The scandal at the Department of Veterans Affairs is a disappointment on many levels, and there is no lack of solutions being offered to fix it. Many of the VA’s highest ranking officials have stepped down. But while making changes to senior management might fix some of the problems, that top-down approach will not yield substantive change.
There are some fundamental processes at the VA that are broken. The way to fix them, and to institute change that’s sustainable, is by working up from the bottom.
That’s a strategy that businesses large and small can learn from the VA. Across Atlanta, CEOs should be watching what the VA is doing to fix its problems, looking at ways to apply the positives and avoid the missteps.
We know the inexcusable inefficiencies of the VA have led to poor health care and even death for some of our veterans. VA administrators falsified records to hide the broken system. But what led to this?
In most cases of inefficiency, the problem is the process, not the people. Employees take short cuts or work-arounds to try to complete their jobs as best they can. Those who doctored records are symptoms of the real problems. On average, most corporate organizations have a minimum inefficiency of about 20 percent. In the case of the VA, inefficiency is likely closer to 40 or 50 percent.
The VA can fix its problems with these five steps:
1. Identify the Root Cause
Leadership must identify the biggest problem areas. The executives at the top won’t be able to find the answers without unbiased data. To uncover the truth, a third party should be enlisted to observe the employees actually registering the patients, coordinating appointments and managing the processes.
2. Research
Choose several VA hospitals and regions as representative areas for the observation. Meet with administrators and observe them side by side. This is not to evaluate the individual, but rather the process. This research will reveal the gaps to an ideal process.
3. Document, Quantify and Validate
Document the third-party observations so they can be shared with the employees, and have them acknowledge the findings. Quantify the findings and review them with supervisors as well, to ensure that everyone agrees the information captured reflects the real issues.
4. Implementation
When ready to take action, prioritize the biggest returns at the lowest costs, and tackle those areas first. Processes should be predictable and reliable. The key is to implement the changes right alongside the employees doing the work, granting ownership to the employees.
5. Sustain the Changes
Having a third-party come in, fix things in isolation and then leave won’t sustain the reforms long-term. Teach the employees, managers and top executives how to continue gaining efficiencies with the new procedures in place.
This bottom-up methodology defines and provides sustained value for companies by maximizing productivity. Getting the process right can deliver hundreds of thousands of dollars in annualized savings, reduce risk by millions, increase accuracy by up to two-thirds, and save thousands of work hours by employees.
Frank Fenello is partner at Atlanta-based UHY LLP, a business consulting firm. Reach him at ffenello@uhy-us.com.
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