This is the third post of a seven-part blog series that chronicles and attempts to dissect and explain the recent and growing issues and challenges negatively affecting the U.S. Department of Veterans Affairs.
Given VA’s workload and the resources it has received, the goals that have been set by VA have been unrealistic. For example, a recent VA audit said that the 14-day scheduling goal was “not attainable” given the current situation.
Most people familiar with what VBA is dealing with recognize that the goal of processing all cases within 125 days with 98% accuracy by 2015 is also unrealistic. (Note: 49% of its pending claims are currently more than 125 days old.)
It’s just not going to happen given the age of its inventory, the complexity of the claims adjudication process, the difficulty of sometimes obtaining records, etc., and VBA’s current resources.
As long as VA sets unrealistic goals, which are placed in the performance standards of its directors, and then holds them accountable for not achieving them, problems will continue to occur. Some people will do whatever it takes to give the organization what it wants. But the organization may not be happy (as in the current situation) with the actions taken to achieve the goals that it has set.
The Missing Metric – True Care and Service For Our Veterans
The VHA and VBA directors also have been struggling with a growing number of performance metrics. While I am a big believer in using metrics, I have heard numerous complaints from the directors that they feel bombarded with too many priorities. These organizations may have reached a point whereby “if everything is a priority, then nothing is.”
On a different note, there is an old saying that goes: “You get what you measure.” That is certainly true within VA. It appears that VA has been, in varying degrees, focusing far too much on transactional metrics, such as the number of days for an appointment, the number of claims pending, the number of claims processed, etc.
In and of itself, there is nothing wrong with these measures. Many organizations around the world use them. The problem in part has been that these measures have often been viewed in a vacuum. As such, they have taken on such importance and created so much pressure that both the organization and its employees have sometimes lost sight of what is truly important, which is, of course, service to veterans.
Moreover, let’s say you were a station director and had 20 performance targets. If you achieved 14 of them, how well did you really do? Were some more important than others? How much more important?
Suggested Metrics for the VA by Stewart Liff
A much better approach is to incorporate realistic numerical goals within the context of balanced scorecards that measure overall service rather than performance on individual measures in both VHA and VBA. This concept was successfully adopted by the VBA in the late 1990s.
The idea is to:
• Measure performance in five areas: unit cost, speed, timeliness, customer satisfaction and employee development and satisfaction.
• Weigh the measures in each area, using a 100-point scale.
In other words, an ideal state was determined for each measure. If an organization achieved the ideal state for every one of them, then it receives an overall score of 100. While no organization, of course, has achieved such a score, each one received a score that represented its overall level of service.
This encouraged people to focus on how well they were doing on all measures in relationship to each other. Overall, service became the focus. The data was much harder to manipulate because doing well in one narrow area does not make that much of a difference on your overall score. This meant you had to focus on all the measures in relation to one another.
VBA, each program, (C&P, VR&E, etc.), regional offices and divisions were measured using the same 100-point scale. I believe that such an approach worked very well at the time and will once again for both VBA and VHA.
Scorecard for Better VA Care and Performance
Listed below is an example of a balanced scorecard that was used by VBA:
About Stewart Liff
Stewart Liff is an HR and visual performance management expert and leading author on managing and transforming government agencies, as well as president of Stewart Liff & Associates. He is also the author of a new book 98 Opportunities for Improving Management in Government, as well as Managing Government Employees and co-author of A Team of Leader and Seeing is Believing.
Go now to download a free chapter from my book A Team of Leaders: Empowering Every Member to Take Ownership, Demonstrate Initiative, and Deliver Results. Get a deeper knowledge today about how you can put into play a better way to get your business on the path to success.
 Department of Veterans Affairs Access Audit System Wide Review of Access Results of Access Audit Conducted May 12, 2014 to June 3, 2014