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Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
1
Phoenix VeteransAffairScandal andthe outcome of healthcare aswe know it. The conceptof
VA scandal was broughtto publicattentionin2012 byan emergencyroom doctorthat feltvery
overwhelmed bythe unethical practice,whowassubsequentlyfired due tothe communicationstyle
that the doctor presented. Fromreadingandlisteningtofilesandvideos concerningthe outcome of the
case onthe VA scandal,itseemsthatthere islack of a lotof leadership,communication,culture, and
organization withinthe healthcare system. How didthe VA organizationenduplike this? Whywere
there somany excusesandcoverups? Were there leadersorwas there a lackof leadership?
Chapter11 discussed topicsaboutculture andethics of how leaders should follow
organization’smissionstatementsand values.“Experiencedmanagersknow thatthe culture andethics
of an organizationstronglydetermine how the organizationperforms.” (Olden,2011, pg 171). Thisis
where Ifeel thatthe VA’sleadershipskills werelacking,which mayhave resultedinthe scandal andwill
isan issue that will definitelyneedtobe reviewedto resolve the problems of all the patientsthatwere
put onthe waitinglist. The VA’smissionstatement addressesthat,“tocare for himwhoshall have
borne the battle,andfor hiswidow,andhisorphan” suggestingthatitistheirdutyto serve and honor
the menand womenwhoare America’s veterans. Furthermore,“VA’sfive core valuesunderscorethe
obligationsinherentinVA’smission:Integrity,Commitment,Advocacy,Respect,andExcellence.The
core valuesdefine ‘whowe are,’ ourculture,andhow we care for Veterans and, eligiblebeneficiaries.”
(U.S.Dept.of VeteransAffairs,2014 para 1 & 2). It seems the VA hasa foundationforitsculture to
follow through withthe missionstatementandcore values,butfora longperiodof time,those core
valuesdidnotseemtomatter. Itmakesme wonderwhere are these core valuesposted? Are they
printedineachhandbook,and giventoeveryemployertobe signedwhenread? Are the leaders
workingtowardsthe culture thatthe VA standsfor?
CNN has reportedthatthe scandal is no newsforthe VA. It has beengoingonfor years.
“Scandal,controversyandVA care inthe US have gone hand-in-handforvirtuallyaslongasthere’sbeen
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
2
a republic.”(Pearson-CNN,2013 par 1). Sowhy isthisone in Phoenix suchatargetedone? Perhapsitis
because Dr.Mitchell,Ms. Pedene,&Mr. Reese finallyspoke upwithaconscience abouthow the VA was
not followingthe culture andethicsasithas beenestablished inthe mission statement. Maybe itwas
alsobecause somany veteransstartedtotake a stand and wantedtogetsome answers. Whywere
these people dying? Why isthere this“pretend”waitinglist? Bythe way,whomade up thisfictitious
waitinglist? Fromthe outlookof things,itseemslike noone hassteppedupasa leadertotake control
to see whatis goingwronginthe system,or to implementsomethingmore efficient. Dr.Griffinonly
wantedtosay that he was not givenenoughtime togetthe documentationsreadyforthe courthearing
and there wasa lot of alteringtoa draft. It seemedeasierforthese leadersatthe time to just“hide”or
“sweepthingsunderthe rug”,who wouldevennotice? If there is such qualitycontrol systemgoingon
withinthe VA system,thensomeone shouldbegintosearchthe outcome of the deathsand make the
changesthere. If the pretendwaitinglististhe cause of the death,more so thanthe actual ailment,
thenthe firststepwould be removingall waitinglist. Then,the nextstepwouldbe tosee if the facility
isactually providingenoughcertifiedphysiciansof all specialties,whichalso have tobe registeredwith
the Medicare’sPECOslist,andhave thembe staffedat all times. The qualityof care isa needfor
improvementinordertorekindle the trustthatthe veteranshave forthe VA system. Honestly,the VA
systemshouldrun ona similarbasisas that of any local hospital. There shouldbe asimilarityto
hospitalsand the VA inregardsto qualityof care. There shouldbe a bridge withall communityhospitals
so that the doctorscan all worktogetherandprovide supportwhere neededforthe VA hospitals. There
isa needforchange not justwithinthe culture of the VA,butthe ethicsas well,orelse, abettergraspof
the already established Mission,vision,andgoal statement.
