Changes in VA. The hospital star rating can not tell the quality of care


When the Interior Ministry issued an annual assessment of hospitals, autumn, the Atlanta center fell, while one of West Haven, Conn., Was shot dead. It was a matter of confusion as to why.

Atlanta hospital has reduced the size of one of the three budgets in the sector, although it has just been "an easy exchange" of quality data for the year before, according to the department. Connecticut's hospitals have increased up to five stars from the three, even if many activities are performed at other locations or have been stopped at the last minute due to problems related to surgical equipment, as in the internal assessment and other accounts according to Senator Richard Blumenthal.

Social issues have established the 2012 evaluation process, hoping to push their hospitals to improve, and will further increase the use of assessments to conduct hospital managers. Lower levels of leaders can be removed, as happened last week in Atlanta, where the head of the staff and head of the emergency department, primary care and access to health facilities were taken because of lower points.

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But a top official in the field of health experts says the system can be confusing, and there is no change in hospitals that might win and lose stars based on statistics alone. More research hospitals improved care but lost stars; none of the other improvements are made.

The most worrying of some of the experts is the role of star players in the current style of designing of hospitals and managers. They say it creates encouragement to hide the problems rather than catch them, to get the bonuses or fines.

"It is a great mistake," said Dr. Ken Kizer, former veterinary secretary, who has been widely used in the use of quality healthcare systems in the field of healthcare.

Dr. Kizer said it is reasonable to pursue quality measures when the goal is to improve patient outcomes, and then develop important mechanisms. But he said the use of data in only one hospital that discipline can cause such problems 2014 postponed scandal, when administrators can not meet the objectives quickly set the patient's appointments to begin with the waiting list of the hearing.

"It's the same way in the conflict," said Dr. Kizer. "The first time you depend on the way you pay or the activity, they become subjects."

The game can add patient care to the line. The hospital is located in Roseburg, Ore., Managers have shifted some patients to the patient to make them impact on clinical points, the doctors said.

The ministry has developed a very good level of Sail points, knowing that in September that 71 percent of hospitals & # 39; veterans & # 39; they have been better than this year since the year 2017. But experts say that some of these improvements can only happen in the letter.

The former director of quality hospital at & # 39; veterans & # 39; & # 39; with a record of five years, and the situation could not be identified to looga prevent further contact from the organization & # 39; Agency, said the hospital has hired two analysts who are working full time to find ways to improve Sail data. Some of their work focused on identifying ways to improve the services, but most focus on ways to improve numbers, such as changing patient records recorded in the hospital register. "I learned how to take the test," said the director.

Sail is designed by Dr Peter Almenoff, a long-term hospital administrator who has been transferred to a quality stadium in 2008 despite any questions about his record. This spring also has the task of reorganizing the hospital who receives a lower assessment.

The department denied many requests to talk with Dr. Almenoff, and he did not answer questions directly on the questionnaire.

Veterans are now relying on Sail to warn the unaccompanied hospitals. But Dr. Stephan Fihn, head of the quality and quality of the department before declining this year, said the system is unreliable.

"It has very serious defects," said Dr. Fihn said. "The first is statistics: the numbers can not be counted as mathematical, secondly, it's not transparent and does not have independent oversight."

Internal assessment in 2014 revealed that the Sail score of the unit was "to increase the apple and cream and try to display the total number".