- - Tuesday, May 20, 2014

The Veterans Administration debacle has been a work in progress for years. Based on feedback, personal horror stories and others’ nightmarish experiences, it would seem the problem is systemic, rooted in the organization, management and work-process deficiencies.

All organizations have internal steering mechanisms, the internal systems that the entity aligns with the outside world. When these steering mechanisms, such as product and service focus, are aligned with the real-world market outside, that part of the internal organization is in alignment, and internal business processes are allowed to function adequately. However, when these internal mechanisms are out of alignment, either because the nature of the outside customer-demand conditions have changed or because the guardians of the internal steering mechanism have allowed the alignments to deviate, alignment is lost and the system goes adrift.

There is a chance in the case of the VA health care delivery system that certain of its critical, internal steering mechanisms are out of alignment and that a management consultant should be dispatched to the scene for a diagnosis and system adjustment.

One thing is certain: Steering-mechanism alignments and work processes do not maintain themselves. Continuous oversight and adjustment are required for system alignment and effective work processes to be maintained. The usual prescription for steady-state performance maintenance is a strong management team that never fails to pay close attention to the correct maintenance of these alignments and work processes. Focus sessions are required at regular intervals led by an effective chief operating officer who interacts with his team of managers who together constantly update their steering -mechanism alignments and work processes. The current VA internal systems and work processes have fallen badly out of alignment.

No general sitting behind a desk somewhere will get this system back on track. That’s the job of an effective, hands-on chief operating officer and a dedicated team of professional managers who communicate and act across organizational boundaries. The government needs a management consultant to come in and reinvent the operational vision — and assure the right team is employed for success at the VA.


North Las Vegas, Nev.

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