tag:blogger.com,1999:blog-32053362.post6169100466725879676..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: Madder than hellPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-32053362.post-34468038802429345732014-05-26T10:08:36.944-04:002014-05-26T10:08:36.944-04:00This is also a good overview on the whole VA situa...This is also a good overview on the whole VA situation. <br />http://www.forbes.com/sites/harlankrumholz/2014/05/23/3-things-to-know-before-you-rush-to-judgment-about-va-health-system/<br />Robinhttps://www.blogger.com/profile/09217934540000926776noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-54885932129925810262014-05-21T12:01:56.005-04:002014-05-21T12:01:56.005-04:00While I agree with the root cause analysis approac...While I agree with the root cause analysis approach, the solutions may prove much harder to implement than in the private sector.<br /><br />There are a host of potential issues in the VA scandal. First, there may be a bureaucratic culture that demands that metrics set at the top must be met at all costs and bad things are likely to happen if they aren’t met. Some VA hospitals with large concentrations of veterans nearby may be overwhelmed with vets needing services while others may have so much excess capacity they should probably be downsized or even closed and replaced with urgent care clinics but the political process makes it incredibly difficult to close a hospital. Some regions may need to add more primary care doctors to reduce wait times but don’t have the budget authority to do so. It might be perfectly appropriate for managers to focus on different issues in different regions but the bureaucracy insists on a one size fits all approach. In light of the bureaucratic rigidity and a civil service culture that makes it extremely difficult to fire people who are not political appointees, the president’s options to effect change are probably much more limited than they should be. The same is likely true for VA Secretary Shenseki. <br /><br />Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-33544928991289097052014-05-21T09:43:06.696-04:002014-05-21T09:43:06.696-04:00TOTALLY - spot on - no leadership! TOTALLY - spot on - no leadership! Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-58026924439079366382014-05-21T09:42:40.486-04:002014-05-21T09:42:40.486-04:00Completely agree. I was thinking. "You are ...Completely agree. I was thinking. "You are mad again that someone in your administration screwed up? Seriously." How about taking responsibility and fixing the problem?Davidnoreply@blogger.com