The VA failed because it set goals based on numbers rather than quality. Read my blog about it, http://www.monteranderson-author.com.

As a veteran, I am very disturbed with the current issues of the Veterans Administration. I am 100% disabled and use the VA medical services for all my medical needs. I can’t complain, but I sympathize with those vets who are on waiting lists for approval for their service-connected disability or for medical services. I think that falsifying waiting times or other records is inexcusable. The problem is at the top. Let me explain why I believe that. I’m not in a position to audit the VA or to review all the data. I base my remarks simply on what I see in the news. I could be wrong. I think not.
You may have heard of Dr. W. Edward Demming. He was instrumental in helping the Japanese after WWII to achieve high levels of quality and productivity. Dr. Demming had a list of 14 key management practices. His number 11 point was to eeliminate numerical quotas and numerical goals for management. The VA leadership committed that error – they evaluated performance by the length of days that vets had to wait. The problem with measuring performance by numerical goals is that workers and mid-level managers learn how to cheat, book the books, or fudge the numbers. Let me give you some examples of using numerical goals to evaluate performance and what could happen.
1. Total number of items (widgets) produced. You should notice that there is nothing in this goal about quality. Producing many inferior widgets leads to a total failure in the market place. Managers learn to cut corners in quality in order to achieve their numbers. I cringe every time I see a sign at a construction site that lists the number of accident free days. This encourages supervisors to hide injuries. I knew a supervisor who would buy pizza if his crew went 90 days without an accident. How would you like to be the employee injured on the 89th day? That accident was probably not reported for a couple of days. I saw this in Vietnam with the “body count.” In order to be declared an enemy combatant or “body” there had to be a weapon. Some commanders had extra weapons to throw down if the body count was low. Innocent civilians were killed, I am sure.
2. Total of telephone calls completed. I once worker for a recruiter who measured performance by the number of completed telephone calls. What could go wrong with that? It was not the number or quality of the people recruited. He believed that if employees made many calls, the other numbers would follow. He went out of business.
3. Total amount of time spent on the telephone. I had a friend who worked for a telephone service provider. I won’t say which one. His boss evaluated him on minimizing time on the phone. He had to talk fast and hang up as soon as possible. There is nothing about the quality or number of satisfied customers in that goal.
4. Total number of patients or customers seen. I won’t belabor this point. You can see the trend. Goals like this forsake quality for numbers.
I could go on. I see many goals that are strictly numerical. The wait time for veterans was that type of goal and it encouraged falsifying reports and establishing secret waiting lists.