Article 65. Why the General Reform Model Works

The General Reform Model was developed by Lawrence Rosier to solve Bureaucratic systemic management problems exactly like those found in VA Medical Facilities.

Why the general Reform Model works to solve VA problems

First we want to reiterate actual findings of the OIG at the Phoenix VA Medical facilities.  See Article 57. Veterans Health Administration Interim Report
1. VA problems are an out growth of Bureaucratic management problems. 
Symptoms are: 
A. Enormous power concentrated at the top of the organization. 
B.  Self serving interests of top management are greater than the need to fulfill the organizations Mission to serve Veterans Health Care.
C.  OIG discovered excessive bullying and sexual harassment tolerated by upper management.

2.  A second problem is found in the toxic culture created by the bureaucratic Management affecting all employees at the VA Medical Facilities.

3.  A third problem is the failure of the organization to focus on its Mission “Serving Veterans in their need for Health Care” by focusing on getting the highest Effectiveness possible with efficiency.

The General Reform Model addresses all of the above problems in a step by step approach

Step 1. Implementation of Enterprise Lean (developed by Toyota) uses employee Lean Teams to address the problem of converting a negative toxic 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.

This step addresses problems 2. creates a transparent work environment where employees are encouraged to come forward when problems need to be addressed and 3. focuses employees on the Mission of the organization.

Step 2. OIG Analysts collect the Lean Team data: the time to do the improved process, who is working on the process, the equipment needed 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.

Right-Sizing  staffs the entire organization.  With this process we know exactly where staffing increases are needed to meet appointment goals.  Every effort to retrain employees from overstaffed areas and move them to where they are needed will be done.

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 secret ballot.  How ever many Professional Teams such as doctors with attending nurses are already in place. Top management of the VA Medical Facility may be selected by the Secretary of Veterans Affairs.

This step addresses the problem of the Bureaucratic management head on. It spreads decision making powers among top management as well as at the bottom of the organization.  The Lean Teams which become Functional Teams are empowered to find the most effective way of doing their jobs with the most efficiency.  Note that when the bureaucratic organization is converted to a Team Management organization most supervisors at the bottom of the organization are placed back into the Functional Teams which elects their own leaders.  Obviously Bullying and Incompetent supervisors will not be elected as Team Leaders. The reasons why they are not elected will be investigated by the implementers of the reforms on a case by case basis.  However every effort will be made to find appropriate jobs for redundant supervisors.  Note that most if not all of the current toxic bureaucratic problems simply disappear with Team Management.