Saturday, May 31, 2014

Learning from the VA Mess

 As I am sure everyone knows, Eric Shinseki resigned his position as Secretary of the Veteran’s Administration. That is appropriate if only because that is how Washington should work. As I was told many years ago, once ‘you’ become the lead part of the story, you need to go. This of course pertains mainly to senior appointees, but the point is simple: Shinseki isn’t supposed to be in that job for his own good; he is there – as is every appointee in every administration – to further the platform of the president who appointed him. So, once you are more news then the organization or the platform the odds are you are taking away from the platform. Thus, time to go.

All that being said, what can we learn from what has happened and what is happening with the VA?

I had an opportunity to talk with a very experienced Washington lawyer this past week about much of this. I made the statement that we don’t even know what is going on at the VA, in a fundamental sense: we don’t have a comprehensive inspection system, and the VA – like all the other departments in the government – has never been independently audited. (The VA, like every other department and agency in the Executive Branch has an Inspector General and a Comptroller – but they do not attempt top to bottom audits, the federal government uses its own accounting system [one that is so far removed from the accounting procedures used by private and commercial sectors that use of it would land you in the hoosegow] and there is no formal process of inspection, reporting and grading in most of the departments, the uniformed services being an exception in that specific regard.)

As my friend said, right now you probably couldn’t complete an audit – a true audit – of the VA. They have operated within the rules of the federal fantasy world that – like DOD – no one really thinks a true audit is possible. (In the mid 1990sDOD was ordered by Congress to switch something approaching ‘common accounting practices’ but has failed to do so. In 2010 Congress ordered DOD to be ready for a ‘full audit’ by 2016; just several weeks ago the comptroller for DOD told Congress that the DOD was not going to be able to meet that deadline – 7 years isn’t enough to prepare for an audit.)

So, the first lesson we need to learn is this: you can’t know what is right and wrong if you can’t know anything. Said differently, you need to keep orderly books. That sounds pretty mundane, and pretty obvious. And while it is for corporate America, there are many small businesses, and even more charities, non-profits, and state and local government agencies that simply don’t have squared away books. And if you can’t put your finger on your assets and liabilities – all of them – then you have no starting point. So, get your books straight.

The second point is this, and this pertains to any organization of more than two people, you need to have standards and you need to inspect to those standards. In the early days of any organization everyone knows ‘where you are going,’ and everyone is working just as hard as they can. But that knowledge and passion can fade quickly.  With it will also fade your excellence. So you need standards. And you need to have some sort of inspection and grading process. Recommendation: set really high standards, ones that look impossible to meet. And establish a yearly (at a minimum) inspection regime for your major elements – whatever they are.

Now, this doesn’t need to be onerous, dramatically formal, or terrifying; it doesn’t need to be a form of punishment. But there does need to be some process to ensure high standards are set and met. Inspections can be used to identify problem areas where you need to commit more training assets or any other type of assets, to include leadership attention. In fact, done properly, inspections can become a key tool for constant improvement of the organization and the people in it.

Third, your organization – the formal organization – will very rapidly grow into its own ‘persona,’ and as such, it will consume energy to protect itself, not help your mission.

As a result, performance can be misleading; you need to regularly dig into the actual workings and understand what is going on. For example, there was certainly some good, and in some cases ex exceptional medical treatment in Russian hospitals at the peak of the Soviet Union; but that's not because the system worked, it's because there is a common thread of decency in most people and the bulk of the people who end up as doctors and nurses - anywhere, any time - want to help. So, they do. The question that needed to be asked then (assuming the leadership in the USSR cared – which they didn’t) and which needs to be asked and answered now with regard to the VA is whether the system is helping, neutral or hurting the practice of doctors and nurses helping patients.

As an old friend used to say (3 decades ago), whenever you debrief any operation, and your decisions in that operation, you need to know what decisions worked and why, which ones didn't work and why not, and which ones were irrelevant and why.

How many times have you heard (said for that matter) something to the effect 'well, the director (CEO, President, etc.) was all hosed up and the directions were a mess, but we figured out a way around the road block and made it work.' (That is nearly the motto of some organizations.) Every time someone says that they are saying the system - the organization - isn't part of the solution. At best it is not helping and not hurting. But, in all likelihood, it is hurting.

You need to take the time to understand precisely how your organization is helping – or hindering – your people in the performance of their tasks. And you also need to understand if and when you are having no impact on the organization, when your ‘decisions’ have no meaningful impact on operations.  But, if your people are constantly commenting on ‘finding a solution’ outside the system, you have a serious problem.


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