3 Bold Steps to Meet Veterans Immediate Care Needs Today

RE: (Olinger, D. and Migoya, D. in VA officials were warned about Aurora project before work began, The Denver Post, posted on May 7, 2015)

According to news accounts, the new VA hospital construction in Aurora, Colorado, has turned into a disaster of over budget designs, threats to close the project midstream for a second time, and disputes among many of the involved parties.

VA Leadership Problems Provoke Concern for Veterans’ Healthcare

Hospital Operating Room

Articles reporting on the Aurora VA hospital construction project shine light on leadership shortcomings in many areas. There are many discouraging and self-limiting viewpoints about VA leadership practices. For example, news articles have reported…

• There is no leadership among the VA’s top managers.
• Top VA managers were bullying staffs and contractors.
• VA construction management leaders have acted outside the law.
• Elected officials are threatening to hold some VA officials accountable.

These news reports give Colorado veterans and their families front row seats to a chaotic healthcare drama going on in the VA. Out of this bedlam, can veterans feel confident about the quality of their healthcare? Especially when news stories accuse former and new VA leaders of so many other transgressions.

• Unnecessary and expensive redesigns, delays, and waste.
• Illegal activities and unsafe working conditions.
• Antagonized relationships among owners, subcontractors, designers, and builders.
• Violating change order procedures.

News media report these leader problems have driven total construction costs up from about $600 million in 2012 to over $1.7 billion today. But there are few reports on unexpected costs this mêlée could have on veterans’ quality of care.

• Will this disorganization and conflict diminish veterans’ care?
• Can our veterans trust the VA system to meet their needs?
• Recently congress agreed to meet veteran’s immediate needs by receiving care from private providers. Who knows for sure what the consequences of exercising this option will be on those veterans who may choose it?

Why resort to public bickering when leaders can take steps take to calm themselves and enhance our veterans’ care?

What if these outspoken leaders—including elected officials—changed their tune? What actions could they take to assure veterans that they will receive high quality care starting today?

The leaders could take the first step below. Some will find it most difficult. At the same time, it is most critical because it signals the veterans of a shift to a more constructive attitude.

Accept Responsibility and Give Constructive Progress Reports

• It is best if leaders to stop blaming others for their problems. It is time they step up en masse and accept responsibility for the mistakes made. After all, it is their directions and lack of direction which allowed many of these problems to occur in the first place.
• Waste not one minute of project time looking for someone to punish. News reports say certain elected officials are on the hunt for someone to “hold accountable.” Concerning veteran’s health care needs, does meting out punishments add any value? If there are offenders, remove them from the project to make sure they will not disrupt its progress any further. Administer retribution for any true liability through a separate process and away from project work.
• It is time for the leaders in all roles to admit to a lack of oversight and to the neglect of the facilities and processes providing care to our veterans. They set no firm limits to stop a ramp up of construction costs from $300 to $600 to $800 million and now $1.73 billion. They allowed many changes in the hospital facility’s design without consulting the construction contractor about the consequential added costs. The leaders—including elected officials—failed to monitor how this project was implemented after legislation was passed and management directives were issued.
• Most important, apologize to veterans.  Do not apologize for how others fouled up. Apologize for allowing a disruption to our veterans’ quality of care.

Update the Leadership Structure

• Robert McDonald, new VA secretary, could acknowledge the VA managers were severely limited in the exercise of their knowledge and expertise. They worked in blind compliance to a miserably inadequate leadership structure. For example, threatening a whistleblower to force him to clam up is in part evidence of this out-of-date leadership structure. Why? Because in an effective structure, people are encouraged to report problems so their damage can be minimized. In addition, there are other symptoms of structural weakness: blaming, disavowing responsibility, finger-pointing, and a lack of clear accountability are some of the most obvious.
• Secretary McDonald, start a redesign of the VA’s leadership structure. Work with your top managers to design one tailored to fit veteran’s current needs. Name leaders who are capable of accepting and fulfilling their accountability for our VA’s most critical outcomes.
• To get out in front of this construction project, to be ready to serve on day one, redesign the leadership structure of the Aurora, Colorado, hospital. Media have reported little about those who are expected to lead in this new healthcare service center. Provide the local leaders with resources to redesign their leadership structure as the hospital is constructed. To show competence the first day their new facilities open, now is the time for them to organize themselves. Demonstrated competence on day one goes a long way toward reassuring veterans about the quality of their care.

Lead Together

• Instead of bullying, VA leaders along with the elected leaders could collaborate with their manager colleagues at all levels. They could join one another to recover from, and in some instances roll back, the misinformed leader practices and early excesses in the designs of the Aurora hospital.
• They could reach out and become reconciled with their beleaguered construction partner(s), Kiewit-Turner and others. Through partnering conversations they could get ready for the upcoming choice points in the roll out of this massive project. Once identified on these choice points, they can agree in advance about how they will communicate, manage conflict, and make sound decisions when each phase occurs.
• They could set limits, without waiting for congress to do it for them, on the scope and allowed cost of this construction.

Finally, VA leaders—including elected officials—can assure veterans their healthcare needs will be met today. They can streamline the use of existing VA and private healthcare systems, both national and local, and fulfill our veterans’ unique healthcare needs.