Word Plasticity – The Scourge of the Modern World

 

 

 

 

 

Non Sequitur - Plasticity of LanguageConsider the following term ‘Flaccid,’ which is often mispronounced as “flassid” instead of the proper pronouncement “Flakcid” (Calvert, 2008).  Whereas, the term ‘Decimate’ does not mean extreme destruction, but the death of every tenth man and originates from Roman Military punishment (Calvert, 2008).  These are but two popular terms that are regularly plasticized in English communication through mispronunciation, lack of understanding the definition, and always with a hidden agenda.  Everywhere in all societies, and throughout all of recorded history, we find intentional misconception being passed as intellectual depth, through the plasticization of words.  Plasticization of words is nothing more than disconnecting words from standard definitions for a personal political agenda.  Many engaged in the intentional plasticization of words are “thought terrorists” who are trying to run their plan and break the mental will of people, demonizing those with knowledge of words as ignorant, and using the court of public opinion to employ emotions as a means to kill debate.

Plasticized words make the most trouble and unfortunately, public education in America does not appear to care; in fact, public educators are some of the worst abusers of words, disconnecting words from meanings to achieve an agenda, again mental terrorism.  Poerksen (1995) discusses this phenomenon in some detail, and the need to be more cognizant of the problem is but a small part of the solution.  Poerksen (1995) for example brings up the term ‘strategy’ the context might not be clear, and without specifying the intention and meaning, the audience becomes lost very quickly, but be confident they know and are doing what they understood.

Hitler’s Germany was famous for plasticizing words to make socially unacceptable actions, to be understood as acceptable with no negative consequences.  Consider how cattle cars were used in the transportation of Jewish Citizens, by plasticizing the term “cattle” the Jews could be eliminated, society could consider what they were doing as acceptable, and the political agenda of Hitler was pushed forward, because a human of different religion, handicap, and so forth has been reduced to cattle.

Poerksen (1995) is correct in labeling those who intentionally destroy language through plastic words as tyrants and their actions tyrannical.  Mao was an excellent speaker, but his methods of deceiving included making words plastic to cover abuses of people, destruction of lives, and to help his followers feel good about what they were doing.  Ex-President Obama used a TelePrompTer because extemporaneous speaking is not his forte, and because of the plastic words which were bent, twisted, and molded to deceive.  We all remember the promises of Ex-President Obama where ObamaCare is concerned.  However, what is fading from the collective public memory are the plastic expressions lauded upon Bergdahl to justify nefarious actions.  Bergdahl is but one small example of how Ex-President Obama manipulated language to hide, obfuscate, denigrate, and deride the American People.

Stretched Words

Shakespeare (2016) uses Hamlet to relate a line that applies to frequently; especially when communicating online, “… thou doth protest too much, methinks.”  Too often, those intent on misusing words are the ones protesting too much about something and now every communication, every interaction, and every person is a threat that must be lorded over by the intellect of the one protesting.  A recent example of this the world witnessed during Justice Kavanaugh’s confirmation process, where the judge’s children were physically and verbally assaulted, but a warping of legal rights and guarantees justified the assault.  A careful review of any newspaper, news broadcast, and many politicians speaking will evidence the plasticization of words to justify actions, e.g. President Clinton, “Depends on what your definition of “is” is,” words to couch a threat while seeming to be helpful and friendly, or worst of all hide abuses of others through twisted logic.  Every time words become disconnected from standard meanings, society crumbles, language becomes useless, and the consequences are multi-generational.  Exactly as what transpired in recovering Germany after Hitler’s demise.

I had the great personal pleasure of speaking to a senior from Germany who lived through Hitler’s oppression and the recovery of Germany post-WWII, and the person I spoke with affirmed the most difficult social problem was relearning words and definitions to communicate without the taint of Hitler’s Germanic Language.  Hence, we can draw several lessons from this experience, language is trained and can be retrained, relearning language is a social problem fixed through social interactions and personal knowledge, and personal responsibility and accountability remain pre-eminent in communicating correctly.  Another lesson from my experience, history repeats itself and those with dastardly designs will always corrupt language to gain the advantage, before showing their true colors.  Every single despot in recorded history has employed plastic language to lull the population into acquiescence, before demanding loyalty.

What is a person to do in these difficult times?

Words Defined

  1. Know words and their definitions. Accurately knowing and using language supports society and improves communication. Do not be afraid of dictionaries, thesauruses’, and asking for help in making sure word selection is the best it possibly can.
  2. Ask questions about words used when unsure. If you know a word’s definition and the context appears to be off, be brave, ask questions, and insist upon the other person either clarifying or using more simple language to prove their point.
  3. Stop all use of emotion in communication. The people who insist upon employing passion do so to thwart logic, stop debate, and ruin lives.  If the sender wants to use emotion, stop talking, stop listening, and let the sender belittle themselves.
  4. Speak simply. Write simply.  Language and punctuation are excellent tools to communicate, use them, not emotion, not complicated terms, and know your intent in communicating.
  5. Speak and write specifically. Pronunciation, annunciation, and clarity come with simplicity and desire to build value for others through communicating correctly.  Know the intent of your communications.  Know and understand the purpose.  Answer through the message, “What do I want the receiver to do or know?”
  6. Listen. Forget active listening; active listening is not satisfactory to the societies we currently live in.  Commit to listening reflectively, for in listening reflectively we take active listening skills and add the desire to achieve mutual understanding.  Lacking mutual understanding means communication remains unsettled and unsettled communication breeds areas to abuse words, meanings, and intentions.

Please note, this does not mean someone becomes a communication police officer or communication stormtrooper.  Fighting plastic words is all about the individuals knowing, doing, and being better as a communication sender and receiver.  Aware of the duality of the roles in communicating effectively, with a desire to be the communicator of choice others follow.  Plastic words are intentional, and the person creating plastic words knows full well their fraud and deception, e.g., Ex-Secretary of State Hillary R. Clinton.  In choosing to de-plasticize words, we choose to respect those who plasticize words but not speak with them until they become honest communicators while monitoring through listening.

References

Calvert, J. B. (2008, June 13). Words, words. Retrieved April 25, 2015, from https://mysite.du.edu/~jcalvert/humor/words.htm

Poerksen, U. (1995). Plastic words: The tyranny of modular language (J. Mason, & D. Cayley, Trans.). University Park, PA: The Pennsylvania State University Press.

Shakespeare, W. (2016). Hamlet [Kindle].

© 2018 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.

Shifting the Paradigms: A Hybrid Leadership Theory Plan – Allowing One’s Self to Create a Leadership Theory Template

Man, as defined as a species, learns by doing; this principle of learning is best showcased by the poem “What man may learn, What man may do” penned by Robert Louis Stevenson.  First, we see, and then we do; if “Imitation IS the sincerest form of flattery,” as proclaimed, then leaders are neither born nor made; thus, leaders are formed through the flattery of perception and emulation (Martin, 2012) [Emphasis Mine].  For example, a new recruit in the military, any military, learns how to be a leader by following, perceiving, and copying those placed above them.  The same pattern is copied time and time again until the top of the leadership pile is obtained or until something drastic happens to the top rung, i.e., premature death, elections, and other influences. This theory of leadership evolution places the training of the leader squarely upon the individual aspiring to lead.  The aspiring leader must choose whom to emulate, and in choosing, form decisions about why he chose that leader over another of equal or greater rank to emulate.

