Annual SAIL report shows services improving at Manchester VA Medical Center

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On June 5, 2018, VA Acting Secretary Peter O’Rourke met with leadership at the Manchester VA Medical Center and was granted an expansive tour of the facility nearly a year after a complete overhaul of the facility. O’Rourke also held a town hall with employees, Congressional leaders and Veterans Service Organizations. Photo/Courtesy Dept. of Veterans Affairs

MANCHESTER, NH — Using an annual web-based report scorecard that measures, evaluates and benchmarks quality and efficiency at its medical centers, the U.S. Department of Veterans Affairs (VA) recently released data that showed significant improvements at the majority of its health care facilities.

Manchester VA Medical Center was one of the facilities that made positive strides in the benchmarks and is striving to continue progress. Improvements made at the Manchester VA Medical Center are demonstrated in the VA Strategic Analytics for Improvement and Learning (SAIL) rating where Manchester VA Medical Center received an additional star for quality performance and Veteran experience.

“Shortly after the settling of the storm, the SAIL rating for the Manchester VAMC dropped to a 2 star out of 5.  This was not unexpected; however, it fueled the workforce at the Medical Center to double down on our improvement efforts to improve the care delivered,” said Alfred Montoya Jr., Manchester VA medical center director and USFA Veteran.

Since July 2017, the Manchester VA Medical Center leadership team has been rebuilt, and 75 percent of the team is made of up of Veterans. We’ve taken over 400 hiring actions, and created 70 new positions. Additionally, the medical center established Office of Community Care (OCC) and expanded active provider agreements to 350-plus across the state, tripling provider agreements in place in July of 2017. In keeping with the Department of Veterans Affairs (VA)  No. 1 Clinical priority, suicide prevention, Manchester VA has doubled its clinical support for suicide prevention.

Over the past year, Manchester VA Medical Center also completed construction for and relocated our Pharmacy and Laboratory to the first floor East Wing of the main campus providing greater ease of access. The Medical Center also established an Outpatient Recreation Therapy Program. Now well underway, the Outpatient Recreation Therapy Program has Veterans out surfing, golfing, kayaking and is preparing for our Winter 2018-2019 sport season.

The Manchester VA Medical Center Strategic Plan for FY18-19 is founded on our Building Blocks to Excellence. This includes focus on the Veteran and Workforce Experience, and Access to Care. Our work will improve overall communications, support growth in services and professionally for our workforce, as well as ensure proper workload and psychological safety for staff. This strategy is not dissimilar to what was applied during the latter part of the FY17-18 which resulted in many improvements including having Manchester VA Medical Center employee satisfaction increase from being rank 31st in the country to #17 when compare to 149 other VA Medical Centers.

“I am proud to announce we received our FY18 Third-Quarter SAIL ratings. Similar to our [Manchester VA Medical Center] improvements in the VA All Employee Survey, which demonstrated Manchester VA Medical Center was the sixth-most improved VA medical center in the country, we have also seen improvement in the SAIL ratings,” said Montoya. “Manchester VA Medical Center is now a three-star in SAIL and marching towardsfive5! It is important to note, no major domains from SAIL are in the fifth Quintile [lowest].”

Compared with data from the same period a year ago, the July 2018 release of VA’s Strategic Analytics for Improvement and Learning (SAIL) report showed 103 (71 percent) VA Medical Centers (VAMCs) have improved in overall quality — with the largest gains seen in areas where there were VA-wide improvement initiatives, such as mortality, length of stay and avoidable adverse events. Seven (5 percent) VAMCs had a small decrease in quality.

“This is a major step in the right direction to improving our quality of services for our Veterans,” said VA Secretary Robert Wilkie. “Over the past year, we were able to identify our problems and implement solutions to fixing the issues at 71 percent of our facilities. I’m extremely proud of our employees and the progress they have made to raise VA’s performance for our nation’s heroes.”

Additionally, of the 15 medical centers placed under the Strategic Action for Transformation program (StAT), an initiative that monitors high-risk medical centers and mobilizes resources to assist the facilities, 33 percent (five medical centers) are no longer considered high-risk and 73 percent (11 medical centers) show meaningful improvements since being placed under StAT in January 2018.

The quarterly SAIL report, which has been released publicly since 2015, assesses 25 quality metrics and two efficiency and productivity metrics in areas such as death rate, complications and patient satisfaction, as well as overall efficiency and physician capacity at 146 VAMCs. It is used as an internal learning tool for VA leaders and personnel to pinpoint and study VAMCs with high quality and efficiency scores, both within specific measured areas and overall. The data is also used to identify best practices and develop strategies to help troubled facilities improve.

“At Manchester VA Medical Center, we continue to collaborate with Veterans, community, state and federal partners, and our workforce to make improvements to bring greater quality to our care, performance and importantly enhance the Veteran Experience,” said Montoya. “I encourage all Veterans who haven’t been to the medical center for a while, and those who may never have been to come in and take advantage of the vast resources available.”

For more information contact the Office of Public Affairs Manchester VA Medical Center at