Article 60. The Chances of reforming VA Medical Facilitates- ZERO Percent

Where we stand in the probability of fixing VA health care problems.
1.The chances of  the VA correcting Patient Scheduling problems and making sure all Vets who desire health care are entered into the VA’s appointment system  - 100 %.

2.The chances of the VA providing the increased health care required by the added enrollment of Vets using current methods -25%. 
OIG Auditors are good at finding and correcting problems in the handling of funds from fraud and mismanagement.  But what also is needed is the means to determine the most effective and efficient use of personnel.  They have ignored the fact that wasted man hours is also wasted funds.  The best a tool for getting the highest efficiency and effectiveness in an entire organization was developed by Toyota "Enterprise lean".

3.The chances of finding a Secretary of the Veterans Affairs that is willing to make changes to the VA -100%. 
President Obama should not have any difficulties in find a new Secretary of the VA with a willingness to fix VA problems.

4. The chances of a Secretary of the Veterans Affairs using current internal VA methods can implement the sweeping change needed in the VA -0%. But this can be turned around by congress passing legislation for outside Consulting Contractors to reform the VA.

What is most likely to happen is plenty of good intentions with the same old results of only minor improvements in a vast healthcare system which will remain in need of massive reform. This is story for nearly every  Secretary of Veterans Affairs that has taken office in the last 30 years.  The dismal record of those with great expectations speaks for itself.

From the Veterans Health Administration Interim Report:
The issues identified in current allegations are not new. Since 2005, the VA Office of Inspector General (OIG) has issued 18 reports that identified, at both the national and local levels, deficiencies in scheduling resulting in lengthy waiting times and the negative impact on patient care. As required by the Inspector General Act of 1978, each of the reports listed was issued  to the VA Secretary and the Congress and is publicly available on the VA OIG website.

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. They are primarily interested in where funds are being expended either through fraud and mismanagement.  Their primary task is in identifying where the money went.  But that is only part of the problem waste in government also includes wasted labor man hours but no one in government is charged with the task of determining how much loss is there in inefficiency and gross mismanagement there is in over-staffing.  All OIGs are auditors and do not have the expertise to deal with labor hours.  The simple truth is that Bureaucracies are not required to know how many man hours it takes to do each job or set of processes with in the organization.  This is the basic requirement for management in industry and exists in very few places in government.

A contributing factor to the problems in the VA is the result of a bureaucracy serving Veterans who have no other choice but the VA health Care system.  Therefore the VA health Care System does not have to care about its patients in fact the fewer they serve the easier it is for them.  The VA health Care System represents the worst case scenario for providing patient needs.

The primary reason for failure in making reforms is that each new secretary of the VA relies on his own organization for making internal reforms.  The problem with this is his own internal organization does not welcome change and will fight reforms. The result is that almost nothing gets done but just enough to suggest that the secretary has been successful in implementing change however minor it is.  The fact is that most bureaucracies cannot be reformed from the inside but must reformed by an outside organization.  The proven axiom BUREAUCRATIC ORGANIZATIONS DO NOT REFORM THEMSELVES has not been understood by most government leaders.  The Veterans Administration  health care has been under serving our Veterans for years while no one seams to have a clue as to how to fix the problems.

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
As Stated above Bureaucratic organizations do not reform themselves.  My proposal as an independent consultant makes the necessary sweeping 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 at the Phoenix VA Medical Facility.  It permanently fixes VA problems and develops management data that can be applied in all VA hospitals.