Losing the Hierarchy: Or, What the VA Needs to Do.

Posted by jlubans on June 03, 2014

20140603-VA iron trinangle.jpeg

The “iron triangle” is one of the concepts I will talk about at a seminar this August. *
It’s named the iron triangle because when all three points – point #1, the agency or bureaucracy (administration and staff); point #2, the clients and interest groups, and point #3, the funding and oversight agencies - are reciprocating with each other all goes swimmingly. The iron triangle appears impervious to external change, especially when the independent media (the Fourth estate!) behaves more like an interest group than a constructive skeptic. Worse, the iron triangle can block desirable internal change initiatives! While the iron triangle can be a protective wall against budgetary interlopers, for the most part it makes manifest many of the worst bureaucratic practices incorporated in Parkinson’s Law.
However, even the best iron triangles have moments of weakness; when one of the points corrodes, the iron triangle may collapse.
Illustrative of this are the headlines in the USA about a large federal agency by the name of the Veterans Administration, the VA. After decades of criticism, internal and external, the icy resistance may be thawing. What is the VA? Its charge is to provide medical care to all USA military veterans. How big? In the 2014 fiscal year the VA budget is estimated to be $150.7 billion. Billion. That only a third of that goes to the provision of medical care is an acre-size red flag. One estimate numbers VA staff at 280,000.
The VA has long had problems, but the iron triangle has handily rebuffed change initiatives. Until now. What’s different?
The VAs iron triangle is composed of patients (clients), the VA (its administrators and staff – including some much maligned and punished whistle blowers - and the funding agencies (Congress and oversight committees). One of this trio, the client, the soldier, is now up in arms. The patients are rebelling and publicly calling the agency bosses and the Congress to task. Aggravating the fall out (for those with vested interest who benefit from the status quo) is the media’s finally showing some critical thinking instead of buying into the governments’ claims that all is well.
At long last, positive change may be around the corner.

Clearly the VA is not a democratic workplace. Of the VA staff I know, they’re good people, wanting to do a good job; really not much different from the rest of us. So, I think using the staff to help heal the VA is a feasible idea. What other ideas do the concepts of freedom at work, leading from the middle, and the democratic workplace offer? Here are a few, not necessarily in order. These are free, and we know what that’s worth! Still, here they are:

First and foremost, a new leader must share an immediate sense of urgency. Create a “war room” and use it for coordination and communication about issues, debate, actions, and progress. Use no titles in the war room. It’s a disaster, all hands on deck.
Use only existing resources, pool the budget.
Establish change councils, linked to the “war room”, and charge them with finding and implementing improvements.
Open the books, budget and personnel.
Unplug the ideas reservoir. Blow up the blockade.
Harvest the low-hanging fruit. (After decades of denial, there ought to be a bumper crop.)
Take the “experts” and consultants out of the room – they are not part of the solution.
Gather ideas from all over, debate and vote on ten best and take action. Repeat.
Set a budget goal: a 10% shift in 2 years from administrative budget to the medical services side.
Freeze 5% of the budget and use it as a creativity pool for testing ideas and implementing them. Include the purchase of new capital equipment, but only if labor and budget savings occur.

I hope the VA can once again function according to its founding principles – to help veterans. “Losing the hierarchy” is a first step.

*”Leading Change”: A seminar on leading and following change in libraries and other organizations. Sponsored by the University of Latvia. August 25-28. (On August 29th there’s a separate library event and a very special reason to be in Latvia: the grand opening of the National Library of Latvia in Riga!)
If you are in Europe, come to the seminar. It’ll be in English, in a beautiful setting (near Sigulda, an hour out of the capital) and in a lovely time of year. Write me and I’ll let you know how to register.

@Copyright 2014 John Lubans

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