Articles

The VA might actually be getting its act together

Trying to emerge from scandals that shook the agency to its core, the U.S. Department of Veterans Affairs is attempting to overhaul what officials admit was sometimes pretty bad customer service.


Quietly, since 2015, the U.S Department of Veterans Affairs has built a national Veterans Experience Office.

The office's first steps have been rolling out over 100 community veterans committees nationwide and retraining employees to be less rigid and more customer-focused.

The VA even hired professional writers to redraft the language of 1,200 official letter templates to make them more reader friendly.

"(We) had somehow gotten away from the primary mission of organizing the enterprise through the eyes of the customer," said Joy White, who leads the office's Pacific district, which includes California and the West Coast.

"(We did) things that made sense to us, made it easy for us as the VA," White said. "But, in all of that, we lost the voice of the customer."

The task at hand: How to change the culture of a massive federal agency that provides everything from medical care to monthly disability checks to funerals.

Or her widow, Mr. President. Or her widow. (Photo: Veterans Affairs)

Some might wonder if — with what's a famously dense bureaucracy — it can be done. Even new VA Secretary David Shulkin has said it's a struggle to fire bad apples, including employees who watch porn on the job.

The new Veterans Experience Office's budget this fiscal year is $55.4 million, up from $49 million last year, "to lead the My VA transformation," according to a budget document. About 150 jobs now fall under this office's umbrella.

Two years in, the nation's veterans organizations are still taking a wait-and-see position.

"We're not sure how much the VEO has improved the VA to date, but we are encouraged by this initiative and hope to see it succeed," said Joe Plenzler, American Legion spokesman. "Any effort to improve dialogue between veterans and VA employees and administrators is time and money well spent."

One vocal critic of the VA said the office has potential but not if it tries to just "paper over" structural issues facing the veterans agency.

"Doing things that are more feel-good measures, but actually don't address some of the core problems of the VA, could distract from what's needed to be done," said Dan Caldwell, policy director at Concerned Veterans for America.

"That's the danger I see, potentially, with this office. But I want to say there's a lot of opportunity here. If this office is managed well and insists that they are here to improve the outcomes for veterans — and not just 'the experience' — they could be successful."

Also read: The VA is set to lower copays for prescriptions

The "veterans experience" campaign started under former VA Secretary Bob McDonald, the retired Proctor & Gamble chief executive brought in by President Barack Obama in mid-2014 following a national scandal over wait times for VA medical care.

McDonald installed a "chief veterans experience officer" in early 2015.

The office reports directly to the VA secretary — now Shulkin, a doctor and health-care executive who is the first non-veteran to lead the agency.

Whether he will continue the "experience" campaign is an open question.

However, in April he named Lynda Davis, a former Army officer and Pentagon civilian executive with experience in personnel and suicide prevention, to head the office. She replaces a former McDonald's executive, Tom Allin, who held the job for about two years.

Talihina Veterans Center (Oklahona Department of Veterans Affairs)

Some of the hiring was for "human-centered design" teams. These teams, which include people from Stanford's prestigious D School, are supposed to re-engineer VA routines that aren't working.

They produced a "journey map" showing what VA patients experience.

It identifies "pain points" along the way, such as cancelled appointments. It also calls out "moments that matter," such as the check-in process and whether it's hard or easy to park.

Two early goals were to establish one consumer-oriented website and one toll-free telephone number for all VA divisions. The result was vets.gov and 1 (844) My-VA311.

The VA is now looking for inspiration from national brands famous for good service. Starbucks, Marriott, and Walgreens are on the list.

"We get the experience that we design. Historically, we haven't put an emphasis as an organization on customer service. There was no program of record that said 'this how we do customer service,'" White told the San Diego Union-Tribune.

"You walk into a Starbucks anywhere in the country, there is something that looks and feels very familiar wherever you go."

