Establishing realistic, measurable goals for the VA

CPT Aaron Kletzing — Tue, 26 Aug 2014 13:00:35 -0400

We have all been on military missions at some point. Critical to any military mission (to state the obvious) is being very clear on what you are intending to achieve, how you plan to achieve it, how you will define/measure success, and what you plan to do if your circumstances change. Let's use these tenets to deep dive on the VA situation.

Many veterans think the VA situation is a big mess, and that it has been for a long time. Now that new leadership is in place, I challenge the RallyPoint community to come to some professional agreement on what success over time will look like -- realistically. For example, a goal of 100% of veterans getting perfect care with no issues whatsoever is not a realistic goal -- let alone one that can be fully measured anyway. It also doesn't help if you just scream out "The VA needs to change!" without actually saying something intelligent beyond that -- so please contribute meaningful thoughts.

So I am asking the RP community these questions:
(1) What should be the key performance indicators of the VA moving forward? Like what metrics should we use to assess the VA's progress over time?
(2) What is a realistic goal for each of the metrics you have in mind, including over what time period (5 years, 20 years, etc)?
(3) What is the biggest risk you see to the VA achieving each of those goals?
(4) What additional things does the VA need in order to implement your plan?

This is meant to be a professional discussion rooted in critical thinking. Please refrain from hijacking this thread and turning your answer into a political tirade, though it may be reasonable in some cases to defend your politics-related thoughts with fact-based data insights, as long as you stay balanced and mature about it.

Looking fwd to everyone's proposals!

Tag: SGM Matthew Quick 1SG Steven Stankovich SSG Robert Burns Col Private RallyPoint Member Capt Brandon Charters 1LT Sandy Annala CMDCM Gene Treants CMC Robert Young

Response by SSG Robert Burns made Aug 26 at 2014 2:12 PM

SSG Robert Burns — Tue, 26 Aug 2014 14:12:25 -0400

I'm going to ask what may be obvious but based off of one of my previous questions along these lines I guess we have to identify that you are specifically talking about the VA Medical side of the house. And the current issues as related to patient waiting list, appointments, and processing VA claims.
So after identify exactly what metrics we are talking about we have look for the root cause before we start talking about solutions. Unfortunately, we have been conditioned through school to have a problem-solution mentality. "I have a problem and here's how to fix it." When we should have a problem-cause-solution mentality. Often times we spend a lot of time, money, and effort on solutions that have nothing to do with the cause.
For example...My car wont start because my batter is dead. (Problem) I need to go to autozone and buy a new battery. Car starts. (Solution) But a week later I'm looking for jumper cables again. Why? Because my alternator belt is slipping and not charging my battery. So I didn't need a new battery even though initially it seemed to fix the problem. It didn't address the cause, which was the belt, which was actually cheaper to fix instead of buying a new battery that I didn't need anyway.
So before we start talking about solutions, let's try to identify the causes of these problems.

Response by SSG Robert Burns made Aug 26 at 2014 2:14 PM

SSG Robert Burns — Tue, 26 Aug 2014 14:14:23 -0400

The KPI's should be based off of a top down approach. What is the mission and vision of the VA Health system? Has it changed with the new leadership? What is the new leaderships vision/goals. Then we can figure out the KPI's.

Response by 1SG Steven Stankovich made Aug 26 at 2014 3:07 PM

1SG Steven Stankovich — Tue, 26 Aug 2014 15:07:20 -0400

Much like SSG Robert Burns states, you need to assess what the root problems are first before you can delve in attempt to come up with COAs for ways ahead and KPIs...

I'm just an old scout at heart and I didn't even stay at a Holiday Inn Express last night, but I do know that if you just throw money at this, all you are going to get are overpaid persons working on the same underlying problems. You have to go in at the ground level, assess what is exactly wrong, and then move to eliminate those issues, one at a time. It needs to be a slow and deliberate process that is sustainable in the long term. Band-aids are not what is needed here. Whatever COAs are agreed upon, they must be sustainable. There should also be methods established for proper oversight to ensure compliance with said COAs and also to ensure that those COAs are continuing to be sustained.

