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WSJ study: VA hospitals' quality of care varies widely; Phoenix among worst-performing

The Wall Street Journal recently analyzed internal records from the Department of Veterans Affairs, and the media outlet found that there is striking disparity in care among VA hospitals across the country, going well beyond secret wait lists and reports of patients dying while waiting for care.

And the WSJ found that the Phoenix VA is among the bottom tier of all the hospitals in the agency, at least according to the handful of categories tracked in the database.

For example, the rate of potentially lethal bloodstream infections from central-intravenous lines the more than 11 times higher in patients in Phoenix than it was at the top-performing VA hospitals, the WSJ found in data that was as recent as March 31, 2014.

Also, the WSJ said the Phoenix VA had a 30-day death rate for patients admitted for acute care that was 32 percent higher than the top-rated hospitals in the agency.

VA medical centers in Phoenix, Atlanta, Houston and Dublin, Ga., were among the systems lowest-rated facilities, according to data the WSJ analyzed, while those in Boston, Cleveland and Minneapolis were among the best.

The findings come from a nonpublic VA database called Strategic Analytics for Improvement and Learning, known as SAIL. SAIL tracks procedure outcomes and ranks VA hospitals on a scale of five stars, the best, to one star, the lowest.

The SAIL data tabulate hospital performance across a wide range of safety measures, such as acute-care death, death from congestive heart failure and pneumonia, and deaths from avoidable causes like urinary-tract infections and ventilator-associated pneumonia.

A VA spokesman said SAIL has emerged as a useful barometer for the agency in the past few years, but is "still very much a work in progress" whose efficacy will increase as the agency "gains more experience with it and refines its development and use."

According to the WSJ, the VA has built several Internet portals that allow the public to see information about each hospital, such as infection rates.

But the database published by the VA is less detailed and offers less ability to compare hospitals than SAIL.

For example, the Phoenix VA doesn't appear to be an outlier on the VA's main comparison website,

Phoenix's rating (out of five stars) was not revealed in the WSJ report.

Last Friday, Eric Shinseki announced he had fired several senior officials at the Phoenix VA facility shortly before tendering his resignation as the agency's secretary. Deputy Secretary Sloan Gibson will serve in Shinseki's role on an interim basis.

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