Duringthe videoof the court hearing, Mr. Griffin- actingInspectorGeneral of VA Affairs,didnot
seemlike he wasreadyforthissort of hearing. I foundhislackof communicationskillsnotmeetingup
to my expectations. He seemedtoeitherturn the wordingof informationaroundorhe justdidnot
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
3
knowwhathe wastalkingaboutdue to the lack of informationthatwasprovidedfromthe VA office and
the court. Mr. Griffin’spreparednessdidnotmake hishearingseemreputable atall. Hislackof interest
didnot seemtoshowmuch care or respecttowardsthe VA patients whichwere inneedof major
medical care. What I have learnedisthatthe key solution iscommunicationanditisnotjust talking;
listening- the nonverbal formof communication,isvery important,aswell. Withsuchan organization,
shouldthe VA needtomeetwithanAccreditationcompanytomake sure that theyare incompliance
withthe currenthealthcare system? If so,thensome of these mishaps of communication thatwere
goingon inside the VA communitywouldhave beenaddressed waybeforeitgotout of control. The
organizationof the Phoenix VA andall VAsingeneral,seriously needtorevampthe organizations’
planning,organizing,jobpositions,and ultimately have more humanresources available,which would
playa good part inthe institutions.
Afterlisteningtothe court hearingonthe VA scandal,the VA board appeared tohave a lack of
confidence andcontrol inthe situation. The presentationof each representative speakingon behalf of
the Phoenix VA,onlyshowedsome formof cowardliness,astheydiscussthe situationsathandto the
court. There wasa lotof questioningfromthe board,presentedto the court, to continuallyclarifyif
documentationswereprovidedfromPhoenixVA officeforthe boardto review. Why were there so
manydiscrepanciesof the filesandpaperworkfromthe PhoenixVA facility? Whydidnoone take
ownershiptothe situation? Chapter15of the textdiscussescommunicationinHCO. The
communicationstylesseemtobe a majorfactor forthe leaders’downfallwithinthe Phoenix VA facility.
From whatwas giventothe lack of reportsthat were askedfor, itseemslike the transmission of
informationwasnotdone withclarity. The administrationdepartmentof the VA facilitywoulduse
programsfor filesthattheyseemedto nothave been trainedon. The outcome of the lackof training
broughtabout some communicationbreakdownbetweenleadersandmanagers.And fromwhatDr.
Griffinhasshared, the staff onlydidwhattheywere toldtodo. Did Phoenix VA facilityfollow a
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
4
“communicationmodel”aschapter15 has discussed? There seemtobe some sortof barriergoingon
to have such a communicationbreakdown witheitherthe encoding,channel,orthe decoding. An
improvementinthisareawouldbe a stepclosertowardsa betterstandardof care.
If Phoenix VA (andall VA s) were heldunderbetterhealthcare standardsashospitals,
pharmacies, andmedical supplycompanies,the use of the patient’soroffice datainformationwould
not be manipulatedasstatedinStarsand Stripesarticle remarksbyDamianReese (Druzin,2014 par 3),
especiallywhensuchmanipulationswere merelyimplementedas “shortcuts”tomake the patients wait
time “look”shorter. Whydoesthe patientsof the VA deserve suchpoorqualityof care where the
hospitalshave alreadyestablishedabetterrecordof providingcare? How can leadersandmanagement
of the VA allowthistohappenforsuch a longtime? Do the elderlypatient’sdeserve care aseveryone
else? Isitthat much cheaperto letthe patient’sdie insteadof providingthe care?Here itseemsthe VA
has been anunderservice. Wouldithave beencosteffective if the VA facilitiesfollowed more of an
“overserviced”mentality? A newoutlookand greatchange isneededforthe VA tocontinue togain the
trust back forservicesfromthe veterans whohave servedforus.These questionsare leftlingeringinmy
thoughtsas I continue towrite aboutthissubject. Where doesone startwithimprovingthe VA’s
system? Howto begintostart over undertaking?I’dliketoespeciallymake note of thisquote from
Chapter14, “Thus,HCOs mustconstantlychange.There have beenmanymoverchangesinsociety,
culture,technology,consumers,financing,populations,andgovernmentpolicy. Whenexternal
environmentchanges,HCOsmustthenchange tosurvive andthrive.”(Olden,2011 pg. 233). With that
beingsaid,VA shouldalsobe aware of these changesas was discussedin Chapter14 and furtheradapt
towardsupdatingtheiroverall organization,planning,improvingonperformances,control, motivations,
as well asproblemsolve tactics, sothattheymay make some inside changes withmanagement,perhaps
by focusingon groupsor teamson a regularbasis.
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
5
It isa time forchange in the VA healthcare system. Somethinghastobe done to helpdevelopa
qualitycare for the VA system,one thatis as equal toa hospital base facility, aswell as regainthe trust
of theirpatients. USSecretaryof Affairs,RobertMcDonaldhasstatedthat there are changesthat will
be made. He startedfirstwith the dismissal of manypersonnelandfederal staff thatfollowedthe path
the VA wentin regardsto the “secretwaitinglist”andothersthatviolatedthe VA values. Then
McDonald beganto discussaboutmakingthe changesinside the systemforimprovements. “VA is
establishingapositioncalled ChiefCustomerService Office,whowillreport toMcDonald,as well as
creatinga newVA- wide customerservice organizationtoensure thattop-level customerservice to
veteranswill be provided.The missionof the new office will be todrive the VA culture andpracticesto
understandandrespondto the expectationof ourveterancustomers.”(Koplowitz,2014 par 5).