Emulation as a leadership theory places personality, emotional intelligence, preferred organizational culture and environment, and every other aspect of the leadership environment into the hands of the person aspiring to lead as choices of preference, while also removing excuses and leaving the leader fully responsible, accountable, and liable for the consequences.  As a species, we not only mimic those we hold in esteem, we magnify them.  Thus, a learner emulates certain behaviors and increases those behaviors (Coloroso, 2008).  Just as a child is taught to hit by watching his parents beat each other and the child, the child will not only hit but also will not understand hitting is unacceptable and will increase violence past hitting to using weapons other than fists.  The third generation of being taught hitting is acceptable generally moves to murder and incarceration.  Upon emulation, magnification occurs, and patterns will continue until stopped.

More often than not, leadership through emulation theory is interconnected to spiritual leadership theory. Fry (2005) claims spiritual leadership theory “… was developed within an intrinsic motivation model that incorporates vision, hope/faith, and altruistic love, theories of workplace spirituality, and spiritual survival through calling and membership.”  While Fry (2005) continues to justify this position, leadership through emulation remains a great-uncharted unknown or only researched through the bias of religious lenses and discounted.  Yet, the great truth remains; humans learn through seeing and doing, and thus, leadership occurs through emulation and agency.

Religion is merely a set of beliefs and practices people adhere to voluntarily.  The term spiritual discusses closely related character interests, attitudes, and outlooks.  While not devoid of religion, spiritual leadership theory does not entirely apply to the reality of life with enough applicable strength to overcome individual zealots or the anti-religious zealotry found in many organizations.  Many people do not realize that allowing religious freedom means accepting the term religion without feeling encumbered to onboard a religious theory.  Fry (2003) expounds upon the spiritual leadership theory, and while this theory includes many aspects of corporate responsibility personally held dear, the reliance upon religion can be a hindrance for those followers who might choose to lead but remain anti-religious.  Wren (1995) discusses leadership theories but focuses too much on a few while denigrating those not mentioned.  By relying too heavily upon charismatic, transactional, and transformational leadership, Wren (1995) loses the forest grandeur by focusing on seeds, not that this diminishes seeds, but there is so much more to see and experience.  The following leadership plan relies heavily upon what works and includes pieces of spiritual leadership for the active moral and ethical code, emulation leadership theory, and flexible thinking in organizational structure design.  The result is a highly trained, experienced, effective leader, capable of creating success in many different industries, environments, and situations.

All successful leaders like Presidents Lincoln, Jefferson, and Washington, Thomas Paine, Benjamin Franklin, among others emulate moral fortitude and character as well as personal integrity to leadership principles and existence in productive work efforts.  These leaders stood firm for core beliefs including truth, justice, mercy in the face of war, and built followers, who could then lead in difficult times and lead well.  The primary chain linking all these leaders remains a single item: when faced with a decision, they acted with no hesitation, no spinelessness, and no hypocrisy.  By choosing whom to emulate, in emulation leadership theory, the best can be onboared, magnified, and broadcast back into the organization forming a bulwark anchoring other people aspiring to become leaders.  Brady (2005) discusses levels of influence in launching a leadership revolution.  Part of the first level requires the aspiring leader to know the environment, history, basics of the organizational culture, and much more.  The main point in the plan is to emulate the best, choose new principles to include, discover new ideas that work, and employ this knowledge in direct personalized solution.  Due to the high amount of emotional intelligence inherent in the current employer organization, transactional and charismatic leadership are of limited functionality.  Transformational leadership theory has more application but does not include many elements needed to enforce the plan or to achieve success.  Leadership requires follow-on levels of influence that include preparation, desire, understanding the role of learning and adversaries, loving people, and developing people, who will choose to develop others.  Of particular importance is the principle of loyal opposition, also known as a courageous follower.  Building upon Chaleff’s (1995) discussion about the “Courageous follower” becoming a courageous leader, who can influence change, lead-in difficulty, and conquer, it remains imperative for followers to become those they emulate or the entire period of training is not valued by followers (Yukl, 2006, p. 134-139).

Personal strengths include a vast repertoire of benchmarks, successes and failures, working knowledge of psychology, depth as being a follower in stressful situations, and the drive of a bloodhound to find and fix.  Skills and talents under constant construction include communication, manners, modesty, and developing interpersonal skills between peers and current leaders without causing insult.  Personal weaknesses include a distrust of followers leading to problems with the delegation of authority, a reluctance to allow failure in followers, and an own abhorrence to perform tasks a second time after a failure.

The leader currently in existence needs experience to improve as described by Brady (2005), Jossey-Bass (2003), and others.  The leader imagined and envisioned for the future needs seasoning to become a reality; thus, allow yourself or your followers time to build into the leadership plan outlined.  The gaps are minor, and the weaknesses cannot improve without more experience in handling complicated situations.  In vague terms, the timeline might look something like this.  Within the next year, advancement would be from customer care professional in fraud to a curriculum designer or teacher/trainer/coach of adults for the current employer.  Within the next three years, or by the conclusion of an academic degree program, advancement would be from designer/coach/trainer into leading other coaches/designers. Within the next eight years, progress would be to a service delivery leader guiding leaders of other coaches/designers/trainers and eventually be advanced to a director of corporate training or vice president of training delivery and human resources.  Keeping this euphemistic plan on track requires sticking with a single employer, building a solid personal brand based upon successes, leveraging educational degrees while maximizing the previous experience and new experiences into solutions for the employer.

Recognizing that attitude, failures, and other people acting as variables on this plan requires communicating intent, working with people to convince them that end goals are attainable and the change needed to realize the end result.  Until this plan launches, it remains imperative to exemplify Chaleff’s (1995) descriptions of a “Courageous follower.”  This type of follower can emulate those in leadership positions while supporting the good and learning from current leadership mistakes.  In a seamless transition, the “courageous follower” employs emulation theories of leadership and gains the advantage while building the needed personal brand and accomplishments and preparing for future leadership (Yukl, 2006, p. 134-139).

Avolio (2008), Brady (2005). Paine (1995), and Wren (1995) among others, discuss another aspect of being a good follower and future leader, liberty.  America throughout history has provided excellent examples of what occurs when free people band into a society dedicated to liberty, freedom, and individuals empowered to choose their destiny.  Being a courageous follower requires freedom of choice, and all future leaders, regardless of theories espoused, need to remember the power of freedom when leading.  While some leadership writers discuss empowerment as a panacea term for everything from agency to low-level decision making, empowerment merely is freedom by a different name.  Free followers are naturally empowered to choose, and with training, proper guidance, and organizational support choose with confidence.  This is known as agency or the power to choose with responsibility and accountability for the consequences.  Honing this power to choose wisely, while protecting the opportunity to succeed and fail, promotes a level of trust and commitment to current leaders that improve morale, lifts people, and builds robust organizations.

