Detroit VA Hospital Ranked Lowest in Country

DETROIT, MI — The lowest-rated hospital in the Department of Veterans Affairs’ vast network is in Detroit, according to recently revealed rankings. The John D. Dingell VA Medical Center has gotten worse instead of better after it was included among a handful of VA hospitals that received one-star ratings earlier this year, the usually secret VA scorecard shows.

VA Undersecretary for Health David Shulkin said the star ratings shouldn’t be used to compare hospitals according to quality and are an internal measure the agency uses to track whether hospitals are addressing identified deficiencies.

The star ratings measuring the hospitals’ quality of care are typically kept under wraps by the VA, but leaked documents showed the Detroit VA hospital slipped from two stars in 2015 to a single star in June of this year. Ten hospitals received one-star ratings, several of them clustered in Texas and Tennessee, but they’ve all gotten better in recent months, the data show.

Detroit’s John D. Dingell Veterans Affairs Medical Center is in a class by itself, according to the star ratings obtained by USA Today.

Shulkins, the VA’s undersecretary for health, said he has misgivings about the data becoming public and said “you’d have to be an expert to get through it.”

“My concern is that veterans are going to see that their hospital is a ‘one’ in our star system, assume that’s bad quality and veterans that need care are not going to get care,” he said. “And they’re going to stay away from hospitals and that’s going to hurt people.”

The Dingell hospital’s medical director, Dr. Pamela Reeves, told the Detroit Free Press the star ratings don’t tell the full story. She said the hospital has shown steady improvement from 2010-2014, but some data sets have been “given no weight” in the criteria for star ratings, including wait times for primary and mental health care.

“Our leadership team is working closely with our performance improvement teams in the development and oversight of action plans to address the opportunities identified by the … data,” Reeves told the Free Press. “The staff will continuously work to improve the care and services we provide to our veterans.”

Factors that are considered in the star ratings include rates of death, infection and avoidable complications, but the VA also keeps secret the precise formula it uses to measure hospitals.

Publicly available data from the VA’s Strategic Analysis for Improvement and Learning, or SAIL, database show that during the three-month period that ended in March 2016, the Detroit hospital outperformed many others in the speed with which veterans were able to get primary and mental health-care appointments and the staff’s response to phone calls.

But by more important life-or-death measures, such as projected deaths from heart attacks and infections from intravenous bloodstream catheters, the Detroit VA hospital had some of the highest rates in the nation.

Reeves blamed the score on heart attack deaths on old data and said “proper hospice placement” for veterans needing end-of-life care has resulted in significant improvement. Only two incidents of bloodstream infections due to intravenous catheters have been reported this year, and none have been reported since July, she told the Free Press.

Illustration via Public Domain