McDonald saiditwouldtake time to getthe new organizationof the VA upand running. He didnotsay
it wasgoingto be the answertoall the situationsthathasplaque the VA,but someone hastostart
somewhere,andwhere betterthan withimprovingcoordinationthroughanational network of
communityadvisors forall the VA.
As CNN hasshared, the timeline of the VA scandal broughtonhow long thisfailed systemwas
goingunnoticed andnoone took the stepsinmakingadjustments. Itseemslike McDonaldcouldbegin
by usingthe SWOT analysistopointoutthe weaknessesandstrengthstostartrevampingthe VA system
whichthe othershave failedtoaccomplish. Fromthere,he could, thendiscusswiththe appointed
leadersof the VA to share inputonthe findings. This wouldallow the appointedleadersof the teamto
understandthe changesandimplementthe necessary changes. Changingthe culture of the VA,
providingappropriately certifieddoctorsandnurses,aswell as anadministrationstaff formakingthe
facilitiesfunctionmore efficiently,are some of the mostlikelystepstostartwith. Why was the VA’s
situationanongoingproblem? Fromthe CNN’stimeline,itseemsthatthe mismanagementof the VA
has beengoingonsince the programstarted,especiallywiththe many change of handsthe facilities
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
6
have gone through. It seemsthatthe organizationwasnot quite putintoplace. Now withthe new
Departmentof VeteransAffairs, SecretaryMcDonald,he hasrecognize the potential of whatneedsto
be done. He seemsverymotivatedaboutdoingwhatneedstobe handledtoimprove the VA systemso
the patientscan receive the properandmuchdeserved care. “We are holdingpeople accountable,we
are takingactionand the organizationischangingandthe culture ischanging”,McDonaldsaid while
visitingVA facilityinDelaware (Bryan,2015 par 6). AsMcDonald takesthe reignsto revampthe VA
system,there are probablymanychangeshe will needtomake. How doesone start? There are so
manycorrectionsthat needaddressingandrevampingtomeetupwiththe healthcare organization’s
stipulations forqualityof care. The approachhe takeswill be one thatwill suithis managementstyle.
McDonald’ssense of directionseemsto be revampingthe systemandtweakingithere andthere,as
seenon the same line as chapter12 & 13 indiscussingthe improvements,makingdecisions,and
problemsolving. Inan interviewwithMcDonald,he sharedthe actionplanthatisnecessarytohelp
vitalize the VA systemandthe facility.
Where doesone start whentryingtorevampa company,like the VA?McDonaldstated"Our
sharedgoalsare to ensure thatVeteranshave aclearunderstandingof VA andwhere togo forwhat
theyneedwithinanyof ourfacilities;thatemployeesare empoweredwiththe authority,knowledge
and toolstheyneedtosolve problemsandtake action;andthatthe productsand servicesthatwe
delivertoVeteransare integratedwithinthe organization."(Kaplan,2014 par 3). Thisisreassuringto
hear. Such a statementcalls forbreakingupdepartmentsandhavingmore smallersections involved
withthe structure of the VA systemsothat these failuresdonotcontinue. AsMcDonaldtakescharge
for implementingthesechanges,he mustalsoinclude the employeesforsuggestionsandtake their
suggestionsinconsideration. One beingwiththe VA’swebsite,there are manydifferentVA websitesfor
each state. By havingVA usingone universal website tostart,the simplerstyle of navigationwill help
withsome of the communicationaswell asusingthe resourcesonthe internettoreceive messages.
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
7
Anotherfocusisto have a more improvedcustomerservice departmentthatiswell knowledgeable with
the systemas well aswithhealthcare. McDonald’smainfocusistorevampthe VA systemand doit
suitably.
Quotedfroman interview withMcDonald&GibsonwithScott Pelley of 60Minutes,Pellley
shared“The firstplace IvisitedwasPhoenix, groundzero.WhileIwasinPhoenix,Imetwitha large
groupof employees.Theywantedtodothe right thing.Theyworkedreallyhard,butthe systemandthe
organizationwasjustnotsupportingthem.WhatI saw there:leadershipfailure,mismanagementand
chronicunderinvestmentinthe system.”(Pelly- 60minutes,2014). It didnot take longfor both
McDonald andGibsonto recognize the situationatthe Phoenix VA facility. A systemthatjustwasfailing
and no one steppingup totake leadershiptohelp correctit. Reviewingall the notesfrominterview,
reviewingthe courthearingvideo,andgatheringinformationfrom myfindings,atfirstIdo not see how
one can correct such an alreadybrokensystem. McDonaldhasan adventurousroadaheadof him. With
hissuccesswithProctor & Gamble as management,thisnew role seemssuitableforhim. Witha lotof
experiencesandbeingagreat“listener”andobserver,thiswillbenefithimforgettingthe VA system
where itneedstobe. The textbookhasshared alot of skills,techniques,andtoolsthatMcDonaldhas
alreadypossessedandexhibited fromhispreviousemployment. Withthe dedicationhe hasputforth
already, McDonald seemstohave a good ideawhere he wantstotake the VA organizationto:“VA’sfive
core valuesunderscore the obligationsinherentinVA’smission:Integrity,Commitment,Advocacy,
Respect,andExcellence.The core valuesdefine “whowe are,”ourculture,andhow we care for
Veteransandeligible beneficiaries.Ourvaluesare more thanjustwords – theyaffectoutcomesinour
dailyinteractionswithVeteransandeligiblebeneficiariesandwitheachother.Takingthe firstletterof
each word—Integrity,Commitment,Advocacy,Respect,Excellence—createsapowerful acronym,“I
CARE,” thatremindseachVA employee of the importanceof theirrole inthisDepartment.Thesecore
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
8
valuescome togetherasfive promiseswe make asindividualsandasan organizationtothose we
serve.”(U.S.Dept.of VeteransAffairs,2014).
