locum providers.

In order to improve the working conditions of our PCPs, VA SORCC has assigned call responsibilities to non-PCPs and reduced some of the care coordination burden for PCPs, leading to more patient care time for PCPs.

Veterans who have lost PCPs will be receiving letters informing them of the opportunity to either select CHOICE or stay on our non-continuity of care panel, to be managed by a team of nurses and doctors.

VA SORCC has sent approximately 4000 appointments to the community and has established a robust process for coordinating and managing this care.

VA SORCC has hired a Clinical Recruiter to focus specifically on facility vacancies

In March of this year, VA SORCC leaders applied a multidisciplinary team who meets weekly to drill down on all SAIL elements to ensure improvement.

Ultimately though, the effort is less about numbers or ratings, and more about improving the quality of a Veteran’s experience.

The larger picture is there is more than one-way to approach a situation and VA SORCC’s top priority in approaching any situation is to always put Veterans first.”

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