Veterans’ Healthcare system (VHA) is a comprehensive plan that provides preventive services to both outpatients and inpatients in U.S. VHA is a major component of United States department of veteran affairs that administers medical provisions through various outpatient hospitals, nursing homes, clinics and medical centers (Kovner Anthony, 2005). The healthcare system through support of government began its efforts to redesign its system in 1995 with an objective of providing high quality healthcare services to its patients. It has become one of the well known institutions that support the health of veterans in a consistent manner. Recently, national headlines have proclaimed VHA as one of the most effective and efficient healthcare system in the nation. This is a clear indication that VHA has undergone numerous transformations before reaching its current state. In this connection, a major concern is establishment of the effect changes have on both efficiency and effectiveness in organization. Relating this matter to VHA, organizations undergo certain transformation that leads to efficiency and effectiveness in carrying on with their duties.
VHA has a long history since its establishment in 1778 that relates to its status currently. Like any other organization, VHA underwent certain changes meant to provide quality healthcare. Redesign models applied by VHA began to bear fruits in 1980’s a time several outpatient clinics were opened. In the mid 1990’s VHA undertook a major transformation step that aimed at improving efficiency of care to its patients. The transformation during this period included elimination of underutilized inpatient facilities such as bed, expansion of outpatient clinics, and restructuring of eligible rules. Another area of redesign was tracking number of performance indicators that included ensuring senior managers are fully responsible for performance and ensuring effectiveness in medical provisions. These measures are similar to those undertaken by organizations, business entities and individuals in the corporate world. Transformation redesign model in VHA that relates to organizational model include leadership, alignment, will, improvement initiatives and integration.
Transformation or changes in an organization is associated with certain effects on efficiency and effectiveness as pertains to VHA. Efficiency in this aspect means the act of carrying out actions quickly and produces results with little effort. Effectiveness is the degree to which actual outputs of a system corresponds to its planned or desired outputs. It means producing powerful effects that relates to satisfaction of customers, patients and individuals. Change is a very important aspect as it helps organizations or entities such as VHA to effectively achieve efficient results. Performance in this scope is a relevant concept that is brought about by a number of transformations within organizations. The managers in any kind of organization should be guided by the principle of performance through adoption of changes (Stevens Rosemary, 2006). As it involves VHA, senior managers are accountable for implementation of strategies that transforms performance within the entity. One effect of change therefore is on the application of little efforts to realize big dreams. Resources are of essence in any kind of organization, changes that lead to efficient use of resources support the general output. Changes in organization affect the manner in which employees work to produce good results. This is a category of effectiveness whereby service provision is done in a manner that results to powerful effects. In the case of VHA, the objective of adopting numerous changes was to effectively provide high quality health care to its veterans. This is an issue of changing mechanism of leadership in the aspect of hiring management with the goal of achieving the system’s goals. Another positive effect of change within an organization as it concerns VHA is the aspect of leadership. Transformation in leadership models is an important consideration that relates to commitment, individual involvement, passion and involving all levels of leadership. Leadership is a very important aspect in transformation capabilities that makes an entity achieve its goals. Personal involvement in the activities of an organization ensures that all efforts are centered towards coordination of activities that results to effectiveness in customer satisfaction. In the aspect of VHA, leadership is a core value relented by senior management and it is one measure that has made the healthcare system provide high quality services to its patients (Asch Steven, 2008). Leaders at VHA are very committed to their work and this is one of the redesign model adopted since 1995 and has seen veterans in U.S access quality medication.
Change on the other hand, within organization has negative effects from the employee’s perspective. Transformation within organization come with positive and negative implications that are welcomed and others threaten job security of employees. Once an organization begins to change, its employees face threats to their positions, jobs, title, roles and resources. In this aspect employees begin to loose trust with their organization. Once the employees have a negative attitude towards their organization, their capacity to work is affected and this lowers organization’s dignity. The perception of employees towards changes implemented within an organization determines entirely n the success or failure of the implementations. In this aspect, when employees contemplate the stress associated with organizational change, their working attitudes, perceptions and reaction strongly determine whether organization will perform efficiently. IN respect to VHA redesign model in culture, senior management was very careful to align manful employee goals and accountability as a counter measure for performance. Alignment of employee goals is a change that results to successful matching of resources with goals for good results.
Evolution of organization design as it relates to the VHA.
VHA has undergone a number of changes that relates to various aspects leading to improvement and learning. The main objective of adopting changes by VHA is the culture of providing high quality medical services and continuous improvement in various aspects of organization. Evolution of design in VHA began with changes in health care systems that relates to alignment, integration, leadership and the will to improve service delivery. Evolution of organization design is linked with the knowledge on how to measure demand and supply, reduce queues, reduce demand, increase supply, optimize environment, manage contingencies, eliminate backlog and predict outcome (Kowalski Dan et al, 2003). A major analysis of organization design evolution relates to certain components such as first, organization work, which constitutes of purpose, objectives and goals. The desire for any organization is to define its purpose, objectives and goals before commencement of operations. This is a very important aspect that makes an organization develop models that transforms its operations. Second, evolution of design within organization is based on the worker. This relates to experiences, capacities, skills, training and education. Consideration of these models makes an organization to meet its goals. Third, work content is the basis for design evolution within organizations as it relates to functions, activates, tasks, performance standards and sub functions. Change within organization is initiated in relation to associated performance measures and activities related to mission statement. In VHA, senior managers considered work organization, worker and work content as the initial step towards evolution of design models. Considering the three components, the healthcare system for veterans in U.S adopted inpatient and outpatient systems redesign, and administrative system design. The change in this aspect led to improvement in service provision and conducting of training. Communication of important message was another design measure implemented by senior managers in VHA (Eastaugh Steven, 1992). Working towards organization dreams is a major reason for implementing strategies that leads to changes in operations. The evolution of organization design in VHA was a very critical step that has made such a system become one of the most efficient and effective veteran’s healthcare system in U.S.
An interview with one of military retirees convinced me about specific changes and improvements he has seen in quality of VHA healthcare services. The retiree provided that VHA has expanded its medical services to cover both men and women including homeless veterans. He said that VHA supports research and training programs in specific area of geriatrics, palliative care, and spinal cord injuries. Another important development is involvement in academic affiliations that saw thousand physicians trained. The retiree provided that leadership has transformed the mechanism of providing medical services to ineligible veterans on the basis of financial need. The retiree claimed that the major change in VHA was the initiative of transition from department of defense health care to VA care based on conditions experienced in Iraq. Leadership has transformed from corrupt to committed leaders who saw the system become more efficient.
References:
Kovner Anthony, 2005, Jonas and Kovner’s Health Care Delivery in the United States, Springer.
Stevens Rosemary, 2006, History and Health Policy in the United States: Putting the Past Back in, Rutgers University Press.
Asch Steven, 2008, Enhancing Organizational Change and Improvement Prospects: Lessons from an HIV testing Intervention for veterans, Human Resource Planning, Vol.67.
Kowalski Dan et al, 2003, Reducing Workplace stress and Aggression: An Action Research Project at the U.S. Department of Veterans Affairs, Human Resource Planning, Vol. 26.
Eastaugh Steven, 1992, Health Care Finance: Economic Incentives and Productivity Enhancement, Auburn House.