Movingforward,McDonald hasa lotto manage withall that has happenedinthe VA system,
and justnot with the recentdiscovery. VA’sculture hassome majorreconstructingtodofrom
administrationtodoctors andnurses. Withan overhaul of the system, Iam sure McDonald will use the
toolsthat he isfamiliarfromworkingwithProctor& Gamble. Asstated,itwill take time togetthe VA
systemtowhere itneedstobe.Everyone hasto be patientas McDonaldgoes througheach department
and eacharea of the systemtoimprove,addresschanges, bringtrustandmake importantdecisions.
The VA systemhasbeenaroundfora longtime going throughthese systemandcultural failures;itwill
take quite a bitof time forMcDonald to make the necessaryimprovementsto gainthe trust fromthe
veterans thathisnew systemwill notfail andthe veteranswillreceive the qualitycare thatthey
deserve. McDonaldmay be on the right track to bringingthe Mission,vision,goals,andcore values
back to the everyagingVA system. The Veteran’sdeserve qualitycare astheyhave givenustheirtime
and service toprotect our livesandcivil rights. Shouldn’twe give itbackto themto live the waythey
shouldlive,without fear?
Citingresource onnextpage.
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
9
CitiedResource:
Bryan, C. (2015). Veterans affairs secretary visits wilmington VA Medical Center. Retrieved
March 2, 2015, from http://philadelphia.cbslocal.com/2015/03/02/veterans-affairs-secretary-
visits-wilmington-va-medical-center/
Druzin, H. (2014). VA settles with 3 phoenix whistleblowers. Retrieved Feb. 21, 2015, from
http://www.stripes.com/va-settles-with-3-phoenix-whistleblowers-1.305609
Kaplan, R. (2014). Robert McDonald announces plans to reorganize the VA. Retrieved
November, 10, 2015, from http://www.cbsnews.com/news/robert-mcdonald-announces-
plans-to-reorganize-the-va/
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
10
Koplowitz, H. (2014). VA scandal update: 35 veterans affairs workers to be fired, 1K more may
get pink slips, secretary says. Retrieved Feb. 21, 2015, from http://www.ibtimes.com/va-
scandal-update-35-veterans-affairs-workers-be-fired-1k-more-may-get-pink-slips-1721538
Olden, P. C. (2011). Chp. 11 leading: Culture and ethics. Management healthcare organizations
an introduction (pp. 170). Chicago, IL: Health Administration Press.
Olden, P. C. (2011). Chp. 14: Managing change. Management of healthcare organization (pp.
233). Chicago, IL: Health Administration Press.
Pearson, M. C. (May 30, 2013). The VA's troubled history.The VA's troubled history
Pelley, S. (2014). Robert McDonald: Cleaning up the VA. Retrieved November 9, 2015, from
http://www.cbsnews.com/news/robert-mcdonald-cleaning-up-the-veterans-affairs-hospitals/
U.S. Dept. of Veterans Affairs. (2014). Mission, vision, core values & goals
about VA. Retrieved March 13, 2015, from http://www.va.gov/about_va/mission.asp
USA Today Timeline. (2014). Timeline: The story behind the VA scandal. Retrieved Feb. 8,
2015, from http://www.usatoday.com/story/news/politics/2014/05/21/veterans-healthcare-
scandal-shinseki-timeline/9373227/
Intellectual Honesty Statement
I certify that this assignment is presented as entirely my own intellectual work. Any
words and/or ideas from other sources (e.g. printed publications, Internet sites,
electronic media, other individuals, groups, or organizations) have been properly
Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015
11
indicated using the appropriate scholarly citation style required by the department or
College.
I have not submitted this assignment in its entirety to satisfy the requirements of any
other course. Any parts of this assignment from other courses have been discussed
thoroughly with the faculty member before this submission so that there is an
understanding that I have used some of this work in a prior assignment.