While less than bare bones in many aspects, the leadership plan described remains flexible enough for significant changes in future prospects while being detailed enough to fit into the current lifestyle of potential interested leaders.  Experience has taught that detailed plans tend to force a locked down mentality in thinking, creating a box that hinders, hampers, and delays.  While some details must be included, a delicate balance is preferred when dealing with the vicissitudes of life.  Staying on track with this plan requires courage, fortitude, and emulation of the best and brightest to become a reality.

References

Avolio, B. J., & Yammarino, F. J. (2008). Transformational and charismatic leadership: The road ahead. Vol 2. Bingley, United Kingdom: JAI Press – Emerald Group Publishing Limited.

Brady, C., & Woodward, O. (2005). Launching a leadership revolution: Mastering the five levels of influence. New York, NY: Business Plus – Hachette Book Group.

Coloroso, B. (2008). The bully, the bullied, and the bystander. (Living ed.) New York, NY: Harper Collins.

Fry, L. W. (2005). Positive psychology in business ethics and corporate responsibility. (pp. 47-83). Charlotte, NC: Information Age Publishing. Retrieved from http://www.iispiritualleadership.com/resources/publications.php

Jossey-Bass, R. (2003). Business leadership: A jossey-bass reader. San Francisco, CA: John Wiley & Sons.

Martin, G. (2012). The phrase finder: Imitation is the sincerest form of flattery. Retrieved from http://www.phrases.org.uk/meanings/imitation-is-the-sincerest-form-of-flattery.html

Stevenson, R. L. (n.d.). What man may learn, what man may do. Retrieved from http://www.poetryloverspage.com/poets/stevenson/what_man_may_learn.html

Wren, J. T. (1995). The leader’s companion: Insights on leadership through the ages. New York, NY: The Free Press.

Yukl, G. (2006). Leadership in Organizations. 6th Edition. Upper Saddle River, NJ: Pearson Prentice Hall.

© 2018 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.

The Johari Window: A Tool of Incredible Proportion – Understanding a Key Psychology Tool in Call Center Relations

The Interest GridTo understand a principle takes time; to apply that principle involves experience; but to indeed change a person, the principle must be absorbed into the very fiber or essence of an individual, reaching comprehension through mental, physical, and spiritual understanding, some might even say the soul of the individual.  Freedom is one such principle; the tool for remaining free is the ability to choose, or agency.  When applied to organizations, the same path to success must be tread, but with many individuals onboarding the principles is a challenge.  Many people believing the same way is often described as a culture (Greenwald, 2008, p 192-195), or society, and when belief turns into dedicated and repetitive action, a paradigm is created (Kuhn, 1996), also called business processes and procedures.

Agency theory is a tool for understanding how organizational cultures become cultures.  Individuals apply agency, and when many make the same choices, the creation of an organizational culture occurs.  Emirbayer & Mische (1998) expand the term agency that gives reason why Tosi (2009) and Ekanayake (2004) both classify agency theory as an “economic theory” and how agency theory “… shapes social action [p 963].”  If Emirbayer and Mische (1998) are correct, placing more emphasis upon individual agency opens doors into re-shaping controls, control mechanisms, and affects the entire organization.  The power of agency to change people, organizations, and societies is immense.  Recognizing that people will always exercise agency, guiding that agency exercise is not so much a discussion of control, but of harnessing energy and momentum to develop individuals into a cohesive whole.

Johari WindowThe Johari Window is a tool for quickly assessing a situation before making a choice.  Consider the job of a call center agent; they must be technically savvy, adept at handling multiple tasks while engaging in productive conversation, and must be able to keep a caller enthusiastically engaged in reaching a solution quickly so that the agent ay meet business set metrics and production goals.  The Johari Window is suggested as a desktop guide in promoting self-knowledge in the call center agent to improve performance.  Having personally employed the Johari Window as part of logical thinking, I explicitly recommend, that before handing an agent this tool, training must be accomplished to help allow for clearer thinking that often leads to more speedy action.  The first Johari Window represented links to a .pdf that contains additional specific information for improving training in the Johari Window principles.

Open Area

Of all the locations in the window, the open area position is where the majority of people want to stay; wherein everybody and everything knows and is known. The unknown is frightening, and change in this location comes the slowest, if at all.  Each call center agent wants to, and needs to, feel confident in what is known and where they go when they do not know; hence, training as a continual process remains the catchword in this location, even though it might not be well received.

While the location is desirable, rarely will customers call in because they already know something.  Agents in a call center should leave new hire and continual employment training and start every working day from this location where they are known and know.  The open area could also be referred to as the preparation location.

Hidden Area

The hidden area is where business in a call center will occur most effectively.  The customer knows what they want, and the call center agent knows how to deliver what is wanted and through reflective communication mutual understanding is achieved to make the hidden area become known.  Imperative to understanding in this area is the power of choice, agency, to choose to reveal only pieces of what is wanted.  If the customer chooses not to disclose what is wanted, it is not poor service when the customer’s wants are not fulfilled. This point is especially important in understanding the voice of the customer (VOC) survey results and quality call review.  The only time the agent is in the wrong, in this location, is when the agent cannot choose and thereby communicates less effectively to the customer, delivering a poor performance in need of remediation.  Both the agent and the customer have something hidden and something known.  The importance of clear communication remains pre-eminent in this location.

For instance, two top call center agents were continally competing with each other for first place evaluation. The agent who routinely came in second asked why. The answer to improving performance is found in the hidden area, opportunities that guided the agent to drop AHT/ACW and increase VOC into productive communication towards a solution.  There is power in the hidden area to capture and employ. Train agents to be alert for hidden areas to gain improved performance, not through active listening, but through reflective listening where mutual understanding between the customer and the agent is reached.

Blind Area

Of all the locations in the Johari Window, the blind area is the most dangerous for call center agents.  When the customer has information the agent does not know, the result is lost resources, productivity, and customers.  Of course, the reverse is also true.  When the agent has information about the customer and does not voluntarily devolve the information, the customer is surprised upon becoming aware and is lost because of this blind area.  Then organizational reputation damage is complete.

For example, I was working in a credit card call center and regularly saw agents not bother to bring up account issues to save AHT/VOC and other metrics.  Hence, the customer upon learning of the negative actions would call back because opportunity in the blind area was sacrificed for potential short-term gains.  Operating blind means the agent and the customer are in danger.

