How Bob McDonald can (really) fix the VA’s health care system — Steven Spear

MIT Sloan Senior Lecturer Steven Spear

MIT Sloan Senior Lecturer Steven Spear

From Fortune , August 8, 2014

The former Procter & Gamble CEO recently confirmed to head the U.S. Department of Veterans Affairs must go beyond government reforms that Congress recently struck and address how the troubled agency measures performance.

On Thursday, President Obama signed into law a $16.3 billion measure to help overhaul the Department of Veterans Affairs, an agency that in recent months has been plagued with criticisms for long wait times for health care and manipulation of records. While the extra funds are substantial and may be necessary for a system that serves some 8.5 million veterans each year, it won’t be enough to fix the problems at one of the nation’s largest health providers.

Newly-confirmed Veterans Secretary Bob McDonald, a former CEO of Procter & Gamble, must create a new dynamic if the reforms are to succeed; he has to go beyond Congresses’ prescriptions and change the agency’s internal dynamics by focusing on what is measured, why it is measured, and what is done in response to the results.

One of the reasons for the VA’s current crop of problems has to do with the way the VA measures performance. The metrics that former administrators focused on pushed people in the direction of highlighting (sometimes exaggerating) what was going right and playing down what was going wrong.

Consequently, systemic problems — which might have been addressed early on before they caused harm — built up until they caused a crisis. It didn’t help that many of the metrics, such as wait times, were beyond the control and influence of the managers being evaluated, so there was even more incentive to game the system.

Read the full post at Fortune

Steven Spear is a Senior Lecturer at the MIT Sloan School of Management and at the Engineering Systems Division at MIT.

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