IT to the rescue: Unraveling bureaucracy at the VA, one project at a time

How a small, fast SWAT team is improving performance at the Department of Veterans Affairs.

In person, it's hard to think of David Paschane as small -- he's 6 feet 5 inches tall. But when you consider his position within the vast U.S. Department of Veterans Affairs (VA), it's clear he's playing the role of a little guy tackling a big, big bureaucracy.

Paschane, 44, is director of the Office of Strategic Services (OSS), a small, SWAT-like team within the VA's Office of Information & Technology (OI&T). The group consists of Paschane, two junior staffers and two contractors.

A performance engineer by training, Paschane's motivating vision is to transform heavy bureaucracies -- where organizational structure controls the people -- into what he calls "light enterprises," where structure is there to serve the people.

If he was looking for heavy bureaucracy, Paschane came to the right place. The OI&T operation at the VA Central Office (VACO) in Washington, with an annual budget of $48 million, employs some 200 IT workers who provide tech support services to 10,000 customers, including 400 members of the Senior Executive Service. Nationwide, the VA employs about 327,000 people (not counting contractors), runs 152 hospitals, 821 outpatient clinics and 300 vet centers, and commands an annual budget of $187 billion. The IT budget alone was $3.1 billion in 2012.

To its critics, the department is bureaucracy at its worst. And indeed, the VA has come in for blistering criticism from all corners in recent weeks for a staggering backlog in the processing of benefits claims that has some veterans waiting as long as a year and a half for resolution. The problems are widely viewed as being partly political and partly regulatory, but also partly the responsibility of a top-heavy, slow-moving IT organization.

In a chat with Computerworld's Tracy Mayor, David Paschane from the Department of Veteran's Affairs talks about his vision of using information technology to make work "more human."

To Paschane, it's the perfect place to start asking the big questions. As he gives an impromptu tour through the maze of cubicles that make up the VACO IT operation, he asks, "How do people affect the performance of an organization? What is this thing called bureaucracy?" And, most pressing, "How do we learn to get better at what we do?"

Paschane has a Ph.D. from the University of Washington in Seattle, where he developed an organizational discipline -- Performance Architectural Science Systems (PASS) -- that aims to answer some of those questions.

PASS is built around the assumption that "unexamined, undisciplined work structures restrict employee growth and lead to inflexible, stagnant operations," says Paschane. On the flip side, he explains, light enterprises are able to respond dynamically to customer demands because their structure is adapted to fit their mission and goals.

Organizations move from A to B, from heavy to light, by tapping both information value and people value, Paschane says. In particular, he is interested in "collegial work" -- that is, optimizing the value of people and information acting together to improve the performance of an organization.

At least, that's the theory.

In his nine-year tenure at the VA, Paschane has launched and overseen more than 25 engineering projects of varying scope and size that have all in one way or another produced a better fit between data and organizational structure, but they haven't brought about revolutionary organizational change -- yet.

Paschane landed in his current position in the Office of Information & Technology at the behest of Horace Blackman, CIO of National Capital Region IT at the VA (and a 2013 Computerworld Premier 100 IT Leader).

Blackman recalls that VACO IT had "17 different missions and 17 different customers" when he assumed his duties as head of a group that's in charge of servicing the VA's police department, administrative court system and the office of a cabinet-level secretary, among other customers. The IT group had been hampered by frequent reorganizations and relocations, high staff turnover that saw new hires replacing retiring experts, and undocumented procedures and poor communications that were unable to keep up with the agency's dynamic and expanding service offerings.

Paschane talks about the results he's seeing from conducting multiple, simultaneous projects at the VA.

Blackman wasn't long at his new position, which he assumed in 2009, before he saw there was room for a performance engineer on his team, and Paschane moved over from a position in the VA's Office of Policy and Programs. The two created the OSS group in 2011.

As part of a three-year transformational effort by OI&T to revamp how IT services are delivered at VA headquarters, OSS staffers and IT volunteers formed multiple ad hoc Method Enhancement Teams (MET) to tackle specific problems. Teams of eight to 10 people brainstormed with subject-matter experts to create and implement action plans for redesigning areas critical to operational performance.

One result of their efforts: performance dashboards that give IT employees a visual representation of their effectiveness in solving help desk, Tier 1 and Tier 2 problems for customers.

MET teams have not only improved performance; they've also upped morale, says Blackman. "It's harder to measure, but from my perspective, the fact that we've engaged people in the change-management process, that we see their ideas coming to fruition, is a pretty significant accomplishment," he says. "You don't want to be reckless and jump on every idea that's proposed, but you have to be willing to listen. Innovation comes from the ground up."

As chief learning officer at the Veterans Health Administration (VHA), Jim Warner is charged with supporting continuing education requirements for the whole workforce, a not inconsiderable task: The VHA is the country's largest integrated healthcare system, with some 270,000 clinical professionals at more than 1,700 sites of care serving 8.3 million veterans per year.

