By November 11, 2011 9 Comments Read More →

Honoring Our Troops with Better Service through Lean

Memorial Day Free Download Poster, Graves at Arlington National Cemetery, American Flag, Veterans Day HolidayIn honor of Veterans’ Day (in the U.S.) and Remembrance Day (in Canada, where I spent most of the last two weeks, often wearing a poppy pin), let’s pause to honor those who have served their country. Let’s also maybe think for a minute about how Lean and Six Sigma improvement methods can be used to improve service provide to those who have served.

Much of the noise about Lean and Six Sigma in the current Republican primary season has been about saving money, including a goal of $500 million saved each year in the U.S. Representatives from Newt Gingrich’s campaign have responded to my earlier questions about this (and their support for Strong America Now) by stating that Newt and his team understand that Lean and Six Sigma are a quality program (as they talk about in their initiative, the more smartly named Effective Government Now effort).

So, how do we honor the troops by providing better service to those who have sacrificed so much?

I can really speak best to Lean, as I’m not a Six Sigma guy myself. To me, Lean is a time-based methodology, as Toyota’s Taiichi Ohno wrote in 1988:

“All we are doing is looking at the time line from the moment the customer gives us an order to the point when we collect the cash. And we are reducing that time line by removing the non-value-added wastes.”

Instead of thinking of reducing costs, can we reduce the amount of time it takes to get benefits to wounded soldiers? How can we reduce the timeline to care, treatment, or benefits by reducing delays and non-value-added time?

This has been a problem in recent years, see the article titled “Disability benefit delays affect vets.”

The article tells the story of one vet (one of many) who was wounded in Iraq. Upon his return to the U.S., there was an awful delay in getting him benefits:

Wisenbaguh applied for disability in October 2009. A Department of Veterans Affairs letter with a “yes” answer came in March 2010.

Why in the world does it take so long to get an answer and approval? This is shameful.

Wisenbaguh is not the only one.

Right now, the VA has 265,266 claims that have been pending for more than 125 days, a department spokesman told 24 Hour News 8. The Veterans Benefits Administration, a division of the VA, has a set a goal of completing claims within 125 days, VA spokesman Craig Larson said. The average claim is pending for about 117 days, he said.

The average time to review a claim is 117 days. How much “value added” time is there in the review and approval process? Given typical rules of thumb from the Lean methodology, there’s probably just a few hours of actual review and approval that takes place. Surrounding the value added time are likely lots of delays in what is likely a “batch and queue” process – and I hate to call it a “process.” The vets are injured and they need benefits because they can’t work. We have to do better. How do we improve flow and/or break the bottleneck in that process?

Also, if the AVERAGE is 117, then, given variation, there are going to be many the surpass the average and the goal. Yup, like 265,000+ of them. Six Sigma thinkers (and good Lean thinkers) know to look beyond the average and to look at the distribution and variation in the data set. This process, even compared against it’s nonsensical and arbitrary target, is nowhere near a Six Sigma quality level of just 3.4 defects per million opportunities.

This story also highlights the foolishness in setting goals and targets. The “goal” is 125 days.

As the late Chris Farley said (or his Matt Foley character): Well, la-di-FRICKIN’-da!!! (video) Big deal that you’re hitting your targets (yes, that’s angry sarcasm). The bar is set way too low, in my opinion. 125 days sounds like a horrible goal when wounded vets are living in poverty. This really makes me upset, these awful delays and this waste. Enough!

Traditional management would look at this whole situation and say, “What’s the problem, we are doing better than our target” (leaving out the somewhat meaningless “on average” part).

But we’re not doing right by the soldiers.

Lean thinkers would look and ask “How do we absolutely minimize the time required to get an approval, working toward an ideal state?” We probably don’t want the V.A. to just approve everything and then come after those who are not deserving of the benefits… or maybe that’s actually a better approach. Or, if we do have a legitimate review, maybe it should really only take a week or two, if we have enough capacity in the system and we minimize waste and delays.

So, I leave you again with this plea – for the troops and for all government processes. Let’s quit look at Lean and Six Sigma as a “cost cutting” or “cost reduction” method for government and let’s look at it as a way of saving time, providing better service, and improving quality. That’s what Lean is really all about. Do we have a chance of convincing those in government that this is about effectiveness, not cost? “Waste in government” doesn’t just mean spending money that we shouldn’t be spending. It also means reduce delays, defects, and non-value-added activity.

Interested in this topic? Listen to my podcast with Mike George, founder of the Strong America Now initiative.

What say you? Can we solve this pressing problem and where else can we reduce time and improve quality in government services? I think the Passport office is an obvious opportunity. Please leave a comment and participate in the discussion.
Creative Commons License photo credit: Beverly & Pack


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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an eBook titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

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9 Comments on "Honoring Our Troops with Better Service through Lean"

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  1. Mark Graban
    Twitter:
    says:

    From Facebook:

    “AMEN! ” Let’s quit look at Lean and Six Sigma as a “cost cutting” or “cost reduction” method for government and let’s look at it as a way of saving time, providing better service, and improving quality. That’s what Lean is really all about.” Its not about taking away services to people!”

  2. Mark Graban
    Twitter:
    says:

    One other thought – this really should be a NON-PARTISAN issue. I hope the Obama administration is already working to improve this situation. Lean and Six Sigma should not be of interest just to Republicans, but with the primary season in full swing, it’s natural to have more political discussion in that party right now.

  3. Mark Holthaus says:

    I am a Government Employee who is also a Veteran. I also happen to be a LSS Certified Greenbelt with 40+ Projects in my portfolio.

    I can tell you, the numbers you display in your article are fiction. I have been waiting for the VA to process my claim for an astounding 448 days as of this writing. I have been told this is “standard” and that I have no basis to complain.

    For someone to fabricate a 150 day target, this is hogwash. If the government truly operated on this turnaround, I would be impressed.

    As it is, I can’t get medical care for my service connected disabilites until the VA finalizes my claim. I have filed “hardship” paperwork 90 days ago and still haven’t gotten even a response.

    150 days is a fairy tale.

  4. Mark Holthaus says:

    Sorry. 125 days. This is more like a fantasy than a fairy tale.

    Oh, and a blatant lie by the VA.

  5. Mark Graban
    Twitter:
    says:

    There are also really long waits for Social Security disability benefits:

    Link (WSJ)

  6. Mark Graban
    Twitter:
    says:

    April 2013, this has NOT gotten better.

    http://security.blogs.cnn.com/2013/03/13/veterans-wait-time-for-benefits-is-too-long-va-official-concedes/

    The VA states the average wait time after a veteran files a claim is 273 days. But for veterans filing their first claim, including Iraq and Afghanistan vets, the wait is up to 327 days, nearly two months longer. In big cities such as New York, veterans could wait for almost two years. CIR analyzed the data obtained from a Freedom of Information Act request.

    “When I look at the numbers four years later … it’s not getting better,” Sen. Mark Begich (D-Alaska) stated during the hearing. “I can tell you that the increase in calls in my office are not going down.”

    Mark Graban recently posted..Bob Emiliani’s “Dooming Cycle”My Profile

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