Unknown Area

Chinese CrisisOf all the locations in the Johari Window, the unknown area possesses the most opportunity for delivering upon a service commitment.  Consider the Chinese character for a crisis that includes danger and opportunity as equals.  The unknown always combines danger and opportunity.  Danger is risk, risk of losing a customer, risk of saying the wrong thing and insulting, etc.  Opportunity lies in making the unknown known.  In the Johari Window, when the unknown becomes known, the unknown quadrant shrinks and the known quadrant grows.  The unknown quadrant could be considered the crisis quadrant.  Good skills in mastering the unknown to thwart a crisis, eliminate danger, and win the opportunity to create a powerful customer interaction.  The unknown area is where confidence in training overlaps with the customer’s crisis to maximize opportunities for service excellence.  If there is a single shred of doubt communicated to the customer in crisis, the opportunity is lost forever because the danger was not ameliorated. The unknown has many hidden dangers to be wary, but fear is not one of them because of excellence in training.

Working as an agent in customer retention was very lucrative.  When we could probe, dig, and investigate, generally we could save a customer and generate new business.  While the company spoke about, preached around, and dictated the use of active listening, the retention department was using reflective listening to glean details and save customers through reaching mutual understanding. In the unknown area, both parties struggle with not knowing and being unknown. Therein lies the opportunity for increasing business by becoming known and learning knowledge that is not currently possessed.

While the current Johari Window reflects proportional space for each location, reality rarely allows for such clarity.  Many times, an agent’s Johari Window will look like any one of the following, none of the following, or a mixture of all:

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The key for call center leaders is to train the call center representatives to first understand themselves and then to visualize who they are in the Johari Window in each call.  The more familiar the agent is with data gleaned from knowing themselves and the business, the more power each agent will have to handle the calls more effectively and efficiently.  In teaching the Johari Window, one of the many lessons I have learned is that people do not understand and second guess their limitations.  If a person has, or considers having, a small blind area, do they know their equally important unknown or open areas.  More than likely the answer is no; why, because of the need to invest time and other resources into improving themselves and their approach to others.

When discussing the agents understanding themselves, the call center trainer, first line supervisor, and managers will employ the eleven principles of change as discussed by Luft.  The agent will need to understand the energy lost in hiding, deceiving themselves, and the problems this causes them.  Cause and effect play a significant role in visually attuning the Johari Window to daily work activities.  The call center trainer, first line supervisors, and managers will need to be able to answer clearly and effectively “why” based questions about processes and procedures, while exemplifying the Johari Window principles.  Luft’s Point No. 5point number five is critical in this process, “Interpersonal learning means a change [is taking] place so that Quadrant 1 is larger, and one or more of the other quadrants has grown smaller.”  Do we understand what this means; as leaders, we exemplify making Quadrant 1 (Open Area) larger by learning.  Leaders are teachers, teachers are leaders, but both teachers and leaders must remain loyal to learning.

Consider Gilderoy Lockhart from Harry Potter.  Gilderoy Lockhart considered himself highly capable, gifted, and talented, but reality proved his ineffectiveness and limitations.  His example opens a second issue when using the Johari Window tool in a call center:  personal perception versus reality.  Gilderoy Lockhart would see his Johari Window as thus:

Johari Window - GL 1

Reality would suggest the following might be truer:

Johari Window - GL 2

The disparity between a person’s perceived understanding and reality causes significant problems in interactions in all types of societies.  In the call center, the agent will interact with various kinds of personalities; hence, the need to train agents in this tool and to understand themselves, including their likes, dislikes, triggers, emotional hooks, and talents brought to each call.  For the best opportunities for your agents to interact successfully, training them in understanding themselves is just as important as training the agent in organizational policies, business products, services, and sales techniques.

Ongoing, regular training remains a key component to highly effective call centers and capable workforces.  Without refresher training, regular training for new products, and annual training, the capable employee gets into a rut, the rut becomes a paradigm, and the employee becomes lost to attrition and slower productivity; but most especially, lost customer interactions hamper all levels of business performance.  One employee working slow can ruin a business, and the first indicator something is wrong is the higher cost of doing business.  Win the employee through training and then treat them respectfully to reduce operational costs and increase sales through training.

In conclusion, never stop asking why, encourage learning, and never fear using the answer, “At this time, I do not know, but I will find out and report back.”  When the discovery loop is closed with the individual, everyone learns, Quadrant 1 grows, and other quadrants reduce perceptibly.  Proving once again the veracity of the axiom, “Train people well enough to leave; treat people well enough to stay; and grow together as an act of personal commitment to the team.”

References

Ekanayake, S. (2004). Agency theory, national culture, and management control systems. Journal of American Academy of Business, Cambridge, 4(1), 49-54. Retrieved from http://search.proquest.com/docview/222857814?accountid=35812

Emirbayer, M., & Mische, A. (1998). What is agency? The American Journal of Sociology, 103(4), 962-1023. Retrieved from: http://www.jstor.org/stable/2782934

Greenwald, H. P. (2008). Organizations: Management without control. Thousand Oaks, CA: Sage Publications.

Kuhn, T. S. (1996). The structure of scientific revolutions. (Third ed., Vol. VIII). Chicago, ILL: The University of Chicago Press.

Tosi, H. L. (2009), Theories of organization. Thousand Oaks, CA: Sage Publications.

© 2017 M. Dave Salisbury

All Rights Reserved

The images used herein, obtained from the public domain, this author holds no copyright to the images displayed.

 

Leading the Call Center: Flavor of the Month Philosophies

Chinese CrisisHaving just completed a project that saw me leading a team in a call center, I want to make something clear; quick fixes and flavor of the month philosophies do not work.  I cannot stress this enough; yet, the practice continues to the detriment of call center employees and the organizations served by call centers.  Flavor of the month philosophies is the latest bestseller to fix the problems in business.  We have all seen these programs including, FISH, WAIT, Strengths Quest, and so much more.  These ideas are good ideas, and they possess value, but when changed monthly, these programs, never do more than briefly mark the surface intellect of the call center.  I am not disparaging these ideas in the least; let me elaborate as to why the flavor of the month idea fails.

The project previously mentioned when concluded saw the call center director very much converted to a program of definite value in and using one’s strengths entitled Strengths Quest as presented by Clifton, Anderson, and Schreiner (2006).  The culture of strength promotes unity, and by extension, organizational power, when combined intellectually, becomes the corporate culture.  Integration in business, especially in call center operations, remains crucial to bottom-line health.  The call center director invested a lot of organizational resources to capture everyone’s strengths, publish these advantages, and use this information to measure the call center.  The problem was the staff has no idea why they are investing company time in completing the “Clifton Strength’s FinderÒ (CSF),” and many completed this assignment while taking calls and distracted.  How verifiable is the data if the attention of the person completing the task is diverted?

My assignment, as a call center supervisor, included gauging the employees in the call center about their strengths.  Of the 10-employees in the call center, two had forgotten and blatantly said they do not care.  Three expressed a desire to retake the CSF to more fully focus on the task instead of completing it between calls.  Four employees asked why and what is the purpose of taking the CSF.  Finally, all the employees, when asked how they use the CSF data in their daily actions, expressed the same answer, I do not know.