Response by Capt Brandon Charters made Aug 26 at 2014 5:48 PM

Capt Brandon Charters — Tue, 26 Aug 2014 17:48:10 -0400

CPT Aaron Kletzing - This is definitely a deep puzzle to get into. At the core of this issue, we ultimately need to see a "better than industry standard" across the board for wait times and overall healthcare treatment services. If I was a healthcare professional, I'd be able to lend some better KPIs, but I think civilian healthcare leaders from diverse backgrounds need to carefully evaluate the entire process and recommend the phased approach of improvements. To me (in a simplistic view), the issue comes down a lack of leadership, integrity, teamwork, motivation and a sense of urgency. We've all been to the VA and realize it's nothing like working in the units we were proud to serve in. The pride we had walking into a motivated unit is priceless. In these units, we had pride in ourselves, our equipment, uniforms, the mission, and most of all each other. The VA is not in need of CBT trainings or other remedial training modules. It needs real leadership that can take pride in that mission and uphold the highest of standards. Motivation and teamwork are extremely infectious. So is low morale and trust. I really hope to see some incredible stories of leadership coming out of the VA in the next 6-10 months.

Response by SGM Matthew Quick made Aug 26 at 2014 10:19 PM

SGM Matthew Quick — Tue, 26 Aug 2014 22:19:31 -0400

With the words, “To care for him who shall have borne the battle and for his widow, and his orphan,” President Lincoln affirmed the government’s obligation to care for those injured during the war and to provide for the families of those who perished on the battlefield.

First, the VA needs to partner with local medical care facilities...a large, bureaucratic organization cannot (and has not) uphold the promises made by our civilian leaders, "To care for him who shall have borne the battle." The problem is bigger than the VA...it's our nation's responsibility to care for our Veterans.

Unfortunately, I am not qualified to answer the specific questions, but a main concern that I see and should be address immediately is REAL ACCOUNTABILITY...criminal charges for those that knowingly and negligently hurt any Veteran.

Response by MAJ Robert (Bob) Petrarca made Aug 27 at 2014 8:34 AM

MAJ Robert (Bob) Petrarca — Wed, 27 Aug 2014 08:34:30 -0400

First and foremost, based on the "backlog" how long is it going to take to get all qualifying vets into the system, seen, and given their initial disability %? The records and numbers should already exist so using available VA resources and perhaps coupling with civilian resources, how do we get the back log eliminated and new veterans into the system with - IMHO - a 30 day max waiting period from claim filed to initial% determined.

While IMHO, every vet should be seen in a VA facility by VA medical staff, do we need a financially based tier system so that the most financially and physically needy vets are seen by the VA and others who have a health plan can be seen under their insurance with a waiver-able deductible if they are being seen for something covered under their disability rating. The time lag for being seen should meet an acceptable standard, depending on the severity, and be comparable to civilian waiting times at a civilian hospital. How much coordination and paper cuts are needed to make this happen?

Anyways, my 1/50th of a dollar.

Response by MSG Bill Lewis, B.A., M.B.A. made Aug 27 at 2014 1:18 PM

MSG Bill Lewis, B.A., M.B.A. — Wed, 27 Aug 2014 13:18:48 -0400

Is establishing realistic, measurable goals for the VA the be all and end all solution. I feel the story is a little more complicated and stems far wider in policy, statistics, people, process and bureaucracy. No doubt that this hits the core of emotions, values, integrity, accountability and leadership within us considering the service of the VA is an entitlement we all earned honorably. This should be the highest level of service. We earned this! When a fellow soldier of any rank or service asked a question or needed something done we never responded without an answer or simply did not get the job done. It all lies in the core values and culture of the establishment. I feel strongly this is where the solution begins and it is just not words on paper.