Student’s Signature __Kathelleen Parsons______ Term _Winter 2015_
Course Submitted _HSAD 334-091____ Date March 18, 2015

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A Healthy Culture - TD Magazine
 

VA scandal

  • 1. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 1 Phoenix VeteransAffairScandal andthe outcome of healthcare aswe know it. The conceptof VA scandal was broughtto publicattentionin2012 byan emergencyroom doctorthat feltvery overwhelmed bythe unethical practice,whowassubsequentlyfired due tothe communicationstyle that the doctor presented. Fromreadingandlisteningtofilesandvideos concerningthe outcome of the case onthe VA scandal,itseemsthatthere islack of a lotof leadership,communication,culture, and organization withinthe healthcare system. How didthe VA organizationenduplike this? Whywere there somany excusesandcoverups? Were there leadersorwas there a lackof leadership? Chapter11 discussed topicsaboutculture andethics of how leaders should follow organization’smissionstatementsand values.“Experiencedmanagersknow thatthe culture andethics of an organizationstronglydetermine how the organizationperforms.” (Olden,2011, pg 171). Thisis where Ifeel thatthe VA’sleadershipskills werelacking,which mayhave resultedinthe scandal andwill isan issue that will definitelyneedtobe reviewedto resolve the problems of all the patientsthatwere put onthe waitinglist. The VA’smissionstatement addressesthat,“tocare for himwhoshall have borne the battle,andfor hiswidow,andhisorphan” suggestingthatitistheirdutyto serve and honor the menand womenwhoare America’s veterans. Furthermore,“VA’sfive core valuesunderscorethe obligationsinherentinVA’smission:Integrity,Commitment,Advocacy,Respect,andExcellence.The core valuesdefine ‘whowe are,’ ourculture,andhow we care for Veterans and, eligiblebeneficiaries.” (U.S.Dept.of VeteransAffairs,2014 para 1 & 2). It seems the VA hasa foundationforitsculture to follow through withthe missionstatementandcore values,butfora longperiodof time,those core valuesdidnotseemtomatter. Itmakesme wonderwhere are these core valuesposted? Are they printedineachhandbook,and giventoeveryemployertobe signedwhenread? Are the leaders workingtowardsthe culture thatthe VA standsfor? CNN has reportedthatthe scandal is no newsforthe VA. It has beengoingonfor years. “Scandal,controversyandVA care inthe US have gone hand-in-handforvirtuallyaslongasthere’sbeen
  • 2. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 2 a republic.”(Pearson-CNN,2013 par 1). Sowhy isthisone in Phoenix suchatargetedone? Perhapsitis because Dr.Mitchell,Ms. Pedene,&Mr. Reese finallyspoke upwithaconscience abouthow the VA was not followingthe culture andethicsasithas beenestablished inthe mission statement. Maybe itwas alsobecause somany veteransstartedtotake a stand and wantedtogetsome answers. Whywere these people dying? Why isthere this“pretend”waitinglist? Bythe way,whomade up thisfictitious waitinglist? Fromthe outlookof things,itseemslike noone hassteppedupasa leadertotake control to see whatis goingwronginthe system,or to implementsomethingmore efficient. Dr.Griffinonly wantedtosay that he was not givenenoughtime togetthe documentationsreadyforthe courthearing and there wasa lot of alteringtoa draft. It seemedeasierforthese leadersatthe time to just“hide”or “sweepthingsunderthe rug”,who wouldevennotice? If there is such qualitycontrol systemgoingon withinthe VA system,thensomeone shouldbegintosearchthe outcome of the deathsand make the changesthere. If the pretendwaitinglististhe cause of the death,more so thanthe actual ailment, thenthe firststepwould be removingall waitinglist. Then,the nextstepwouldbe tosee if the facility isactually providingenoughcertifiedphysiciansof all specialties,whichalso have tobe registeredwith the Medicare’sPECOslist,andhave thembe staffedat all times. The qualityof care isa needfor improvementinordertorekindle the trustthatthe veteranshave forthe VA system. Honestly,the VA systemshouldrun ona similarbasisas that of any local hospital. There shouldbe asimilarityto hospitalsand the VA inregardsto qualityof care. There shouldbe a bridge withall communityhospitals so that the doctorscan all worktogetherandprovide supportwhere neededforthe VA hospitals. There isa needforchange not justwithinthe culture of the VA,butthe ethicsas well,orelse, abettergraspof the already established Mission,vision,andgoal statement. Duringthe videoof the court hearing, Mr. Griffin- actingInspectorGeneral of VA Affairs,didnot seemlike he wasreadyforthissort of hearing. I foundhislackof communicationskillsnotmeetingup to my expectations. He seemedtoeitherturn the wordingof informationaroundorhe justdidnot
