For more than a month we have been working with a USA Today reporter on a story looking closely at our internal quality improvement tool called Strategic Analytics for Improvement and Learning (SAIL) and the rankings it uses to help our facilities improve. The story posted online today and we want to share with you, in a spirit of transparency, what this tool represents.
All of us at VA care very much about the quality of care our patients receive. We are committed to continuously improving that quality. In fact, our latest SAIL data indicates that 82% of VA medical centers (120 of 146) have made improvement between the 4th Quarter of FY2015 and the 3rd quarter of FY2016.
We have done our best to tell our story – of creating a culture of continuous improvement, of measuring the right data that best capture health care quality and access, and how we use these measurements to deploy national resources to those facilities that need help and assist medical centers before their rankings drop. Still, this data ranks facilities from best and worst.
Because we are a government department, we are held to a different higher standard and reporting on this matter is viewed by some as the public’s right to know.
Because this is a national story, it is important for you to know how we use SAIL to help facilities improve.
- First, SAIL data does not provide a complete picture of the care that Veterans receive at our Medical Centers. We view it as an important internal learning tool for VA leaders and employees to pinpoint and learn from those VA medical facilities that have high-quality and efficiency scores, both within specific measures and overall. We know that each facility is continuously working to address the issues that are identified in the SAIL data and have taken numerous steps to ensure more timely access to care, and that employees responsible for that care receive appropriate guidance and training.
- VA is similar to most hospitals and health systems in that it maintains an internal data system used for identifying and implementing improvements in quality. VA’s internal quality improvement system is called SAIL. SAIL is one of the most robust and comprehensive systems of its type in the healthcare industry and allows VA to assess and improve the quality of care delivered to Veterans.
- The SAIL/Star rating system was designed for comparing VA hospitals to one another so that within VA we can share learnings and improvements can be made. In the SAIL/Star rating system, if one VA hospital improves in performance, then another will drop in performance. Therefore, by design there will always be a distribution of VA hospitals between 1 and 5 stars.
- The SAIL/Star rating system was not designed to compare VA hospitals to non-VA or private sector hospitals. This SAIL/Stair rating system is intended to be used by facility and clinical leadership for improvement purposes and not intended for the use of Veterans to make healthcare choices.
- Over this past year, 82 percent of VA facilities have seen an improvement in SAIL scores. This means we are doing a better job in serving veterans and we will continue to focus our efforts to accelerate these improvements.
For years we have posted the SAIL metrics for each VA facility on our website. You can find them going back to 2012 here: http://www.va.gov/QUALITYOFCARE/measure-up/Strategic_Analytics_for_Improvement_and_Learning_SAIL.asp
While we may not agree with all of the elements of this story, it represents an opportunity for our facilities to work with their stakeholders, including the media, to add context and explain improvements that are occurring on a local level.
Keeping the lines of communication open is important. I want you to know what we are saying and as a Team, we are working to improve our processes and to make VA the best care anywhere.