Let’s be clear; there is nothing wrong with the latest flavor of the month programs to improve an organization, provided the leaders understand change, embrace change, train and teach “the what” and “the why,” and then remain committed long after the excitement over the bright new object fades.  I had the misfortune of working in a call center where the entire corporate culture was expected to change with every fresh flavor of leadership, and the organization is a mental mess.  What is a leader to do when each new flavor-of-the-month is presented as a potential fix for organizational dilemmas?  I suggest the following as a launching point for corporate discovery and leadership support.

  • If the organization is going to invest resources in a particular program, do not change for a set period, which includes pre- and post- measurement and evaluation. If the organization does not know where they start, they can never know what happened or where to go in the future.blue-money-burning
  • Organizational change must be more than surface polish or potential money (Blue Money) is lost, never to be recovered. Organizational change needs to fundamentally affect the organization and be allowed to produce measured results.  Does this mean that if something is not working, we keep at it?  No!  It means to provide sufficient time and measurement to gauge the application and the organizational change.  Many times beta-testing the proposed change can identify the processes, procedures, and other trouble points to be mindful of, or correct in beta-testing, to ensure full organizational change may occur with a higher chance for success.
  • Get everyone involved, enthused, and a willing advocate for the change. Getting everyone involved is not producing marketing materials and desk references.  Getting everyone involved requires explaining why and detailing what in the organizational change.  Getting everyone involved means there will be feedback, pushback, and rebellion.  Expect pushback, but never allow pushback to derail reform.  Pushback is a healthy activity that provides essential opportunities for the leader to explore solutions, answer questions, and evaluate the results.
  • Teach and train; train and teach. Learning should be a constant and desirable outcome of organizational change.  Teaching is not training, training is not teaching; but, both are critical skills needed for leaders and learners.  Teaching is helping someone else acquire knowledge.  Training is teaching a behavior or ability.  Teaching is usually one-way communication using measurement tools, e.g., tests to gauge knowledge learned and retained.  Training should be two-directional communication, is completed through experience in closely monitored environments, and includes 360-degree feedback to improve the training environment.  Never allow teaching and training to become the same confused term; while the words are closely related, they are not the same action.
  • When was the last time you discussed what you are reading with front-line employees? When was the last time you engaged a front-line worker about what they are reading, thinking, and ask for suggestions to improve?  When was the last time you asked to be trained on a process, procedure, or organizational action by those who do it all day?  If recently, did you ask why, a lot?  I promise you will be surprised when you have these conversations, especially since they open up opportunities to explain and expound, learn, change, adapt, and engage with those you lead.
  • Organizational change requires enthusiasm from all parties to begin to engage and deepen the shift from surface polish to fundamental culture adaptation. Enthusiasm takes many shapes, sizes, and colors, including the loyal opposition of followers, opinions, and feedback.  The leader must exemplify and honor, or support, the enthusiasm around them as a tool for succeeding in changing the organization.
  • Clarify intentions. Clarify processes.  Clarify procedures.  Clarify by asking follow-up questions and reflectively listen to obtain mutual understanding.  Clarification remains one of the most critical tasks in organizational change.  When confusion rears its ugly head, respond with explanation and follow-up, as detailed in two-directional communication.  When the comprehension is doubted, ask for feedback as an opportunity to increase clarification.  Clarification is both a tool and an opportunity; do not waste this opportunity and tool by neglecting those needing clarification.
  • Organizational change needs a mechanism for gathering data from many sources, including the employees affected, the vendors, the suppliers, and the customers. Open the valve for data to flow back.  One of the most horrific organizational changes it has been my displeasure to witness was increased because the leaders operated in a vacuum and never allowed data flow that was contradictory to the previously agreed upon results.  The leaders in this organization worked hard to refuse hard data, which contradicted their bias, and this ruined the business, the employees, and the customers.

I cannot guarantee following all these points will make organizational change succeed, roses bloom, bottom lines inflate, rainbows dance, and all of life fall into organized lines leading ever upward.  I can guarantee that without these points, organizational change that promotes an environment of learning will never be more than polish.  Consider the axiom, “Lipstick on a pig.”  The lipstick is not bad, the pig is not bad, but placing lipstick on a pig is out of place and does nothing to improve the pig.  Flavor-of-the-month changes are lipstick on a pig, not bad, but out of place until the entire organization is on board and enthusiastically supporting the move, and proper measurements are in place to gauge, measure, and report the change.

Business theorist Chris Argyris put forth a model, later discussed by Senge (1994) explaining our thinking process as we interact with the world.  This seven-step method is called the Ladder of Inference; according to this model, as we move up the ladder our beliefs affect what we infer about what we observe and therefore become part of how we experience our interaction with other people.  Organizational change can be plotted along the same model or ladder of inference.

Leadership LadderOrganizational change begins with information output; then collect data, preferably through listening and observation while doing the work; interpreting the data includes obtaining data, evaluating meaning, deciphering intent, and understanding value.  Please note, the assumptions should not be made in a vacuum and could be wrong; thus, always return to the data producers and ask questions to ensure mutual understanding.  Once conclusions are mutually understood, they become beliefs; but, don’t stop until beliefs become actions.

If a model is needed, please benchmark Quicken Loans and Southwest Airlines, both organizations are doing a tremendous job with the ladder steps, especially moving organizational beliefs into motivated organizational action.  Remember, one does not climb a ladder to view the horizon and scenery, they climb a ladder to begin working, carrying the tools needed to perform the work, and possessing certain knowledge that the work can be accomplished.  Climb the ladder of success with the intent to work, achieve, and move forward.

References

Clifton, D. O., Anderson “Chip,” E., & Schreiner, L. A. (2016). Strengths quest: Discover and develop your strengths in academics, career, and beyond (2nd ed.).

Senge. P. M. (1994). The Fifth Discipline: The Art and Practice of the Learning Organization. New York: Currency Doubleday.

© 2017 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.

Farmers, Ranchers, and Dairymen – An Open Letter Regarding Food Safety #COOL

To the Elected Officials Across America:

I write by way of admonishment and with a plea.  You must cease capitulating to BIG farm, ranch, dairy corporations immediately.  You must forthwith and without any delay, come forward and show true support and allegiance for America’s independent farmers, ranchers, and dairymen, upholding the heritage of agronomy in America.  Most importantly, legislation must begin forthwith to protect America’s food safety through the country of origin labeling (#COOL).  The sleight of hand, backroom deal that ended country of origin labeling on a “must-pass” piece of legislation, was the purest form of chicanery and political skullduggery in the Obama administration; sadly, this was not the only piece of legislation to be affected in this manner!

I am calling out both parties (Republican and Democrat), the national food safety councils, the national ranching/farming/dairy associations, and every other political hack, political action committee (PAC), and lobbyists.  I am calling out the staff members of the elected officials who write the laws and perform the skullduggery that allowed country of origin labeling to cease.  I am calling out and upon every single one of you to listen and act without delay!

