Few stories about government failure have been more egregious than the 2014 story about 40 veterans who reportedly died while waiting to get an appointment at the Veteran’s Affairs Department facility in Phoenix. Following the scandal, an internal VA audit found a pattern of pressure in the agency on schedulers to manipulate data to make it appear that wait times were better than they were, leaving more than 120,000 veterans waiting or simply with no access to care.
How is it possible to end up with an organizational culture that is so corrosive that many people had to collude to not only hide the truth, but to simultaneously enable the payout of merit bonuses while veteran’s died?
When the truth is unacceptable, people convince themselves that they have no choice but to join in the deception. When people don’t have control over the results they are accountable for, the temptation is to rationalize counting what they can control. For the VA, as demand for services outstripped staffing, the choice seemed to be narrowed to two options, failure or deception.
Leadership sets the tone. If leaders don’t walk into and embrace the hard truth, others will walk away from it. The failure to meet scheduling targets is an opportunity to learn, to grow, to improve. The belief that the only option is to throw more money at the problem is also a failure of leadership; often there is no more money to throw, so absent options desperation sets in. Leaders at the VA needed to open new doors to innovation, not to believe that all that was required of them was pressure to perform.
There’s a lesson to be learned from state government, where a movement is gaining momentum to drive results to the forefront. In the book Government That Works: The Results Revolution in the States, examples abound of how government leaders are taking the fear out of failure and delivering stunning results. Some examples:
- Colorado reduced unwanted teenage pregnancy by 49 percent in four years.
- Washington state reduced traffic fatalities from 658 to 439 in seven years.
- Michigan eliminated 1,577 sets of rules.
- Maryland increased certified cover crop to protect the Chesapeake Bay from 52,305 to 410,530, a 685 percent increase.
- Oregon Youth Authority’s improved across-the-board outcome measures by 27 percent in two years.
No citizen experience with government is more common than the proverbial trip to the Department of Motor Vehicles, the bailiwick of states. The Carlsbad, New Mexico, branch ended up on the front page of the local paper after it closed its doors at 3 p.m. one day because the line was so long they could not serve all of its customers by the 5 p.m. closing time. A customer got angry and the police were called, making poor customer service front-page news. In addition, the branch had people camping out in front of its offices in lawn chairs every morning before opening because wait times typically were around 90 minutes.
What did the leaders do? They led by:
- Listening closely to customers in order to understand their needs.
- Engaging employees in the mission to satisfy customers.
- Showing employees how to improve the processes they used to deliver services.
- Teaching employees how to use scorecards to track progress.
Within a couple of months processes were fixed, wait times dropped to less than 10 minutes and morale in the office shot through the roof. The key to reducing fear is to stop blaming the people and start improving the processes. When all was said and done Gov. Susana Martinez went to Carlsbad and hosted a community barbecue to celebrate the success along with agency leader Mark Williams.
Certainly federal agencies are larger and more complex, and the forces that drive fear in these organizations work in the shadows. It isn’t easy. But that demands leaders seek the truth and expect the same for everyone who works for them. Bearers of bad news have to be celebrated. The truth they bring represents one more opportunity to put fear out of its misery as people learn problems open the doors to solutions.
John M. Bernard is the author of Government That Works: The Results Revolution in the States, and chairman and founder of Mass Ingenuity, a consulting company specializing in transforming state government.