  • 3. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 3 knowwhathe wastalkingaboutdue to the lack of informationthatwasprovidedfromthe VA office and the court. Mr. Griffin’spreparednessdidnotmake hishearingseemreputable atall. Hislackof interest didnot seemtoshowmuch care or respecttowardsthe VA patients whichwere inneedof major medical care. What I have learnedisthatthe key solution iscommunicationanditisnotjust talking; listening- the nonverbal formof communication,isvery important,aswell. Withsuchan organization, shouldthe VA needtomeetwithanAccreditationcompanytomake sure that theyare incompliance withthe currenthealthcare system? If so,thensome of these mishaps of communication thatwere goingon inside the VA communitywouldhave beenaddressed waybeforeitgotout of control. The organizationof the Phoenix VA andall VAsingeneral,seriously needtorevampthe organizations’ planning,organizing,jobpositions,and ultimately have more humanresources available,which would playa good part inthe institutions. Afterlisteningtothe court hearingonthe VA scandal,the VA board appeared tohave a lack of confidence andcontrol inthe situation. The presentationof each representative speakingon behalf of the Phoenix VA,onlyshowedsome formof cowardliness,astheydiscussthe situationsathandto the court. There wasa lotof questioningfromthe board,presentedto the court, to continuallyclarifyif documentationswereprovidedfromPhoenixVA officeforthe boardto review. Why were there so manydiscrepanciesof the filesandpaperworkfromthe PhoenixVA facility? Whydidnoone take ownershiptothe situation? Chapter15of the textdiscussescommunicationinHCO. The communicationstylesseemtobe a majorfactor forthe leaders’downfallwithinthe Phoenix VA facility. From whatwas giventothe lack of reportsthat were askedfor, itseemslike the transmission of informationwasnotdone withclarity. The administrationdepartmentof the VA facilitywoulduse programsfor filesthattheyseemedto nothave been trainedon. The outcome of the lackof training broughtabout some communicationbreakdownbetweenleadersandmanagers.And fromwhatDr. Griffinhasshared, the staff onlydidwhattheywere toldtodo. Did Phoenix VA facilityfollow a
  • 4. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 4 “communicationmodel”aschapter15 has discussed? There seemtobe some sortof barriergoingon to have such a communicationbreakdown witheitherthe encoding,channel,orthe decoding. An improvementinthisareawouldbe a stepclosertowardsa betterstandardof care. If Phoenix VA (andall VA s) were heldunderbetterhealthcare standardsashospitals, pharmacies, andmedical supplycompanies,the use of the patient’soroffice datainformationwould not be manipulatedasstatedinStarsand Stripesarticle remarksbyDamianReese (Druzin,2014 par 3), especiallywhensuchmanipulationswere merelyimplementedas “shortcuts”tomake the patients wait time “look”shorter. Whydoesthe patientsof the VA deserve suchpoorqualityof care where the hospitalshave alreadyestablishedabetterrecordof providingcare? How can leadersandmanagement of the VA allowthistohappenforsuch a longtime? Do the elderlypatient’sdeserve care aseveryone else? Isitthat much cheaperto letthe patient’sdie insteadof providingthe care?Here itseemsthe VA has been anunderservice. Wouldithave beencosteffective if the VA facilitiesfollowed more of an “overserviced”mentality? A newoutlookand greatchange isneededforthe VA tocontinue togain the trust back forservicesfromthe veterans whohave servedforus.These questionsare leftlingeringinmy thoughtsas I continue towrite aboutthissubject. Where doesone startwithimprovingthe VA’s system? Howto begintostart over undertaking?I’dliketoespeciallymake note of thisquote from Chapter14, “Thus,HCOs mustconstantlychange.There have beenmanymoverchangesinsociety, culture,technology,consumers,financing,populations,andgovernmentpolicy. Whenexternal environmentchanges,HCOsmustthenchange tosurvive andthrive.”(Olden,2011 pg. 233). With that beingsaid,VA shouldalsobe aware of these changesas was discussedin Chapter14 and furtheradapt towardsupdatingtheiroverall organization,planning,improvingonperformances,control, motivations, as well asproblemsolve tactics, sothattheymay make some inside changes withmanagement,perhaps by focusingon groupsor teamson a regularbasis.