National Councils are supposed to represent the independent rancher, farmer, and dairymen, whose membership pays for the political dinners and political action committees in capitals across America.  People who make money off association and membership dues, then forget their members and associates at the drop of a hat for political expediency.  I have been on your websites and am thoroughly embarrassed at your performance where the country of origin labeling is concerned.  Big Farm/Ranch/Dairy, your actions continue to be the purest and most detestable acts of tyranny ever recorded in American history.  I have been on your websites, I have seen the lawfare you unscrupulously pursue against independent farmers, ranchers, and dairymen, and I will cheer the day you are brought to the bar of justice.  The disregard for independent farmers, ranchers, and dairymen remains inexcusable!

When was the last time you visited a farm, a ranch, or a dairy and asked what the government (or council) can be doing to improve their businesses?  You want these people’s votes, association, membership, mostly you want their money.  Then you proceed to demean, denigrate, and plot to actively undercut and abuse the independents, all while capitulating to the demands of the BIG representatives.  This byzantine behavior is beyond despicable and remains abhorrent!

Where are the monies promised from the CARES Act that was supposed to go directly to the farmers, ranchers, and dairymen who are unable to sell their products because of the government shutdown of the economy?  The local farmer, dairymen, and ranchers, their families, and their communities are precious to the American soul.  Each loss of an independent farmer, rancher, and dairymen needs to be mourned, but instead, all I observe are parties celebrating, paid for by PAC’s working to undercut America’s food safety.  Your actions to withhold monies and support is reprehensible chutzpah at best!

Fact: General George Washington, first President of America wanted to be, and worked hard to be, America’s first farmer.  He worked in the fields with his people, he did farm duties and got his hands dirty.  Except for photoshoots can you claim any type of work, let alone that done by a farmer, rancher, or dairymen?

Fact: Thomas Jefferson was a farmer who got his hands dirty.  Both Jefferson and Washington were researchers in agronomy, piloting many of the techniques still used today to grow crops.  What useful activity are you performing?  I guarantee it is not productive!

Fact: President General Washington, said the following: “Agriculture [is] the proper source of American wealth and happiness;” and predicted Americans would continue to be “an agricultural people…for ages to come.”  Yet, too often since the 1980s, the politicians of America have turned a blind eye to the agricultural heritage of America.  Stooping to actively bring foreign products into America even when those products, too often, are unsafe, poor quality, or worse actively harmful to America’s citizenry and the farmers, ranchers, and dairymen who can, and DO, produce better than their foreign counterparts.  You have bankrupted the agriculture legacy of America and you need to begin to make amends!

Fact: When I expressed interest in being a farmer or a rancher as a child, I was encouraged to stay away from those “dying professions” by teachers, guidance counselors, and regrettably even some farmers and ranchers.  People who, after a life of working at a job they loved, were getting out and selling out because it had just become too much, too political, and too expensive.  A sheepherder in Utah, been in the business for multiple generations, could not find a market and had to sell his animals for glue and parts, losing his job at 70, with nothing from social security.  A dairyman in Maine, on the same plot of land since before America was a country, bankrupted by a corporation, then purchased by the same corporation, at a bankruptcy sell.  I have seen too many of these tales personally.  Good, honest, hardworking people, betrayed by their government at the local, county, state, and federal levels, disavowed by their associations and councils and left to destitution and poverty.

Fact: The founding fathers in America all wrote extensively and worked diligently on farms, ranches, and dairies.  What politician, lobbyist, staff member, or other political hacks, can say the same?  Which of you can relate business topics, having met a customer face-to-face?  Can you still say you have met a customer face-to-face?  I know some of you were doctors, are you still a practicing doctor seeing patients?  What about lawyers, are you still seeing clients?  What about farmers or ranchers, how is your farm or ranch doing?  Are the laws you are passing, that are killing your constituents, being felt personally?  What about you presidents and political activists of farming, ranching, dairy, or food safety councils and associations, have you been on a farm recently, to work?

Fact:  Jefferson wrote that “those who [labor] in the earth…are the chosen people of God if ever he had a chosen people, whose breasts he had made his peculiar deposit for substantial and genuine virtue.”  In December 1778, John Adams wrote to a Massachusetts friend from France that “it is some comfort to me to think that I shall be soon a private Farmer.”  Two incredible people who saw their work in politics as a hindrance to being a farmer.  They knew productive work and did productive work, they knew the struggles of the everyman and could temper their political actions against the consequences.  Of President Adams it is related, “Adams occasionally dug ditches, shoveled and transported manure, spread fertilizer, slaughtered livestock, and worked under the hot sun in his fields both at harvest time in the early autumn and in May, July, and September, when the hay was stacked following the mowing of the meadows.”  Can any of you say the same?

Fact: In 1769, Benjamin Franklin wrote Henry Home: “There seem to be but three ways for a nation to acquire wealth. The first is by war, as the Romans did, in plundering their conquered [neighbors]; this is robbery. The second by commerce, which is generally cheating. The third by agriculture, the only honest way…wrought by the hand of God in His [favor], as a reward for his innocent life and his virtuous industry.”   Biographer Carl Van Doren observed that “Franklin was one of the earliest Americans to perceive that the agricultural resources of the country should not be wasted and that farming must be something of a business and a science as well as a way of life.”  Your actions are killing the American way of life and I demand to know why!

Since the 1980’s America has seen the death of too many independent farmers, ranchers, and dairymen, compounded and multiplied by first losing the farm, ranch, or dairy, then again to suicide.  Time Magazine has written about the death, neigh almost extinction, of America’s independent farmers, ranchers, and dairymen, as recently as November 2019.  Check your offices, you might still have this issue sitting on the low table in your outer office.  I know my first magazine article on this topic (1991) was seen in a dentist’s office, in Belfast Maine.  I had to see the dentist as I broke a tooth working as a farmer, a fruit picker, and dairy hand.

Let me help you out with a few more facts, sourced from the Time Magazine article mentioned above, and these numbers could be much higher.

Fact:  “Farm debt, [is] at $416 billion (2019), an all-time high. More than half of all farmers have lost money every year since 2013 and lost more than $1,644 this year. Farm loan delinquencies are rising.”

Fact:  “Chapter 12 farm bankruptcies were up 12 percent in the Midwest from July of 2018 to June of 2019; they’re up 50 percent in the Northwest. Tens of thousands have simply stopped farming, knowing that reorganization through bankruptcy won’t save them.”

Fact:  “The nation lost more than 100,000 farms between 2011 and 2018; 12,000 of those between 2017 and 2018 alone.”

Here’s an interesting correlational fact: “Congress included #COOL repeal in the $1.4 trillion omnibus spending bill after the World Trade Organization (WTO)  ruled Canada and Mexico could begin imposing more than $1 billion in tariffs on U.S. products to punish it for the [undue] harm the labeling requirements were doing to them.”  Answer me this, when Either country has to put labels on their products for trade with the European Union (EU), those labels are not considered “undue hardship,” but the cost of doing business with the EU, the cost is then passed along to the EU consumer.  Why is trade with America on food safety, all of a sudden an “undue hardship” to label where the food is originating?  It seems to me, if you are not trying to poison Americans, you should be proud to be labeling your country on your products.

