Article 59. OIG Response Team Fixes for the VA

The VA Office of Inspector General (OIG) has dispatched some 42 Response Teams to various VA Medical Facilities.  Their primary direction was to assess Patient appointment times by identifying secret lists of veterans waiting to be admitted to the VA Medical facility. Their objective is to make sure all veterans are listed in the VA electronic Schedule for admissions.

My approach in quickly solving this problem
1. Make sure all Vets Who want an appointment are added to the electronic appointment Schedule.

2. Make a detailed assessment of each patient’s medical needs to determine where and by how much the VA Medical Facility will be impacted.  I recommend a mass screening of the 1700 new patients with interviews and blood tests.  By reviewing 100 patients a day the task of finding what the patients health care needs are can be completed in a month.  The impact on the Medical Facility will be an estimate because more precise numbers are beyond the expertise of the OIG Team.

3. For the Identification of exactly where the VA hospital is going to be impacted with the required increased staffing I recommend the following approach.

    A. Identify all systems processes affected by increased patient loads from the mass screening and establish an employee Lean Team for each set of processes.  Empower the Lean Team to come up with the most effective and efficient approach for doing the process.  This approach will also identify the need for equipment and machines to be purchased by the VA.  In doing this approach the Team will have also determined the time for doing the entire set of processes.

As Principal Consultant I will take the lead in this endeavor with the help of OIG Analysts.  Formal training in Lean is not needed for employees and will cause unnecessary delay.  To understand how the process works to get the maximum patient throughput see Article 55. Obtaining Maximum Patient Throughput with The Highest Effectiveness. 

    B. The time for doing the processes will be added to the time for each and every system affected by patient impact in a particular area within the VA medical Facility.  The required staffing can now be calculated to meet the Patient Appointment Standard (14 days).

    C. If the VA Medical facility can not meet staffing requirements for Patient Appointment standards then the following immediate steps to correct the problem may be put in place.
        (a).  Retrain nursing staff from other areas to fill the requirement.
        (b).  Hirer nursing and doctors as quickly as possible.
        (c).  Allow Vets with critical needs such as cancer patients to go to private Medical facilities at government expense.

This quick solution approach can be followed by reforms initiated by my General Reform Model which will begin with the implementation of Enterprise Lean throughout the entire Facility. See Article 56. Congressional Veterans Affairs to Tap the GAO to Fix the VA. (at the Phoenix VA Medical Facility).

The approach uses proven industry methods such as Enterprise Lean developed by Toyota bundled in the General Reform Model.  The General Reform Model: empowers VA Employees through Lean Teams; determines the actual cost and staffing required to meet appointment standards; changes the current Bureaucratic management to a Team Managed organization; and replaces incompetent and corrupt managers.

This is a low cost solution available now which can yield results in the Phoenix VA Hospital within three months with full implementation within six months to a year.  The process develops management data that can be applied in all VA hospitals with cultural changes that can be replicated in all VA Hospitals permanently fixing VA problems.