  • 5. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 5 It isa time forchange in the VA healthcare system. Somethinghastobe done to helpdevelopa qualitycare for the VA system,one thatis as equal toa hospital base facility, aswell as regainthe trust of theirpatients. USSecretaryof Affairs,RobertMcDonaldhasstatedthat there are changesthat will be made. He startedfirstwith the dismissal of manypersonnelandfederal staff thatfollowedthe path the VA wentin regardsto the “secretwaitinglist”andothersthatviolatedthe VA values. Then McDonald beganto discussaboutmakingthe changesinside the systemforimprovements. “VA is establishingapositioncalled ChiefCustomerService Office,whowillreport toMcDonald,as well as creatinga newVA- wide customerservice organizationtoensure thattop-level customerservice to veteranswill be provided.The missionof the new office will be todrive the VA culture andpracticesto understandandrespondto the expectationof ourveterancustomers.”(Koplowitz,2014 par 5). McDonald saiditwouldtake time to getthe new organizationof the VA upand running. He didnotsay it wasgoingto be the answertoall the situationsthathasplaque the VA,but someone hastostart somewhere,andwhere betterthan withimprovingcoordinationthroughanational network of communityadvisors forall the VA. As CNN hasshared, the timeline of the VA scandal broughtonhow long thisfailed systemwas goingunnoticed andnoone took the stepsinmakingadjustments. Itseemslike McDonaldcouldbegin by usingthe SWOT analysistopointoutthe weaknessesandstrengthstostartrevampingthe VA system whichthe othershave failedtoaccomplish. Fromthere,he could, thendiscusswiththe appointed leadersof the VA to share inputonthe findings. This wouldallow the appointedleadersof the teamto understandthe changesandimplementthe necessary changes. Changingthe culture of the VA, providingappropriately certifieddoctorsandnurses,aswell as anadministrationstaff formakingthe facilitiesfunctionmore efficiently,are some of the mostlikelystepstostartwith. Why was the VA’s situationanongoingproblem? Fromthe CNN’stimeline,itseemsthatthe mismanagementof the VA has beengoingonsince the programstarted,especiallywiththe many change of handsthe facilities
  • 6. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 6 have gone through. It seemsthatthe organizationwasnot quite putintoplace. Now withthe new Departmentof VeteransAffairs, SecretaryMcDonald,he hasrecognize the potential of whatneedsto be done. He seemsverymotivatedaboutdoingwhatneedstobe handledtoimprove the VA systemso the patientscan receive the properandmuchdeserved care. “We are holdingpeople accountable,we are takingactionand the organizationischangingandthe culture ischanging”,McDonaldsaid while visitingVA facilityinDelaware (Bryan,2015 par 6). AsMcDonald takesthe reignsto revampthe VA system,there are probablymanychangeshe will needtomake. How doesone start? There are so manycorrectionsthat needaddressingandrevampingtomeetupwiththe healthcare organization’s stipulations forqualityof care. The approachhe takeswill be one thatwill suithis managementstyle. McDonald’ssense of directionseemsto be revampingthe systemandtweakingithere andthere,as seenon the same line as chapter12 & 13 indiscussingthe improvements,makingdecisions,and problemsolving. Inan interviewwithMcDonald,he sharedthe actionplanthatisnecessarytohelp vitalize the VA systemandthe facility. Where doesone start whentryingtorevampa company,like the VA?McDonaldstated"Our sharedgoalsare to ensure thatVeteranshave aclearunderstandingof VA andwhere togo forwhat theyneedwithinanyof ourfacilities;thatemployeesare empoweredwiththe authority,knowledge and toolstheyneedtosolve problemsandtake action;andthatthe productsand servicesthatwe delivertoVeteransare integratedwithinthe organization."(Kaplan,2014 par 3). Thisisreassuringto hear. Such a statementcalls forbreakingupdepartmentsandhavingmore smallersections involved withthe structure of the VA systemsothat these failuresdonotcontinue. AsMcDonaldtakescharge for implementingthesechanges,he mustalsoinclude the employeesforsuggestionsandtake their suggestionsinconsideration. One beingwiththe VA’swebsite,there are manydifferentVA websitesfor each state. By havingVA usingone universal website tostart,the simplerstyle of navigationwill help withsome of the communicationaswell asusingthe resourcesonthe internettoreceive messages.