#COOL labeling was considered onerous and was despised by Congress, even though #COOL labeling was on such a tiny number of agricultural products.  Yet, the US Congress caved and a weak-kneed president signed off on this omnibus spending legislative fiasco.  So, let us discuss labeling legislation for a moment.

Fact:  Feel free to look this one up. 49 U.S. Code § 32304. Passenger motor vehicle country of origin labeling.  Prominent placing is critical to the country of origin labeling on all vehicles, and this labeling is not considered “undue hardship” by the WTO.  Even small assembly parts can be included in the vehicle country of origin, not considered an “undue hardship” by the WTO, and falls under the vehicle mandated country of origin labeling.  In fact, the manufacturing of foreign parts can be hidden, provided proper labels are designed, and the country of origin masked, and this is not considered an “undue hardship” by the WTO.  No one ever saw Congress cave on vehicle country of origin labeling, and the auto industry has been slammed in America by foreign vehicles and foreign trade.  Closing the rust belt and extinguishing America’s manufacturing jobs without a single cry from Congress, about “undue hardship.”  No staff member tried sneaking in a repeal of the country of origin labeling into a “must-pass” piece of legislation.  How many lobbyists and political action committees are dedicated to removing the labeling requirements on vehicles?

Fact:  Page 76 of the “Overview and Compilation of U.S. Trade Statutes” lists pipes and pipe fittings as requiring country of origin labeling, not considered an “undue hardship” by the WTO.  Failure to comply with all pipe types and fittings having the country of origin labeling is punishable by hundreds of thousands of dollars in fines to the manufacturer, the retailer, and the potential for lengthy prison sentences.  Best of all, there are “no exceptions” [emphasis mine] allowed to the country of origin labeling requirements for pipes and pipe fittings, manhole covers, gas cylinders, and more.

Fact:  Mushrooms must have a country of origin label per the “Overview and Compilation of U.S. Trade Statutes” manual.  Native American Jewelry, computers, phones, monitors, rugs, floor mats, and practically every single item in an American home must-have, under penalty of law, no exceptions, labels demanding where that product originates.  Also, not considered “undue hardship for labeling are specifics on sizes, volumes, and much more.  Yet, for food country of origin labeling, is considered an “undue hardship” for other countries to comply with, and thus, American food producers, the ranchers, farmers, and dairymen, are unfairly able to compete.  What about the complaints of America’s manufacturers, restaurants, and others who got nailed by the incredible labeling costs under Obama’s FDA mandate for nutritional labels?  A simple rule change at the FDA condemned hundreds of small businesses, eateries, café’s, and food producers to bankruptcy; yet, none of the political activists, staff members, committees, PAC’s, etc. even cared.  In fact, many of them cheered and helped waste a lot of reporter ink on this topic.

Let me see if I fully understand this problem, and I fully anticipate your full and transparent commentary, as well as your forthright action to correct this problem.  American chicken companies can purchase foreign-born and raised, chickens, have them shipped to the US, killed in a US factory, and do not need to tell anyone that chicken came from overseas.  Why?  Isn’t this the same as a car manufacturer, having all the parts for a car made in Vietnam, shipped to America, and sold as an American car, and just as illegal?  What about Brazilian beef that caused Americans to become sick, that miraculously now is available for retail again, while American ranchers cannot get their products to market at all?

What about all that romaine lettuce that has been causing E.coli across America for multiple years?  The growers are Mexican and others south of the border, the seller is an American company, and Americans are still suffering from this disease madness.  Yet, if a pipe manufacturer did exactly the same thing, with sewers exploding from poor pipes not bearing the proper country of origin labeling, that retailer, manufacturer, and the entire supply chain can be held liable for the harm, accountable for legal penalties and every class action lawyer in America would be dreaming dollar signs for injuries, damage, and mental harm caused.  But where food is concerned there is no problem, no foul, nothing to see here.

What about the Chinese Melamine Pet Food fiasco?  How is the purchase of melamine-contaminated food which was then processed into foods for pets and humans, not requiring country of origin labeling, different from a computer?  If the computer fails because a chip made in Ireland was poorly manufactured, there would be significant problems, legal interventions, trade embargoes, and a political rant for years.  Yet, because China was contaminating the source ingredients, there were no problems to be seen here.  Israel manufactures many phenomenal products for technology; let one of those products cause a tiny amount of inconvenience and the news reporters will try to run out of ink reporting Israeli manufacturing problems and defects of that product.  Lots of political pandering from 2007 saw China poisoning with melamine story die very quickly.  Why?  Are pets somehow less important than people; if America’s spending on pets is any indicator, that answer is a resounding NO!  Yet, not only did you pander to China, you killed the US Media reporting this issue, and then repealed a law that should have been useful in preventing this fiasco from ever happening in the first place.

Forget pets and melamine for a moment, do your political brains have sufficient room to remember when melamine was found in baby formula and killed infants?  Melamine tainted food is a hallmark of China, and yet somehow China is now able to send “safe” food to America all without a country of origin label.  I find this fascinating and demand to know why the country of origin labels are required by law on every other tradable good or product, but not foods!

Fact: Research published in February [2011] claimed that up to 10 percent of rice sold in China was contaminated with heavy metals, including cadmium. Data collected by Nanjing Agricultural University found that the problem was most acute in Southern provinces, wherein some areas 60 percent of samples were contaminated, some with up to five times the legal limit of heavy metals.  Where is the demand for the country of origin labels?  When you plant a seed in the ground with contamination, that contamination grows into the seed and will be found in the fruit that seed produces.  This was a fourth-grade science product where we changed the color of celery by contaminating the water with food dye.  How many rice producers in America cannot compete for shelf space in their local supermarket, even though they have a superior product, all because of heavy metal rice from China?  The same China who has a multi-year deadly hog disease that has killed millions of pigs and raised meat prices in China.  You cannot grow safe food or animals in contaminated environments without getting that contamination into the food!

China, the same country where fake water was sold, where machinery oil has been used to cook food, rotten meat has been used to create oils to cook food, and so many more food safety violations.  Yet, importers can import all sorts of meat that “meet proper regulations” and not have to declare where the meat was raised, what the meat actually is, and when that meat was slaughtered.  Importers can sell all types of vegetables and fruits grown in unknown ground conditions, which infect the fruit with the same ground and water contaminants without ever identifying sources and origins.

Does anyone else remember the DARK (Denying Americans the Right to Know) Act (July, 2016)?  a GMO labeling bill that allows companies and producers to use QR codes, 1-800 numbers and other difficult to access technology to label food products that contain GMOs, instead of clear, on-package text.

