Article 104. Enterprise Lean and the New Government Management System

Enterprise Lean and the New Government Management System

Before we discuss the VA reforms it is important that we recognize that the VA Health Care System with all its faults is half the cost of our Fraud Based Private Health care system.  There is no conceivable way to bring our Private Health care system under proper management control.   My recommendation is that the entire corrupt system be scraped and replaced an efficient government run system such as the reformed VA system.

The following is a simple explanation of how the Veteran Affairs reforms of Enterprise Lean and the new government management system will work.  This will be the very first finitely controlled government management system employed in US Government history. This approach fits all government operations that are repeatable on a regular basis such as in Veterans Health Care.  Other attempts to manage government are from a macro point of view and are valid in cases where world events force new management decisions. But even in the macro decision area operations are of a repeated nature and can be managed efficiently using the Enterprise Lean approach.

Enterprise Lean
Enterprise Lean developed by Toyota is currently being used in: Washington State, Iowa and Minnesota governments to make continuous improvements in government processes. It has also been successfully implemented in the Cleveland Clinic well known for its health care.  The process consists of working teams that meet regularly to review and discuss how the work they are doing can be improved upon.

The key activity I require by my Lean Teams that they development a graphic depiction of the processes that they do on a daily basis.  This depiction, a Daily Plan may be in the form of a wall chart where each operation performed by members of the Team are depicted graphically in the sequence that the work is done. The accuracy of the wall chart depends on an accurate time for each process.   When the wall chart has been reviewed and no other improvements are known photos of the wall are made and passed to other teams doing the same operations in other VA Hospitals.  The final wall chart is not carved in stone but available for continuous improvement.

Implementation of Enterprise Lean and the New Management system at the VA
The intent is to grow the implementation of VA reforms starting with the kickoff training provided by the Principal Consultant for current employees of the VA.

The VA has an Office of Inspector General (OIG) with OIG Analysts which investigate waste and fraud within the VA hospital system.  It is believed that problems of this nature will decrease with the Lean Teams who elect their members by secret ballot and are protected whistle blowers.  First OIG Analysts will be trained as Facilitators setting-up and organizing each Lean Team.  The number of VA Lean Teams will depend on the number of functions within each hospital.  An OIG Analyst will be able to Facilitate about 20 Lean Teams. After setting-up the Lean Team the OIG Analyst will monitor and assist in the development of the wall chart. The OIG Analyst will become the manager of his Lean Teams.

The OIG Analyst will be trained to manage about 20 Lean areas:
1. He will work closely with each Lean Team in making improvements including the installation of additional equipment.
2. He will develop and monitor a schedule for each Lean Team based on patient backlogs.
3. He will make a monthly progress report for each Lean Team.
4. He will create a bottoms-up manpower budget for each Lean Team.
5. He will create a annual budget for his Lean Teams.

An Advantage of this Approach
The advantage of this approach is that all actual manpower and operations costs are known creating a minimum known budget.  This means that only addition added budget items need to be negotiated and not the entire Department Budget. 

Additional management Improvements can be made to decrease the cost of operations.  I have experience in creating an effective Management Team that reduces Bureaucratic redundancy by allowing the Elected Team Leaders to become the bottom level supervisors.  Because they are doing what low level supervisors normally do.

Contact Lawrence Rosier
Lawrence Rosier Consulting
12143 Cedar Grove Rd.
Rolla, Missouri 65401
573 578 4716
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