  • 7. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 7 Anotherfocusisto have a more improvedcustomerservice departmentthatiswell knowledgeable with the systemas well aswithhealthcare. McDonald’smainfocusistorevampthe VA systemand doit suitably. Quotedfroman interview withMcDonald&GibsonwithScott Pelley of 60Minutes,Pellley shared“The firstplace IvisitedwasPhoenix, groundzero.WhileIwasinPhoenix,Imetwitha large groupof employees.Theywantedtodothe right thing.Theyworkedreallyhard,butthe systemandthe organizationwasjustnotsupportingthem.WhatI saw there:leadershipfailure,mismanagementand chronicunderinvestmentinthe system.”(Pelly- 60minutes,2014). It didnot take longfor both McDonald andGibsonto recognize the situationatthe Phoenix VA facility. A systemthatjustwasfailing and no one steppingup totake leadershiptohelp correctit. Reviewingall the notesfrominterview, reviewingthe courthearingvideo,andgatheringinformationfrom myfindings,atfirstIdo not see how one can correct such an alreadybrokensystem. McDonaldhasan adventurousroadaheadof him. With hissuccesswithProctor & Gamble as management,thisnew role seemssuitableforhim. Witha lotof experiencesandbeingagreat“listener”andobserver,thiswillbenefithimforgettingthe VA system where itneedstobe. The textbookhasshared alot of skills,techniques,andtoolsthatMcDonaldhas alreadypossessedandexhibited fromhispreviousemployment. Withthe dedicationhe hasputforth already, McDonald seemstohave a good ideawhere he wantstotake the VA organizationto:“VA’sfive core valuesunderscore the obligationsinherentinVA’smission:Integrity,Commitment,Advocacy, Respect,andExcellence.The core valuesdefine “whowe are,”ourculture,andhow we care for Veteransandeligible beneficiaries.Ourvaluesare more thanjustwords – theyaffectoutcomesinour dailyinteractionswithVeteransandeligiblebeneficiariesandwitheachother.Takingthe firstletterof each word—Integrity,Commitment,Advocacy,Respect,Excellence—createsapowerful acronym,“I CARE,” thatremindseachVA employee of the importanceof theirrole inthisDepartment.Thesecore
  • 8. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 8 valuescome togetherasfive promiseswe make asindividualsandasan organizationtothose we serve.”(U.S.Dept.of VeteransAffairs,2014). Movingforward,McDonald hasa lotto manage withall that has happenedinthe VA system, and justnot with the recentdiscovery. VA’sculture hassome majorreconstructingtodofrom administrationtodoctors andnurses. Withan overhaul of the system, Iam sure McDonald will use the toolsthat he isfamiliarfromworkingwithProctor& Gamble. Asstated,itwill take time togetthe VA systemtowhere itneedstobe.Everyone hasto be patientas McDonaldgoes througheach department and eacharea of the systemtoimprove,addresschanges, bringtrustandmake importantdecisions. The VA systemhasbeenaroundfora longtime going throughthese systemandcultural failures;itwill take quite a bitof time forMcDonald to make the necessaryimprovementsto gainthe trust fromthe veterans thathisnew systemwill notfail andthe veteranswillreceive the qualitycare thatthey deserve. McDonaldmay be on the right track to bringingthe Mission,vision,goals,andcore values back to the everyagingVA system. The Veteran’sdeserve qualitycare astheyhave givenustheirtime and service toprotect our livesandcivil rights. Shouldn’twe give itbackto themto live the waythey shouldlive,without fear? Citingresource onnextpage.
  • 9. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 9 CitiedResource: Bryan, C. (2015). Veterans affairs secretary visits wilmington VA Medical Center. Retrieved March 2, 2015, from http://philadelphia.cbslocal.com/2015/03/02/veterans-affairs-secretary- visits-wilmington-va-medical-center/ Druzin, H. (2014). VA settles with 3 phoenix whistleblowers. Retrieved Feb. 21, 2015, from http://www.stripes.com/va-settles-with-3-phoenix-whistleblowers-1.305609 Kaplan, R. (2014). Robert McDonald announces plans to reorganize the VA. Retrieved November, 10, 2015, from http://www.cbsnews.com/news/robert-mcdonald-announces- plans-to-reorganize-the-va/
  • 10. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 10 Koplowitz, H. (2014). VA scandal update: 35 veterans affairs workers to be fired, 1K more may get pink slips, secretary says. Retrieved Feb. 21, 2015, from http://www.ibtimes.com/va- scandal-update-35-veterans-affairs-workers-be-fired-1k-more-may-get-pink-slips-1721538 Olden, P. C. (2011). Chp. 11 leading: Culture and ethics. Management healthcare organizations an introduction (pp. 170). Chicago, IL: Health Administration Press. Olden, P. C. (2011). Chp. 14: Managing change. Management of healthcare organization (pp. 233). Chicago, IL: Health Administration Press. Pearson, M. C. (May 30, 2013). The VA's troubled history.The VA's troubled history Pelley, S. (2014). Robert McDonald: Cleaning up the VA. Retrieved November 9, 2015, from http://www.cbsnews.com/news/robert-mcdonald-cleaning-up-the-veterans-affairs-hospitals/ U.S. Dept. of Veterans Affairs. (2014). Mission, vision, core values & goals about VA. Retrieved March 13, 2015, from http://www.va.gov/about_va/mission.asp USA Today Timeline. (2014). Timeline: The story behind the VA scandal. Retrieved Feb. 8, 2015, from http://www.usatoday.com/story/news/politics/2014/05/21/veterans-healthcare- scandal-shinseki-timeline/9373227/ Intellectual Honesty Statement I certify that this assignment is presented as entirely my own intellectual work. Any words and/or ideas from other sources (e.g. printed publications, Internet sites, electronic media, other individuals, groups, or organizations) have been properly
  • 11. Kathelleen Parsons HSAD334 Final PaperMarch 18, 2015 11 indicated using the appropriate scholarly citation style required by the department or College. I have not submitted this assignment in its entirety to satisfy the requirements of any other course. Any parts of this assignment from other courses have been discussed thoroughly with the faculty member before this submission so that there is an understanding that I have used some of this work in a prior assignment. Student’s Signature __Kathelleen Parsons______ Term _Winter 2015_ Course Submitted _HSAD 334-091____ Date March 18, 2015