The Veterans Affairs Medical Center in Buffalo scored better than average for avoidable in-hospital complications, but lower than average for avoidable infections, according to a rating of national VA centers.
The rating system examines VA medical centers on a scale of one to five stars, with five awarded to the top-rated hospitals. The system uses dozens of measures – from mortality rates and wait times to nurse turnover and job satisfaction.
The medical center in Buffalo received a 3-star rating. The Buffalo facility did better in 2016 than in 2015 for overall hospital quality.
Ten hospitals nationwide received one star for the fiscal year ending Sept. 30, including facilities in Albuquerque, Dallas, Detroit, Phoenix and Los Angeles.
Fourteen facilities earned five stars, including those in Cleveland, Pittsburgh and Boston.
The VA reported that 120 of 146 facilities showed small or large improvements over their prior year performance. The star ratings, available at www.va.gov/qualityofcare, also show if a hospital's rating improved or declined from 2015 to 2016.
"We feel proud of what we've done. We have improved in each quarter," said Dr. Grace Stringfellow, chief of staff at the Veterans Affairs Medical Center in Buffalo.
The star ratings are based on measures in a VA internal quality improvement monitoring system known as Strategic Analytics for Improvement and Learning. Measures have been published since 2012 but not the overall ratings. The system compares VA hospitals to one another, as well as to a benchmark goal, so that it is possible that a facility can improve and not necessarily climb in the ratings, according to the VA. In addition, the measures in the VA system do not mirror the measures in star ratings for non-VA hospitals.
Buffalo's Veteran Affairs Medical Center on many measures rated at or near the average for the VA overall:
- Death rate among hospital patients: below national benchmark; average (50th percentile) for the VA overall.
- Avoidable healthcare associated infections: below national benchmark; below average for VA overall.
- Avoidable in-hospital complications: below national benchmark; better than average for VA overall.
- Length of stay: below national benchmark; average for the VA overall.
- Mental health coverage: below benchmark; much better than VA average overall
- 30-day readmission rate: below the national benchmark; average for VA overall.
- Overall patient rating of hospital: below national benchmark; lower than average for VA overall.
- Rating of specialty care providers: below national benchmark; better than average for VA overall.
- Overall job satisfaction: close to benchmark and average for VA overall.
- Registered nurse turnover rate: below national benchmark; better than average for VA overall.
- Get routine or urgent appointments: below national benchmark; in most cases, better than VA overall.
- Speed of response to call center calls: below benchmark; slightly below average for VA overall.
When looking at the Buffalo rating, individuals should consider that the patient population at the medical center does not reflect the average general patient population, Stringfellow said.
"Our patients are older. Many have complex conditions and psycho-social issues, as well as and issues with compliance with medical care that we deal with," she said.
The hospital is aware of and working on those measures where it rated worse than average, Stringfellow said. She and others also noted those measures in which the facility did well, such as nurse turnover and mental health coverage.
"We are close to reaching the benchmark in how veterans are utilizing our mental health services," said Jill Murray, behavioral health care manager.
Patrick Welch, an advocate for veterans issues, said he has witnessed improvement at the Buffalo medical center over the 50 years that he has used it.
"It's not perfect. They get dinged on things. But for the most part, I believe veterans are pleased with the services – maybe not ecstatic, but pleased. From my own experience, the Buffalo hospital has improved 1,000 percent from the day I went in for care in 1966," said Welch, who was wounded in the Vietnam War.
Welch, the former director of the Veterans Services Agency in Erie County, sits on the medical center director's advisory board.
"There was a period in the 1960s and 1970s when I called it the ugly VA. But things started to change in the 1980s and 90s," Welch said. "Now, I believe, it is the good VA."