Also read: Starbucks donated free coffee to every US service member in Afghanistan

One change the Veterans Experience Office has led: hiring for customer-service skills, instead of just looking for people qualified for a position.

"We weren't hiring for attitude," said White, who said her office identified questions to insert in the VA's interview process to draw out whether an applicant had customer service aptitude.

In a changing health-care industry, this is a bandwagon that the VA is belatedly jumping on.

Other hospital organizations have rebooted their customer experience in the past decade in response to a shift in Medicare reimbursement policy that now rewards for patient satisfaction, experts said. The power of social media is also a factor.

The Cleveland Clinic was the first major academic medical center to appoint a chief experience officer in 2007. Across the country, hospitals have built grand entrances, opened restaurants intended to draw non-patients and put flowers by bedsides.

"My sense of it is that we live in the age of the empowered consumer," said John Romley, an economist at the University of Southern California's Schaeffer center for health policy.

"VA customers maybe have less choice in the matter, but at the same time, there's a great deal of sensitivity in the broader population about how we treat these people in the VA system."

The VA's new customer service motto — Own the Moment — sounds a bit like a commercial TV jingle.

Training is rolling out across the country, including at the La Jolla VA hospital.

The premise: Each VA employee should "own" their time with a customer, the veteran, and do their best to ensure the person gets the help he or she needs.

That contrasts to the like-it-or-lump-it experience that veterans have sometimes complained about in the past.

"We're moving away from a rules-based organization to a more of what we call a values, principle-based organization," said Allan Castellanos, the VA employee teaching the La Jolla seminar.

"I call it more like integrated ethics, like doing the right thing for the right reason," he said.

The employees were shown a video of VA workers going the extra mile to welcome an uncertain new veteran into a clinic.

In another, VA workers allowed the family of a dying veteran to bring his horse onto hospital grounds.

The VA is trying to emerge from bunker mentality after back-to-back national embarrassments.

First, in 2013, the backlog of disability claims rose to mountainous proportions, bringing down the wrath of Congress and the public.

We just wanna see more vets smiling. (Photo: U.S. Department of Veterans Affairs)

Then, in 2014, news reports revealed that VA medical workers were keeping secret lists of patients waiting for appointments to make wait-time data appear satisfactory.

All of this occurred as the VA struggled to handle a flood of new veterans coming home from the Iraq and Afghanistan wars.

A few of the ideas being pursued by the Veterans Experience Office have origins in San Diego.

Officials acknowledge that what they are calling Community Veterans Experience Boards — the 152 community boards they eventually want to create nationally — came from San Diego's longstanding example.

San Diego veterans leaders meet monthly with VA officials here in both closed-door and public sessions.

Additionally, the tragic suicide of 35-year-old Marine Corps veteran Jeremy Sears appears to have helped spur a campaign to redraft VA correspondence to make it more user friendly.

Sears shot himself at an Oceanside gun range in 2014 after being rejected for VA disability benefits despite the cumulative effects of several combat tours.

Veterans advocates suggested that the VA rejection letter could have offered advice on where to go for counseling and other assistance, instead of just a "no."

"That was one of the 'pain points' that was identified," White said, referring to the veteran's "journey mapping" that her office did. "There was a lot of legalese, when in fact we just want it to be simple and clean."

They started with the Veterans Benefit Administration's correspondence and are working their way toward the Veterans Health Administration's appointment cards.

Veterans Experience Office officials first told the Union-Tribune that they could provide examples of the rewritten letter formats, but later said they weren't ready yet.

The Veterans Experience Office, headquartered in Washington, now has split the country into five districts and dispatched "relationship managers" to each.

The Veterans Experience Office is now trying to finesse those moments that matter to veterans. In 2017, officials expect to roll out a veterans real-time feedback tool in 10 locations. They also plan to release a patient experience "program of record."

"Our goal is to build trust with veterans, their family members, and survivors," White said. "How do we do that? By bringing their voices to everything we do."

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