The “gaming strategies” were used to make it appear that veterans were getting appointments within target times set by the department, according to a 2010 department memo to VA facility managers aimed at fighting the practices.
Or as Sen. Patty Murray, D-Wash., put it at hearing this month: “As soon as new directives are put out, they’re torn apart to find out how to get around the requirements.”
But the fact it is a problem has been detailed in VA inspector general reports and GAO reports to Congress going back a decade.
“We have worked very hard … to root out these inappropriate uses of the scheduling system and these abuses …. This has been a very important thing to us for at least the last four years.” Clinics used tried-and-true techniques to game system. The News-Gazette, Wednesday May 28, 2014.
Why did they try to game the system? Let’s look at some of the comments for any indications:
- “target times set by the department”
- “root out these inappropriate uses of the scheduling system”
- “a problem … going back a decade”
Sure. Did anyone ask how those target times were set? What methods were put in place to improve how well we met the appointment timing needs of veterans?
Yes, we should never do anything wrong. We should never say we are doing something and do something else. We are always wrong if we do this. It does not matter how silly or ineffective the targets that are set. Just do it.
In addition, see Lying in industry is normal
I recall a engineering manager says “yes, I’ll try to make the deadline.” The senior manager kept asking him if he would make it or not. The engineering manager would never say “yes, we’ll make it” only that he and his team would do their best effort. The senior manager was clearly getting annoyed especially since he had extracted a “yes, we’ll make it” from his other managers just prior to this one stubborn and overly … honest manager.
The fact that the deadline turned out to be completely unrealistic is besides the point. Right?
In just about every situation I’ve encountered where the organization had routinely practiced lying, cheating and … well, you know, bad practices, it had always been under the edict of … well, you know, very bad management direction.
Dr. W.Edward Deming had said that “management owned the process.” If the process didn’t achieve its intended results (e.g., patient appointments on time) then there was something wrong with management or the process, not with the folks trying to carry out the process. If the process is not working well (e.g., not delivering projects on time) then just setting an edict “that we will deliver this project on time” makes no sense and is doomed to failure.
Any goal needs to be backed up by a method of reaching that goal. A real method. Something that is actionable made by people that are both involved and well acquainted with that process.
What we did was simple. We looked at how long it had actually taken on average to deliver the last few projects and said that average is our current plan. Yes, it was significantly longer than what management wanted. It was however close to how long it had taken in the past. We then delivered on time with surprisingly improved quality.
See why quality improves because 3+9 is not equal to 12.
This was with the same people who had “failed” in the past at delivering at the time set by senior management fiat. Our customer praised us for finally delivering on time. We did not go out of business or lose customers by finally admitting how long it was taking us to deliver and then delivering it.
However, there was more to the story. While we didn’t always get much faster on future projects, we almost always delivered more functionality in each of the projects we delivered to our customers. Do you know what happened? Our customers started to tell us “whoa, slow down, there’s too much new stuff coming in too fast!”
The whole dynamics of the situation and business had changed. We were no longer beating ourselves up for not delivering in an unrealistic time period. Instead we were trying to better organize the tsunami of productivity that threatened to do almost as much damage as missing our deadlines. However, it was a much better place to be with our customers and a better problem to deal with.
This was all with the same people and organization. You know, those people who just couldn’t meet the goals that were imposed upon them for years. You know, those people who when new unrealistic goals were imposed, tore apart the goals to find ways to at least sound like they were meeting them.
We no longer needed to root out people who were using the process in inappropriate ways (ok, some always will). It was because the process could now finally be used to achieve the goals. Imagine that. Who would had ever conceived it that someone would be inclined to game the system when the process and goals were horribly out of balance?
When you find people gaming the system do you look to punish the gamers or do you first figure out why they felt compelled to game the system in the first place?