Describe
a common story in your organization and discuss its implications on the
organization. Does this story promote the goals and ideals of the organization?
Does it help describe "who we are and what we stand for?" What is the
story's impact on the culture of the organization?
I first heard the phrase “if you’ve been to one VA,
you’ve been to one VA” when I began my career with the U.S. Department of
Veterans Affairs almost ten years ago. I
was working with a counterpart who worked at a different medical center than I
worked. We were trying to solve an issue
and having some difficulty when he said the aforementioned phrase to me. I responded to him with a puzzled look on my
face because I had no idea what he meant.
He explained that despite all medical centers falling under the
VA organization, each facility operated independently and had their own way of
doing things. I had trouble grasping
that concept because I was used to the Air Force, my prior organization, where
we operated in a very standardized manner.
This way it would be possible to work at an Air Force Base in one
location and fit right into another Air Force Base on the other side of the
world because the same systems, regulations, and procedures were used. It is evident the lack of standardization across the VA
creates an enormous barrier to successful collaboration and continuous
improvement.
The biggest implication of operating without
standardization on the VA is inefficiency.
Granted, some medical centers figure out efficient ways to operate, but
not all. For example, when a new policy
is published throughout the VA, each medical center institutes their unique
procedures to follow it. Or, if a VA has
a process proven to be effective and efficient, it is not shared among other VA’s. This results in some medical centers with
highly efficient procedures and others who are extremely inefficient. This can be very detrimental to a medical
center when multiple inefficient procedures are compounded. This equates to a lot of wasted time, energy,
and taxpayer dollars. It may even go as
far as having an adverse effect on veteran patient care. A perfect example of inefficiency affecting
patient care was the highly publicized patient wait times for appointments. Such inefficiency contributed to patient
deaths and VA employees manipulating the wait times. These actions directly and adversely affect
the goals and ideals of the VA organization.
The VA core values are integrity, commitment, advocacy, respect, and
excellence; none of which are demonstrated by trying to manipulate patient wait
times. The actions of a few VA’s do not
represent “who we are and what we stand for” as an entire organization. It is truly unfortunate what started out as a
lack of efficiency resulted in a complete disregard of integrity and excellence. It is also unfortunate that the action of a
few VA’s resulted in an overall negative perception of the VA as a whole.
I still hear the phrase "if you've been to one VA, you've been to one VA" fairly often from employees. It seems to be the mantra when an employee becomes frustrated with a process. That tells me the VA still has work to do addressing the standardization of processes. However, the positive side of each VA medical center
operating independently is that some are tremendously efficient and exceptional
at providing care to the Nation’s veterans.
I am fortunate to be an employee at one such medical center. I have personally witnessed the tireless
efforts employees give to achieve such high standards and exemplify the VA’s
core values. Nonetheless, if best practices
and standardization was shared across the entire organization, then all medical
centers could be held in such high regard.
I only hope VA leaders can one day recognize that standardization would
lead to all VA medical centers operating at the highest level of care in the
industry.
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