Wednesday, June 11, 2014

How to Bring About Dramatic Improvement of the Veterans Administration




If I were the US Secretary of Veteran Affairs This is what I would do to turn things completely around and the timetable to do so.


1) Working with others, while still maintaining strong leadership, I would immediately put in place a new Mission Statement for the VA. This Mission Statement would be placed in a prominent location in every VA facility in the nation. The Mission Statement would contain a reference to our very purpose of existence....to serve all veterans to the highest possible level of promptness, quality, care, customer service, and follow through. Our human concern for their care will be paramount. I would make it clear that all employees of the VA understood and followed this Mission Statement as a condition of employment.

2) I would ask the President and the US Congress to pass immediate legislation that would allow me and my designates the ability to fire any employee of the VA that did not perform and live up to the highest standards of veteran care.

3) I would assemble a meeting of all regional heads of the VA and let them know specifically what our new standards are and what will now be expected. At this meeting I would let them know that any manipulation of records or performance would result in immediate dismissal and possible criminal prosecution.

4) I would do away with all internally generated measures of performance and put in place ONE PRIME MEASURE. That measure would be based upon input from veterans, themselves. Veterans will be asked on an ongoing basis to rate the performance of the VA on the following:

a) Promptness of gaining an appointment and ability to receive responses...customer service.

b) Quality of their medical care and their processing as a patient.

c) Follow through on them as patients.

d) How they were treated, the human care and dignity aspect exhibited by the VA.

A rating system would then be summarized for each location and region and kept constantly visible. The veterans will determine performance, not some bureaucratically generated internal rating system. Where the veterans ratings of a location are low these will be investigated. Not all problems may be due to individual performance but due to other factors that need change and support. Yet individual performance will also be judged based upon veterans input and corrective action taken.

5) New standards of expectation will be put in place. These standards will be partially derived from ongoing studies of results from the private and public sectors concerning medical care, particularly from some of the best performing hospitals and clinics in the nation. Also such things as the number of patients typically seen in a day for given specialties as compared to the VA.

6) People, including good VA employees, thrive where there are clear rules and high standards and when they succeed they are rewarded. To begin with the pay of all VA employees will be slightly better than the average for their job description or specialty in the public or private sectors. Based upon veteran ratings, they will be subject to bonuses. Performance, pay raises, and promotions will also be tied to veteran ratings.

7) High performing locations and individuals, based upon veteran ratings, will be celebrated and recognized.
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At the end of 6 months you will see initial progress.

At the end of 1 year you will see notable progress.

At the end of 2 years you will see substantial progress.

At the end of 3 years the VA clinics, hospitals, and patient care will be recognized as being the best in the world.

All of this CAN be accomplished. This is a guarantee.


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