The VA debacle has been a work in process for years. The problem, based on feed back, personal horror stories and nightmarish experiences can safely be branded as a systemic problem rooted in 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 ,then that part of the internal organization is in genuine 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 has changed or because the guardians of the internal steering mechanism have allowed the alignments to deviate, alignment is lost and the system goes adrift.
In the case of the VA health delivery system those critical internal steering mechanisms are out of alignment.
One thing is certain. Steering mechanism alignments and work processes do not self maintain. Continuous oversight and adjustment are required for system alignment and effective work processes to be maintained. The usual prescription for steady state performance is a strong management team who 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, work processes and correct any deviations. 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 and keep it working. That is the job of an effective hands on COO and a dedicated team of professional managers who communicate and act across organizational boundaries.
The government needs “Management Consultant ,Inc” to come in and reinvent the operational vision and assure the right team is employed for success at the VA.