‘Lean Six Sigma’ comes to the VA; Collins cheers

WASHINGTON – Veterans Secretary Robert A. McDonald on Friday spelled out his progress and plans for revamping the long-troubled VA health care system – and his plans sound a bit like those of then-Erie County Executive Chris Collins, circa 2007.

“We started training leaders on Lean Six Sigma last month,” McDonald said at a National Press Club luncheon. “By December 2016, we intend to have 10 percent of leaders trained.”

For those of you who don’t remember, Lean Six Sigma is the business-world tool Collins utilized to try to streamline county government and improve county services.

Now a Republican congressman from Clarence, Collins still swears by Lean Six Sigma – even though he lost his 2011 re-election bid as county executive after his opponent, Democratic County Executive Mark Poloncarz, argued that the savings supposedly produced by the management technique were overblown. And in an interview earlier this year, Poloncarz said he took pride in making county government “less Lean Six Sigma-like.”

But it’s clear that McDonald, whom President Obama appointed to head the Department of Veterans Affairs 15 months ago, thinks highly of Lean Six Sigma.

Asked what prompted him to bring the business-management tool to the world of veterans services, McDonald got a don’t-you-know-already look on his face.

“This is what the business world has been doing for years,” said McDonald, a retired chairman of Procter & Gamble.

The “lean” management techniques, pioneered by Toyota, “improve service speed or lead time by eliminating the waste in any process,” according to the Lean Six Sigma Institute. Meantime, Six Sigma – developed by Motorola – “improves the quality of products and services by eliminating variability.”

To make the VA more efficient, McDonald is combining Lean Six Sigma with another management technique called Human-Centered Design.

“Great customer service companies use Human Centered Design to understand what customers want and need, and then design customer experiences to meet those needs,” he said in his speech. “Lean Six Sigma makes these processes effective, efficient and repeatable.”

McDonald said that’s just the kind of new thinking he is trying to instill at the VA, which he joined at a low point in the agency’s history in the middle of last year.

Scandals at the agency stretched from coast to coast: In Buffalo, the problems had been the reuse of contaminated needles and poor record storage; in Phoenix, the problem was long delays in medical appointments that officials tried to cover up.

To fix all that, “we’re bringing the best practices from business to government,” McDonald told reporters after the speech. “And what we find is it works.”

McDonald spelled out the VA’s progress in his speech. Most notably, thanks to the addition of more than 15,000 staffers nationwide, the long wait times for medical appointments appear to be coming to an end, he said.

Between June 2014 and June of this year, the VA completed 7 million more medical appointments than it did in the prior year.

“Right now, 97 percent of appointments are within 30 days, 92 percent are within 14 days, 87 percent are within seven days, and 23 percent are same day,” McDonald said. “Specialty care wait time is six days. Primary care is four days. Mental health care is three days.”

The VA also has speeded up the processing of claims. Veterans now have to wait about 93 days for claims decisions, which is six months shorter than the wait in early 2013.

And all that happened before Lean Six Sigma came to the VA – which is something that makes Collins very happy.

Told of McDonald’s comments, Collins said: “That’s some of the best news I’ve heard in a long time. There’s a good chance, then, that they’re going to get the problems at the VA fixed. … I have great hopes that this will make for a profound, positive change.”