While one congressional investigation last month said the Salt Lake VA Medical Center may be among the worst in the nation, a new one now says it is among the best in the West.
The new study by the U.S. General Accounting Office - a research arm of Congress - shows that the Utah hospital earned the second-highest score in 1989 among the 24 Department of Veterans Affairs hospitals in the West that were accredited that year.The Salt Lake Medical Center's score of 76 (of a possible 100) in the 1989 study was also the 14th highest score among the 56 VA hospitals nationwide that were accredited in 1989.
This is good news, especially considering that a yearlong investigation concluded last month by the House Government Operations Committee said the Salt Lake hospital was among the 14 worst in the VA in 1989 and among the 10 worst in 1988.
Instead of looking at accreditation scores, the congressional study looked at how often certain medical complications and procedures occurred that are signs - not proof - of possible poor care.
Dr. Richard Lee, Salt Lake VA Medical Center chief of staff, is very pleased to have the positive report publicized. Last month, when the scathing congressional report made front-page headlines, Lee adamantly defended the reputation of the hospital, citing it as one of the "flagships of the fleet of 172 VA centers."
In the midst of the criticism the first report generated, Lee was aware of the 1989 rating that placed Salt Lake as a leader in VA health care in the West. He said he realized the negative label was unfair and damaging but felt frustrated in getting the news out to the public.
"Bad news always seems to get the attention of reporters quicker than good news. Hopefully, the public will now look at the positive news," said Lee.
An upbeat outcome of the furor over the negative rating, said Lee, was an outpouring of letters from veterans who had received care at the Salt Lake facility complimenting the hospital and expressing anger at news reports. Many letters were also received from other local private hospitals, commending the VA for excellent care.
The Salt Lake facility will undergo reaccreditation in 1991. Lee predicts the hospital will receive a 90 percent rating the next time round.
However, the 1989 study found the average score for non-VA hospitals that year was 78 - two points higher than the score received by the Utah VA hospital.
But Lee contends that the trend is changing. He saidVA hospitals are continuing to gain ground in comparison with private hospitals.
The new study was requested by Sen. Alan Cranston, D-Calif., by the private, non-profit Joint Commission on Accreditation of Healthcare Organizations, to see what the VA was doing to improve its scores.
The study noted that the commission told the VA in April 1990 "that VA medical centers performed significantly worse than non-VA hospitals in accreditation surveys conducted from 1987 to 1989. . . . VA argued that the findings were due to a lack of documentation and did not mean that the quality of care provided in VA medical centers was poor."
The study said the VA was able to dramatically increase its scores from an average of 70 in 1989 (when the Salt Lake hospital received a 76) to an average of 79 in 1990.
The study said the vast improvement "was a direct result of intensive efforts by the VA central office, regional offices and individual medical centers to assure that medical centers are (now) following commission requirements and properly documenting their quality assurance activities."
The new study said that VA hospitals in the West may have received generally low scores before because regional administrators did little to help them prepare for accreditation visits.
"The regional office made minimal efforts to prepare centers for their surveys. . . . The region's overall average compliance score (of 62) in 1989 was the lowest of any in VA."
In 1990, the Western region of VA did more to help its hospitals, and their average compliance scores jumped from 62 to 82, the study said.