The VA leadership structure needs a redesign starting right at the top. Then they can roll out the new leadership structure design process to leaders of the other divisions and major locations around the United States.
What is a leadership structure? It is defining the critical outcomes, granting the accountability, and integrating the roles needed to support a new strategic vision. It is a leadership process where leaders become organized to stay organized.
How do I know leader structure needs redesign? The VA’s two assessment reports say so. That is, (a) the Army Corps of Engineers assessment report and (b) the report of a consortium of three of the most prestigious consulting firms of our nation. Just as telling are the headlines and stories about the VA from the last four weeks. They are listed after the following report overviews. There are consistent themes reported throughout: the VA leadership deficiencies are disrupting construction projects and healthcare centers across the nation. Here are excerpts.
Report A: The Army Corps of Engineers Spots Construction Deficiencies
The VA construction division suffers from conflicts in their lines of authority, priorities, expectations, and standards for accountability.
When these elements of a leadership structure are not aligned with an up-to-date mission and vision, they become large obstacles to progress. On the other hand, when they are all in sync everyone is better able to deliver critical outcomes and fulfill the Veterans Affairs vision.
Report B: The Consortium Report of Rand, McKinsey, and MITRE
After looking at the VA health care system, this group criticizes the wait times and facility costs, oppression of anyone who would speak up about a problem; the lacks of innovation, sharing best practice, and collaboration; and the inability of the VA to carry a standard clinical case load.
Sample of Headlines Expose Outmoded VA Leadership Structure
In addition to these assessments, headlines about the VA’s troubles show their struggle to get by with their current outmoded leadership structure. The headlines, from across the country, along with the above mentioned assessment reports, show how the VA’s outmoded structure and lack of new vision is turning this organization into an operational nightmare for veterans as well as for the people who deliver their care.
Some VA Headlines: Previous Four Weeks, August – September, 2015
- “Senate passes short-term bill to continue construction at VA hospital” (this is the first of several votes required to fund the completion of Aurora, CO, VA hospital but funding will still not cure the underlying problems with leadership structure that created these problems in the first place)
- “Whistleblowers: VA inspector general a ‘joke'” (retaliation against whistle-blowers and lack of accountability )
- “VA Needs ‘System-wide Reworking,’ Independent Report Finds: Congressionally mandated independent review of Veterans Affairs health-care system identifies widespread problems” (WSJ reports “unsustainable costs” and a flawed bureaucracy with leadership and budget problems)
- “Report blasts Veterans Affairs for wait times, facility costs” (report of Rand, McKinsey, and MITRE engaged by the VA for this assessment)
- “Colorado Springs VA clinic’s wait times among nation’s worst” (12th worst out of 240 veterans clinics and hospitals)
- “Poor planning, bungled engineering and delays send costs soaring for VA hospitals, report says.” (the Army Corps of Engineers claims VA construction is victim of multiple design changes, conflicting lines of authority, slapdash planning and undisciplined VA leadership)
- “Legionnaires disease bacteria found in Phoenix VA hospital water system” (what else could go wrong?)
- “Wisconsin veterans hospital’s former director no longer on VA payroll” (improper prescription practices)
- “Medical errors are up at VA hospitals, but they’re actually doing less to figure out why”
- “Memphis VA Hospital: Allegations of Neglect” (patient care rule violations)
- “Watchdog Report Critical of St. Cloud VA Was Quietly Shelved” (hospital administrator claims the deficiencies have been corrected)
- “Pressure Increases on VA to Let Others Handle Construction” (U.S. Rep. Coffman and others say VA is not capable to handling construction projects)
- “VA has fundamentally mismanaged hospital construction” (VA allowed several building projects to spiral out of control)
- “SA Whistle-blower says VA Hospital Exposed Workers to Asbestos“
- “‘We’re left to the wolves’: Videos allegedly show Memphis VA leaving disabled vets unattended” (veterans left unattended during staff meetings)
- “Thousands of vacant VA jobs costing taxpayers billions” (forcing veterans to find private care)
- “Bush calls Aurora VA hospital a ‘disaster,’ but argues for completion” (candidate Jeb still supports building it)
- “Report: 1 in 6 positions vacant at Wichita VA Hospital” (low staffing levels leave some veterans to wait)
- “The Disturbing Thing That Happens Every Day at a VA Hospital That Treats Quadriplegic Veterans” (video by man in motorized wheel chair to point out staff go missing for 30 minutes every day).
- “‘VA is lying. Veterans are dying!’ billboard appears across from VA Hospital” (various locations across the country)
What Congress Wants Is Not Necessarily What Is Best
Some news reports say Congress members are demanding the VA Secretary fire any executives responsible for the cost overruns at the Aurora, Colorado, VA hospital construction. Of course, this will not fix the VA leadership structure. It only punishes the people who made the mistakes. It doesn’t give any direction to those who stay and have to clean up the mess. Without redesigning the overall leadership structure, any positive effects of firing leaders in the construction functions will probably be short-lived.
As you can see, there are many arrows pointing to the need for a leadership structure redesign. How long should veterans have to stand in line and wait for the services they need? Where should the redesign start?
The top needs to start first and soon because if the central VA leaders find out they cannot get their act together, there is probably no reason to expect much improvement anywhere else.