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.

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General Motors should expect more failed parts — Steven Spear

MIT Sloan Senior Lecturer Steven Spear

MIT Sloan Senior Lecturer Steven Spear

From USA Today

General Motors CEO Mary Barra appeared before a Senate panel once again Thursday to discuss the company’s flawed ignition switches and vowed that GM will “do all it can to make certain that this does not happen again.”

In terms of damage control, much of what Barra and GM appear to be doing right now is positive: fessing up about product failures, bringing in outside investigators and firing employees that failed to take appropriate measures.

And while these are important steps, they amount only to a good, if somewhat belated, crisis management strategy. In fact, these efforts pale against the very real organizational challenges that lay ahead for GM and Barra. In order make good on her promise to Congress, Barra must prevent the kinds of engineering failures that caused the ignition problems in the first place and the organizational failures that propelled the problem to its current tragic magnitude. And that will mean changing the culture at GM.

Engineers like to be right. They like to prove that they have the correct answer.

Highly trained and highly motivated to solve problems, at the point of releasing a design or demonstrating a model or a prototype, everything in them is wired to prove that they’ve arrived at the right answer. The premium is so high on being “right” that even when data starts proving them wrong, they work to show that they are right somehow. They seek to explain what is happening is an exceptional outlier or an aberration; not that it is a sign of a problem. Read More »