Shortly after his arrival in August 2012, Warner found himself struggling to get his arms around the multi-tentacled systems that track continuing education. On one side, he needs to reduce costs by being better able to ensure that practitioners are getting approval only for courses they actually need and by making sure those courses are delivered in the most cost-effective ways.

On the other side, Warner wants to streamline the process by which the VHA interacts with the 13 different credentialing associations, such as the American College of Healthcare Executives, that grant medical and healthcare practitioner certifications, each of which has unique and constantly changing requirements.

"My question to [Paschane] was, 'How do I use my experts -- my human capital -- in a more efficient way?'" says Warner. "Through PASS, we are looking at the entire system end to end."

Paschane elaborates: "Essentially we are re-engineering the way VHA analyzes requests and approves conferences by subjecting data to more rigorous review," he says. "We're cleaning the data and making it fit the structure so the internal core operation is smarter and more effective."

The expected end result: The 450 analysts who serve the continuing education needs of the entire VHA organization will be able to more accurately assess continuing education requests, getting practitioners approval for the right training more quickly.

"What's really powerful about this is that we're freeing our human capital to focus more on the exceptions and less on the routine," says Warner. "We're able to put more resident expertise into the software, build more of the process into the [system], which allows us to increase capacity without a significant increase in cost or in human resources," he says.

Paschane describes Method Enhancement Teams, which benefit both the VA as an organization and individual IT employees.

As Deputy Assistant Secretary for Administration in the VA's Office of Administration (OA), Roy Hurndon's portfolio of responsibilities is vast. His customers are 10,000 VA staffers in the Washington area; the services he offers them include transportation, facilities management, health and wellness, environmental safety, media support, protocol requirements for cabinet-level employees, and more.

Hurndon has worked with the OSS on several projects aimed at using data in new ways to improve decision-making and reaction times within his organization.

In keeping the PASS discipline's commitment to monitor "emergent thinking" on performance from employees and customers, the OSS team designed and analyzed a rapid comment-card system and a more in-depth annual customer survey.

The digital comment cards, available via the VA's intranet, are engineered so administrative office staffers are notified immediately if there is a problem. For example, if a shuttle bus failed to show up at a scheduled stop, the comment-card system would make it easy to dispatch staffers to remedy the situation.

"Most comment cards are drop-down windows where you select your problem from a list of issues," explains Suzanne Campbell, a program specialist with the OA. "David's team went one step further and added a section where employees can actually type in their specific concerns. This has been a big hit," she says. "VA employees have truly appreciated the personal side of this program, and I do too."

Analysis of data from the survey, which goes out to 5,000 employees once a year, can reveal longer-term adjustments that make sense for the organization. For example, Hurndon says his office recently adjusted the makeup of the fleet of vehicles used to transport senior leaders within the national capital region after survey results suggested that shuttle buses would, in some cases, be more rapid, flexible and efficient than individual cars.

We're trying to take down bureaucracy bit by bit, and yes, there has to be a desire among top leadership for that to happen. David Paschane, Department of Veteran's Affairs

In the area of facilities management, Hurndon's organization teamed with the U.S. General Services Administration to install meters to monitor water and energy usage building by building. Paschane's OSS group filled the gaps with an application that presents the data from those meters in a way that lets service directors take specific actions -- or urge employees to do so -- to reduce costs related to heating and cooling, lighting and energy consumed by IT systems and other equipment.

"David's group is effective at distilling data into usable bits that help us with actionable decision-making," Hurndon says of the project, which has the potential to save $3.5 million over 10 years.

To address the ongoing and rising costs of space management, Paschane and his team are in the process of developing a tenant use optimization scorecard for Hurndon's group that will give executives a snapshot of how their policy and management decisions -- including leasing vs. owning, where to house contractors, and the extent of any telecommuting policies -- compare against 170 mixed-use federal facilities in the Washington area. "There are no easy sensors for collecting that data," Paschane explains. "Up until now, it's been scanned from paper or self-reported."

As successful as the OSS projects for OI&T, VHA, OA and other departments have been, it's unclear if they will generate enough momentum to achieve the overarching vision of Paschane's PASS discipline -- to "change the nature of work" inside a vast organization not known for agility.

"If you look at the performance statistics of the VA, whatever they're doing is not working," says Chris McGoff, founder and CEO of The Clearing, a Washington consultancy that specializes in change management. "What I like about [Paschane's] work is his focus on both collective and individual change, the local tribal change and the overall leadership change."

It's the latter that's likely to prove most challenging, McGoff warns. "David has a lot of passion, but as we know, 90% of corporate change-management projects fail," he points out. "The question becomes, can the VA afford to shrink from this challenge? Will they find the moral conviction to beat those odds?"

"We're trying to take down bureaucracy bit by bit, and yes, there has to be a desire among top leadership for that to happen," acknowledges Paschane. "If we get support and commitment from the top, we can get in there and start working."

This article, IT to the rescue: Unraveling bureaucracy at the VA, was originally published at Computerworld.com.

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This story, "IT to the rescue: Unraveling bureaucracy at the VA, one project at a time" was originally published by Computerworld.

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