Article accessed through Kaiser Health Blog

http://politi.co/1n9zCjA VA Whistleblowers to Detail Retribution

According the whistleblowers interviewed for this article, the VA had a pervasive culture of punishing anyone who raised questions about safety, quality, or fulfilling the core values of the VA (French, 2014). The VA’s website states that the core values – integrity, commitment, advocacy, respect and excellence (I CARE) – define the culture of the organization and how it cares for veterans. However, when some employees attempted to make changes that improved the care of veterans, or exposed problems that jeopardized the safety of veterans, they were demoted, sidelined, fired, or sued. In reality, the stated values of the VA culture and the actual values of the VA culture were not aligned, and this misalignment is a serious impediment to organizational health. “The importance of values in creating clarity and enabling a company to become healthy cannot be overstated” (Lencioni, 2012, p. 91).

• A values-based culture is strengthened by leaders who demonstrate application of the values in large a small ways everyway (Daft, 2012). Members of the organization learn the values of the organization by watching the leaders, and not by being told what the values are (Daft, 2012). In an organization with a constructive culture, leaders value whistle-blowers and react swiftly to correct problems for the benefit of the organization, instead of focusing on the harm to a specific department that exposing problems may cause (Daft, 2012). Unfortunately, in the examples cited in this article, employees at all levels valued personal convenience over serving the needs of veterans (French, 2014).
• Core values already exist and do not change over time (Lencioni, 2012). Aspirational values are values that an organization wants to develop (Lencioni, 2012). It is common for organizations to confuse core values and aspirational values (Lencioni, 2012). According to employees interviewed in this article, I would conclude that the VA labeled its aspirational values as core values (French, 2014). Therefore, there was no clarity for employees, which is vital to organizational health (Lencioni, 2012).
• Rolland states that whistle blowing happens in healthcare organizations that place loyalty to the organization above loyalty to the patients (2008). In the Politico article, the general reaction to safety concerns voiced by whistleblowers is to protect the VA and the status quo, at the expense of the patients (French, 2014).  It is the leaders’ responsibility to communicate the ethics and values of the organization, and to be responsive when problems are reported through internal channels (Rolland, 2009).

A well-known example of the ailing organizational health of the VA is the scandal related to wait times for veterans to get appointments. In some instances, schedulers were pressured to falsify wait times for appointments, and many veterans waited months for urgent appointments. (Oppel & Goodnough, 2014). The repercussions of that scandal and the harm in caused to the VA and to veterans continues to make news.

References

Daft, R. (2012). Chapter 10: Organizational culture and ethical values. Organization Theory and Design. Cengage Learning. London. 390-429.

French, L. (2014) VA whistleblowers to detail retribution.  Politico.  Retrieved from http://politi.co/1n9zCjA

Lencioni, P. (2012). The Advantage: Why Organizational Health Trumps Everything Else in Business, Jossey-Bass: A Wiley Imprint. San Francisco, CA.

Oppel, R. A., & Goodnough, A. (2014). Doctor shortage is cited in delays at VA hospitals. The New York Times. Retrieved from http://www.nytimes.com/2014/05/30/us/doctor-shortages-cited-in-va-hospital-waits.html

Rolland, P. (2009). Whistle blowing in healthcare: an organizational failure in ethics and leadership. Internet Journal Of Law, Healthcare And Ethics, 6(1), 11.). Retrieved from http://ispub.com/IJLHE/6/1/9204#

U.S. Department of Veterans Affairs. (n.d.) Mission, Vision, Core Values & Goals. Retrieved from http://www.va.gov/about_va/mission.asp