The Department of Veterans Affairs has released the newest performance ratings for each of its 146 hospitals. The department cited improvements in the past year at some of its lowestperforming facilities. The fiscal 2018 ratings include nine one-star hospitals, the lowest possible, down from 14 hospitals that received one-star ratings in 2017.

Fayetteville’s VA received a two-star rating, which the agency describes as trivial. A star ranking system was used to designate a facility’s performance in individual measures, domains and overall quality. Ratings indicate each hospital’s quality of care and are based on data such as death rates, patient satisfaction and efficiency.

In years past, VA withheld the data from the public. In 2016, the performance ratings were released under pressure that followed a USA Today investigation. Overall, 38 hospitals improved their star ratings in 2018, 40 dropped in the ratings and 68 stayed the same as the year before.

Five VA hospitals received onestar ratings in 2017 and showed no improvement this year: Big Springs and El Paso, Texas; Loma Linda, California; Memphis, Tennessee; and Phoenix, Arizona. Four other hospitals were added to the worst-rated this year: Montgomery, Alabama; Tucson, Arizona; Washington, D.C., and Atlanta. Georgia.

Eighteen hospitals received five stars in 2018, the best possible. Four of them are in Pennsylvania. The Asheville, North Carolina, VA was one of the fivestar facilities. “With closer monitoring and increased medical center leadership and support, we have seen solid improvements at most of our facilities,” VA Secretary Robert Wilkie said in a statement. “There’s no doubt that there’s still plenty of work to do, but I’m proud of our employees, who work tirelessly to move VA in the right direction for veterans and taxpayers.”

A VA Inspector General’s Comprehensive Healthcare Inspection of the Fayetteville VA released in March of this year indicated that current leadership has been stable with the most recent assignment of the associate director in February 2017. In the review of selected employee and patient survey results regarding facility senior leadership, opportunities to improve both patient experiences and employee attitudes toward leadership were noted.

The report found that the leaders should continue to take actions to improve performance of the Quality of Care and Efficiency metrics likely contributing to the current two-star rating. In the review of key care processes, the inspector general issued 10 recommendations attributable to VA Medical Center Interim Director Mark E. Shelhorse, the chief of staff, and associate director.

Of six areas of clinical operations reviewed, office of the inspector general noted findings in five needing improvement: quality, safety and value; medication management; coordination of care; environment of care; and post-traumatic stress disorder care. The report noted a generally safe and clean environment of care at the facility.

The Veterans Integrated Service Network Director and Shelhorse agreed with the Comprehensive Healthcare Inspection Program review findings and recommendations and provided acceptable improvement plans.