Article 63. Open letter to Senate & House VA Committees

June12, 2014
To: Senator Bernie Sanders Senate Veterans Affairs Committee and Representative Jeff Miller House Veterans Affairs Committee
From: Lawrence Rosier Principal Consultant

Subject: Implementation of Reforms in the VA organization

With the recent disclosures from the VA Office of the Inspector General there is evidence of a clear failure of the VA in its mission to serve Veterans in their health care needs.  This has been labeled as systemic throughout the VA Health Care bureaucracy.  I suspect that this is an unfair label because parts of the system are doing an excellent job in serving Veterans. 

In my experience I have found that when sweeping reform is necessary in an organization both public and private.  The reforms must be implemented from outside the organization.  Reforms implemented from inside can only be cosmetic in nature due to the massive objection of Management.  This is especially the case for the VA where “Management” failure is the primary problem.  This means that a new Secretary of the Veterans Affairs will have limited success in implementing change and will fail in any attempt to implement sweeping reforms from within the VA.  For more on this visit my website Article 61. Why the Federal Government is Unlikely to fix the VA.

I recommend the implementation of my General Reform Model which uses proven successful tools from business to achieve the following.

Step 1. Implementation of Enterprise Lean (developed by Toyota) uses employee Lean Teams to address the problem of converting a negative cultural work environment into a positive environment and focuses employee attention on improving the systems and processes they are working on.  The results get the highest effectiveness and efficiency possible with continuous improvement.

Step 2. OAG Analysts collect the Lean Team data: the time to do the improved process, who is working on the process, the equipment need for the process.  This data is collected in a spreadsheet and a database.  The results of the data when the entire organization is totaled allows for Right Sizing the organization (reducing over staffed areas and identifying under staffed areas needed to meet Appointment Schedules.  The totaled data also provides an accurate budget for all work processes other than Management and overhead.  For the first time in government we have accurate tools for the management of variable work enabling the balancing of work loads.

Step 3. The conversion of the Bureaucratic organization to a Team Managed organization is really a quite simple process because we already have Lean Teams in place at the lower level and in Management. Many of the lower level teams will be self managed with their leaders being elected by secrete ballot.  How ever many Professional Teams such as doctors with attending nurses are already in place. Top management of the VA Medical Facility would be selected by the Secretary of Veterans Affairs.

Note that most if not all of the current toxic bureaucratic problems simply disappear with Team Management. With this process we know exactly where staffing increases are needed to meet appointment goals.  Every effort to retrain employees from overstaffed areas to where they are needed will be done.

Funding to implement the general reform model is minimum because most of the work is done by current employees.  The entire implementation is under the direct supervision of myself as an independent Consultant.  Training support will be required from professional Enterprise Lean trainers.

The Fix For the VA Management Problem
There is little chance that the sweeping reforms needed to fix the VA will be initiated from within the VA itself because of its systemic management problems.  Therefore I recommend that sweeping VA reforms be implemented by a Congressionally Chartered Veterans Affairs Reform Committee.  This Committee should have the power to bring in outside Consultants to implement the needed reforms. These major reforms to the VA will not be implemented unless the Veterans Affairs Committees take the lead.  See my Article 56. Congressional Veterans Affairs to Tap the GAO to Fix the VA.

I propose that a pilot implementation be made at the Phoenix VA Medical Facility where OIG Analysts will receive on-the-job training in the Implementation of my General Reform Model.  The OIG Analysts will have the capability to implement the General Reform Model in other VA Medical Facilities.  For more details of the Proposal visit my website: Article 62.  Fixing the VA Now with New Disclosures.

The urgency of meeting the health care needs of our Veterans and the VA’s lack of expertise in the area of accurately determining work loads and staffing requirements has the high probability of continued failure of the VA in serving our Veterans.

Since the Federal Government does not recognize proposed Consulting Agreements such as mine legislation will be necessary to make this proposal a reality.


Lawrence Rosier Principal Consultant  573 364 8789  cell 573 578 4716
12143 Cedar Grove Rd. Rolla, Missouri 65401 email: LawrenceRosier4@gmail.com
Educational website: LawrenceRosierConsulting.blogspot.com