Wednesday, July 2, 2014

Veterans Administration Debacle.....New or a Chronic Problem

No one should be pleased with the recent publcity regarding the VA hospital situation.

VA officials, Democrats work to offset scandal damage

As Department of Veterans Affairs (VA) hospitals work toward solutions to delayed care, vulnerable Democrats want to mitigate damage from the revelations surrounding the scandal.

The VA administration has taken several steps to fix departmental problems, So far, various agencies conducted several reviews and investigations, including a report from the VA's independent office of inspector general, an internal audit and a broad review of the VA network pointing to a "corrosive culture" in which management retaliated against whistleblowers,

In addition, the VA banned executive bonuses and made several leadership changes; VA head Eric Shinseki resigned in June, and President Barack Obama this week nominated former Proctor & Gamble CEO Bob McDonald to replace him. In the meantime, interim VA Secretary Sloan Gibson reached out to more than 100,000 wait listed veterans to schedule appointments and discuss their healthcare needs, according to the Washington Post. Furthermore, the VA removed seeing patients within 14 days of appointment requests as a goal, a target White House advisor Rob Nabors called said was unrealistic, overly vague and had potentially "incentivized inappropriate actions."

The director of Richard L. Roudebush Veterans Affairs Medical Center in Indianapolis is touting the results of steps the facility took to fix problems, telling visiting members of Congress that patient wait times are down two-thirds,according to the Indianapolis Star. Director Tom Mattice said the 229-bed facility reduced average wait times from 42 days to less than two weeks.

Obama to name former Proctor Gamble CEO as new VA head

Bob McDonald tapped to replace Shinseki as Secretary of Veterans Affairs

The choice of a successor to Gen Sinsheki is a bit out of the 'box' Typically the head of the VA is chosen from a list of military generals with a large amount of experience in military and government organization. Although Bob McDonald graduated from West Point and had a relatively brief career in the military, his most recent success was as head of Proctor and Gamble. His position at P&G (80 billion dollar business) gives him a strong consumer oriented approach to a product.

The VA administrative organization is heavy with ex-military personnel who have a direct path to civil service positions when they retire from their military activity. Their strength may be in organizational and hierarchal decision making, but lacks a patient oriented attitude unless they were in a health care related positon in the military.

The rigidity of the VA does not readily adapt to patient needs, and the prevailng attitude is to squeeze the patient into the system, instead of designing a system to fit the patient.

The change in leadership in this direction indicates that a 'patient centric' approach will mimic the change in other areas of health care.