Article 100. Growing Government Reform from the VA Pilot to the Entire Federal Government

Growing Government Reform from the VA Pilot to the Entire Federal Government
Based on Article 99 Reform of the US Government in General and Article 96 the reform of the pilot VA.

The Republican Party has this present unique window of opportunity to bring spending under control and prevent the need to continually raise the debt limit making the US Government financially sound again.  My Reform proposals give an overview of how the Trump Administration can bring innovation and reform to the US federal Government saving the tax payers $trillions. The strategy is to Grow Government Reform with the VA Pilot and then spread the reforms throughout the Entire Federal Government.

The Reform process in the current Trump administration has already begun with the new Budget using the approach of first simplifying government using new tools such as the Effectiveness Test to determine how well an item meets the expected results of its originators. Waste from duplication of government efforts by multiple Agencies is yet to be addressed.  The process of reform continues with the prototype implementation of Veterans Affairs Hospitals making them efficient through Continuous Improvement.

The Recommended Startup Plan focuses on the implementation of Reforms in the Veteran’s Administration Under the direction of the White House Office of American Innovation lead by Jared Kushner to begin within the first six months of the Trump Administration.  This article explains how a single person the Principle Consultant can make this implementation happen without hundreds of consultants swarming all over the government costing $millions and leaving the government after a few years in turmoil.  So how can one person effectively reform the US Federal Government. The answer is he can’t without strong Congressional and Presidential support.  But it can be done by growing an organization such as the OIG within the Federal Government to become the implementers of the reforms followed by becoming the managers of government. The basic reform process is called Enterprise Lean developed years ago by Toyota and has now been successfully implemented in Minnesota and Iowa State governments.

I propose that a single Principle Consultant such as myself can begin a training program for OIG Analysts first in being Facilitators for setting up Enterprise Lean Teams in each function of the DC Veterans Hospital.  Each OIG Analyst will organize several Lean Teams, helping them to elect their leaders and follow on with the building of wall charts(from the 1980s). Now a 60 in. flat screen TV with a modified spreadsheet will serve the same purpose.  The Wall Screen allows each Lean Team member to view the entirety of their functional work flows and provide input to improving the function's processes.  When the Wall Screen is completed the result is placed into actual use in the hospital's function and after testing a thumb drive of the screen is shared with all VA Hospital's OIG analysts and their Lean Teams.  The documented wall screen is not the final method but can be updated by any Lean Team and the improvement be shared with other Lean Teams.

The second part of the OIG training will be in the work measurement of each of the processes that are a part of the function and necessary in building the wall Screen.

A third part of the OIG training will be in the collection of the measured data into a database representing the total hours for the function.  As the functions develop their work hours for all the members of the Lean Teams the Departmental database will be collected into what I call a bottoms-up manpower budget.  This will be used to determine right-sizing of the function based on patient backlog.  From this the OIG Analysts will be schooled in the scheduling needed to meet patient backlogs.  We now have the data to manage the Federal Government for the very first time in history.

Critics will argue that this will lead to making VA hospitals employees work harder.  But what we have done is simply removed the wait times for employees waiting on other employees, allowing employees to work smarter rather than harder. Working smarter allows for Continuous Improvement in the Lean Teams function.  With 90% of VA personnel meeting once a week in Lean Teams Continuous Improvement can result in thousands of what appear to be small fixes such as the: removing red tape or Improvements in patient care to major cost reductions.