Article 73. Fundamental Innovation at the VA

The main concern of the three Senators and the five Congressmen who voted against HR 3230, the latest appropriations bill funding the VA, is that the enthusiasm for solving VA problems might be the normal government action of simply throwing money at a national problem.  We can also view the problem from Secretary McDonald’s point of view coming from the private sector.  I think he would most likely view the funding as seed money for meeting the mission of the VA through innovation.

With all innovation there exists a fundamental component, having accurate cost data for making the key decisions about which innovative proposals and adventures are cost effective.  Unlike many government leaders Secretary McDonald is well aware of this problem.  Accurate cost data in most government operations including the VA simply does not exist. Yes; you will find cost data everywhere in government but not the kind of cost data I am referring to.  What you will find is after-the-fact cost data what was actually spent on the operation not what should have been spent by employing Best Practices and innovation to get the highest efficiency with a balanced work load. The Development of a balanced work load in each medical area is the key to determining the minimum staffing needed to meet patient appointment schedules.

Meeting the VA’s Mission objectives
When we hear of mass hiring of VA personnel doctors and staff we must ask the fundamental question of how many staff members with what expertise and where should they be located?  Innovation begins here, how do we develop the fundamental cost data so that the above question can be answered in the shortest possible time to dramatically solve the problem of meeting patient appointment schedules.  Serving the current Veteran’s patient needs is an obvious first objective.   In the following article I have addressed how the needed cost data can be generated and used to create a balanced work load.  Article  72. Restoring Management Excellence at the VA.

Now that we have established a cost basis for the VA the VA can move on to examining what we normally think of as innovation:
1. Evaluating current VA Medical functions to determine the correct staffing using Right-Sizing.
2. Converting a Clinic’s first shift operation to a two operation.
3. Establishing Mobile Clinics for under served areas especially in our Western states.
4. Developing  hardened prefabricated hospital units such as that used in prefabricating housing units.
5. Assembling the best medical minds in a high level advisory council.
6. Establish a Federal Program to certify skilled nurses as doctors.  Be prepared for a flood of highly skill nurses from the public sector.
7. Establish a job training program for Vets undergoing extensive physical therapy to certify them as Physical Therapists for jobs in the private sector.

This list is far from being complete and misses the important innovations generated by VA employees through innovation and continuous improvement of their jobs resulting from the implementation of Enterprise Lean.