Article 58. Reinventing the VA

Now that we have identified the Veterans Medical facilities as having systemic problems with a lack of respect for its primary objective in serving the medical needs of our service men its time to think about reinventing the VA system.  See Article 57. The OIG report from the Phoenix VA Medical facilities. 

It is important to realize that parts of the VA Medical system are in fact doing an excellent job so we must be careful in labeling the entire VA system as systemic.  However much of the VA Medical System has been derelict in doing its duty for years.  Now with the increased pressure from returning war vets the system has become overrun in many areas.

Why Attempts at Fixing the VA have Failed
The primary reason for failure to fix the VA is that the federal government has never had the proper tools needed to fix systemic toxic bureaucracies.  The Office of Inspector General is an audit organization which investigates misuse of funds through fraud and mismanagement. The OIG has neither the expertise nor the authority to reform a bureaucracy.   All OIGs are imbedded within their bureaucracies and are not free to investigate problems within their bureaucracy.  My solution to this problem is the establishment of a single investigative organization.  A US Inspector Generals Office with all OIGs reporting directly to it and funded by it  See Article 52.  Establishment of a Government Wide United States Inspector Generals Office.

Why  OIGs Can Not Reform a Systemic Bureaucracy
The explanation may be difficult to grasp even though the VA OIG is doing an excellent job on reporting irregularities at the Phoenix VA Medical facilities they can only achieve partial success in fixing VA Problems.  This is because they represent a piecemeal approach correcting management and scheduling problems as revealed by their audit investigations, one at time. This is like fixing the trees in a forest when the entire forests needs to be addressed. The correct approach is to completely reform the entire organization all at once.  The problem is that no one in government knows how to do this.  The DOD has discovered one of the Tools needed to reform government, Lean Six Sigma.  They have had a great deal of success in fixing high level military delivery systems. The other tools I have incorporated in My General Reform Model and Includes Enterprise Lean.

My Recommendations for Fixing US Federal Government Problems
1. Establish a US Office of Inspector General with all OIGs being funded by and reporting to it.  This will require Legislation from Congress.  This establishes an organization with the authority to investigate and fix all government problems. See my Article 52.  Establishment of a Government Wide United States Inspector Generals Office.
2. Provide the tools needed to make the proposed USOIG more than an just an audit organization but with the expertise needed to reform Government.

My Approach for Fixing current VA Problems
This is accomplished by implementing my General Reform Model starting with the implementation of Enterprise Lean through out the Phoenix Medical Facility.   The reason this is done is to transform the toxic bureaucratic environment into a positive culture focused on employees doing their jobs in serving the Vets.  To accomplish this I will train VA OIG Analysts in the skills and approach needed to make the reforms in the VA. With these skills the OIG Analysts can implement reforms in the whole of the VA.

Implementation of Enterprise Lean
The implementation begins by organizing nearly all VA employees into Lean Teams and training them to find the most effective and efficient way to do their jobs.   The process fixes all of the systems to get the highest effectiveness and efficiency possible. Once this is done we will collect the Lean data from each Lean Team which will give us process times for every operation in the facility. Now we have the management data for staffing all operations. From this we can calculate exactly how many staff members and what expertise are needed to meet patient appointment standards (14 days). 

This is followed by the final step the transformation of the toxic bureaucratic organization to a Team Managed organization.   The process of implementing Team Management will expose and eliminate incompetent and corrupt management.

Why is this Necessary
Bureaucracies such as the VA DO NOT REFORM THEMSELVES.  My proposal as an independent consultant makes the necessary changes in the VA that the current VA management can not do.  This is a low cost solution available now which can yield results in three months with full implementation within six months to a year. It permanently fixes VA problems and develops management data that can be applied in all VA hospitals.  See my  Article 56. Congressional Veterans Affairs to Tap the GAO to Fix the VA.