Lessons from the VA…leaders get your houses in order

Speak and listen quote

New information about the inadequacies of leadership at the U.S. Veterans Affairs (VA) medical centers continues to be revealed daily. The headlines astound, “Bad VA care may have killed more than 1,000 veterans, senator’s report says.” In summary, for years the wait times reported by many medical centers in the management system for measuring effectiveness were simply false. As a result, veterans have not been served well and most everyone is outraged.

After an independent investigation reported findings, it seems that managers trained and instructed staff to use the false logs, the problems are systemic across multiple sites and numerous whistleblower disclosers (more than 50) were ignored. As reported by CNN, “Fear kept the VA scandal a secret.” Unfortunately, it again comes back to a culture of fear that perpetuated these activities. Even more concerning, when a few employees found the strength to come forward, the culture of fear was so strong at both the leadership and the management levels, that fear resulted in more false audits and zero action to correct the poor practices.

A time to reflect
As the stories continue to focus on what was not done and how behaviors were swept under the rug for years, leaders outside of the VA who are faced with their own set of challenges should take pause.  I encourage leaders to take pause and think deeply about their own responsibilities. I wonder how many other “VA” like scandals are occurring in other public and private organizations. Many leaders are certainly speculating about how they would effectively respond to a crisis like this if one occurred in their own organization. The more difficult question is how to know if there is one lurking in your organization in the first place.

Take action 
Begin with a reality check. What is currently in place in your organization to ensure that problems like we have described surface sooner than later? Is it time to put more of a focus on creating the environment of trust and transparency where issues are being proactively surfaced and dealt with constructively? Many times leaders are told by their advisors that systems are in place and that good feedback (across and vertically) is happening in the organization, when it simply is not the case. As leaders, we need proof and we must dig deeper. It’s important to ask more questions, listen, require examples and take action ourselves. Invest time to ensure that you are creating an environment of trust and transparency. Don’t rely on the words of others, seek the truth yourself.

David Fahrenthold of the Washington Post write “One great test of any bureaucracy is whether it can effectively deliver bad news to the top of its chain of command.”

The focus is on actions you can take to proactively insure that feedback loops are in place and providing accurate information that is grounded in reality, not fiction. Leaders must be concerned and must take action to ensure that they are getting the news, the good, the bad, and the ugly. My experience has been that most of what top organizational leaders see and hear is exactly what their reports think they want to see and hear.

What To Do
We know that it is our beliefs that drive our behaviors and inform our actions; therefore, leaders must approach the exercise not as if they think everything is “good” in the organization, but rather the opposite. Approach the mission with confidence that there are issues and concerns that you don’t know about. Otherwise, too many leaders will produce findings that once again, align with what they want to find, everything is good and nothing is hidden. Leaders can take the following actions to move beyond the everyday structure that is in place, to create a disruption that will potentially uncover the real story of their organization.

Create a Disruption

#1 – Move beyond the normal channels of communication
Many leaders have standard channels of communication established with the same rhythm and the same people. Take a proactive approach to reaching out directly and gathering information from different communication channels. Specifically, focus on supplementing your formal communication channels with a variety of informal methods in order to make sure you are surfacing issues from employees, and potentially, directly from customers (see # 5).

#2 – Engage with different employees who operate at different levels
As leaders we have our trusted advisors that we rely on and those lower level employees that we may spend time with, are often coached and prepped prior to a meeting with us. Instead of meeting with the “designated” employee that were chosen, pull other employees who were not “officially” selected to participate in your discussions. You can skip levels of traditional feedback and get direct communication from all levels of the organization. Focus more on listening than communicating out to employees. Many leaders have found success in building informal relationships with “influencers” that know the “word on the street” in their organizations. These are often long-service employees, high-performers or others that employee naturally gravitate to when there are problems, issues or questions. Look for drama and frustrations at the surface and search for a deeper problem that might exist.

# 3 – Visit different locations (departments, teams or sub-groups), unexpectedly
When the C-suite leaders visit organizational company sites, too much acting is going on. As the leader of an organization, you will learn more from two unexpected visits to your facilities than you will from ten planned visits. Use the element of surprise and insist on one-to-one meetings with employees periodically, and don’t let their supervisors or managers sit in on your ten minute informal discussions.  Look for inconsistencies in feedback across individuals. Watch body language and facial expressions to see if the discussions are leading to some uncomfortable thoughts. Do everything possible to maintain a patient, positive, and humble attitude as you ask questions and listen intently. Build a reputation for transparency and constructive action at all times.

#4 – Reward employees with special assignment work to support communication, feedback, and to surface potential challenges
In the spirit of “Undercover Boss”, sometimes we need to intentionally move key employees to different roles and locations. Some companies are effectively using special roles or temporary long-term assignments for not just cross-training, but for focus on continuous improvement, strong feedback and for uncovering potential problem areas in the organization. No stone should be unturned and no expense should be spared to ensure that the right information is being delivered to you.  Employees that have good people skills and understand how to evaluate situations to assure fit with your purpose and values are invaluable for helping you understand the pulse of reality in the organization.

# 5 – Get feedback directly from your customers, clients, patients….
One of the key gaps in the VA issue was a real lack of direct patient feedback to the leadership team.   Feedback from employees is not enough. Often we can uncover gaps when we cut through all of the bureaucracy and go directly to our customers for insights into the experience they are having with our organization. More listening and being transparent with our customers directly aligns with A.G. Laffley’s leadership approach where he speaks about seven focus areas to achieve organizational success and growth.

“I didn’t know” is never acceptable
No leader wants to be in the uncomfortable position of saying, “I didn’t know.” By taking proactive steps and approaching your teams and organization as if there may be a problem, you will be in a better position to ensure that there are no cultural barriers prohibiting the flow of honest communication across the organization. As leaders, our best response to the VA scandal is to ensure that we don’t let something similar happen in our own organizations.

Do you agree that these actions can support leaders in their quest to uncover any differences between reality and what is being reported? What other ideas or feedback do you have?

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Kathryn Baker is the owner of AdviCoach of Michigan, a business coaching practice where she and her associates coach business owners and executives, helping them increase profits, build teams of great people and execute on solid strategies for growth. She is the co-founder of the consulting firm The Culture Advantage and CultureUniversity.com. She has over 18 years of business development, sales, marketing, strategic planning, and organizational development experience working with organizations in the technology, industrial, manufacturing and retail spaces.

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