Fact:  “Over 90% of Americans support clear mandatory GMO labeling, but President Obama signed [legislation] giving way to the Big Food industry to continue to hide GMO contaminants in American sold products.  Even though these same companies must declare GMO contamination clearly on the package for products sold elsewhere in the world.  The DARK Act, supported by Senators Pat Roberts (R-Kan.) and Debbie Stabenow (D-Mich.), as well as trade groups representing the Big Food industry like the Grocery Manufacturers Association and biotech companies such as Monsanto, is an unfortunate example of how powerful corporations and moneyed interests have taken over our democracy.”  Have you noticed the rise in farms, ranches, and dairies failing to correlate with the labeling legislation?  It appears that every time Congress changes the labeling laws allowing more inferior fruits, nuts, veggies, meat, etc. come into America, and more independent American farms, ranches, and dairies fail!

Your actions to adopt country of origin labeling requirements on the most important items in a person’s home is beyond despicable.  The following is a statement from Andy Kimbrell, executive director at the Center for Food Safety:

“I don’t know what kind of legacy [President Obama] hopes to leave, but denying one-third of Americans the right to know what is in the food they feed their families isn’t one to be proud of. This law is a sham and a shame, a rushed backroom deal … the law also represents a major assault on the democratic decision making of several states and erases their laws with a vague multi-year bureaucratic process specifically designed to provide less transparency to consumers.”

I unequivocally and absolutely support the country of origin labeling (#COOL) for all foods imported into America.  If the WTO does not like this, let them eat cake from China; preferably, made from fake flour, and melamine-contaminated milk, with eggs from hens raised in a heavy metal contaminated environment and manufactured from an environment that has been shut down for violating the cheesy food safety rules of China.

The time has come for America to cease bowing to every global interest body, large food growing corporation, and return to supporting her local farmer, rancher, and dairymen.  Take pride in those who do this work and demand #COOL!  Choose, do you want your food from an unknown environment and a big corporation that doesn’t care, or the local guy; I know my choice #COOL!

By way of praise, I want to thank the Lehrman Institute for their excellent work in documenting historical resources on the founding fathers that improved this letter.

 

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

 

As the Department of Veterans Affairs Goes, So Does America – A Warning!

I-CareWould the honorable elected representatives please answer the following question: “Are the veterans of America’s armed services the next ‘Tuskegee Syphilis Study?’”

While we await this answer, here is why the question is raised.  The Department of Veterans Affairs – Office of Inspector General (VA-OIG) just posted their investigation results of the Critical Care Unit Staffing and Quality of Care Deficiencies at the Charlie Norwood VA Medical Center in Augusta, Georgia, and the results remind me of the game musical chairs and the disaster caused by the Tuskegee Syphilis StudyTuskegee Syphilis StudyMusical chairs because the VA-OIG was unable to ascertain direct harm because of record screw-ups, gross mismanagement, and a detestable and despicable perception of the patient.  The Tuskegee Syphilis Study because real harm to real people was caused, and the leadership did not care enough to fix the problems without an official investigation.

More on the Tuskegee Syphilis Study – History can be viewed in the link.

The VA-OIG report begins with the following:

“Critical Care Unit Staffing and Quality of Care Deficiencies at the Charlie Norwood VA Medical Center (VAMC) in Augusta, Georgia discusses significant patient safety issues including events related to noncompliance with pressure injury policy, intensive care unit cardiac monitoring, and sitter availability for high-risk patients.”

Pressure Injuries
Bedsores/Pressure Injury Progression

But concludes with the following:

“Publication is warranted so that other facility leaders and healthcare practitioners can be made aware of OIG-identified problems applicable to their own facility.”

Leading me to ask, of the VA-OIG, is this warning to proactively fix, or retroactively hide the nefariousness of poor management and dead patients?

Pressure injuries are exceedingly painful, can become deadly very quickly, and leave scarring and pain.  Pressure injuries are the nice term for bed sores, which are caused by critically ill patients who are already unable to move and circulate blood properly to the skin.  Thus, the tissue dies, a sore develops, then the skin breaks, and by this time that patient who is already in trouble, is now in danger of death.

Pressure Injuries - Example
Bedsore

Bedsores, pressure injuries, are serious conditions; yet, the Charlie Norwood VAMC has record-keeping problems, staffing issues, and without outside impetus refrained from fixing the problems.  All reminiscent of the “Tuskegee Syphilis Study.”

Hence the articles originating question, “Are the US Military Veterans the next ‘Tuskegee Syphilis Study?’”

If so, I refuse, and those leaders who think this conduct is allowable need to be held personally responsible for the harm they are causing.  If the answer is no, why are so many VA-OIG reports of leadership and management’s nefarious deeds being allowed until the VA-OIG comes knocking?  Even after the VA-OIG investigates, is anything being done?  Are people being held accountable?  The leadership issues are repeated, and while those repeats might not be an exact match from VAMC to VAMC, the leadership problems are real, glaring, and real people are dying!

America was shocked and angry when the whistle and plug were finally pulled on the Tuskegee Syphilis Study, and rightfully so.

Tuskegee-Patient
Syphilis wounds

Yet, it appears that the VA learned nothing from the history of Tuskegee except to keep playing musical chairs on responsibility, paperwork, and hiding the evidence from accountability.

America, your medical system, which before President Obama was the best in the world, is now on the same train of failure the VA Medical System is on.  Are you paying attention to the harm caused to veterans?  Do you want the same?  I do not!

America, to correct the problems at the Department of Veterans Affairs, and to reduce the costs to the taxpayers, as well as beginning to correct the damage done to your health care, the following is needed immediately.

  1. Legislation needs to be written and passed repealing ObamaCare.  Every single mandate, every single costly item, and sunder forever this socialism experiment.  The answers to the rising costs of medical care, including dental and vision, are not to be found in increasing the size of an already bloated government.
  2. Legislation needs urgent action to provide Secretary Wilkie the powers of any other CEO to clean the Department of Veterans Affairs. The leadership between the veteran facing employee and the Secretary’s office needs to be culled, and the only way to do this is through legislation.
  3. Demand accountability. The VA-OIG reports these issues constantly, the findings need to be on the news and be topics of conversation.  No longer should a bureaucrat be able to shift responsibility, harm patients, and keep their comfortable jobs and benefits.  Real harm to real people is being caused by the medical system paid for by your tax dollars, demand more!

Understand the following principle, know it well, and let us begin processing the reversal of this trend.  Charles Reich (1964) wrote a Yale Law Journal article describing “New Property.”  The new property Reich discusses is you and me, and how we are used by bureaucrats like property to be abused, harmed, and mistreated, all through the largess of the government we pay for.  Like a wheelbarrow or a hammer, we are the fodder upon which the bureaucrat steals money from one person to pay another person through government benefits, all to the enrichment and personal satisfaction of the bureaucrat.

Government Largess 2The actions of the nameless and faceless bureaucrat are unconstitutional, but allowed in the name of “government action.”  Every time you hear the government is acting on your behalf, it means that the power of the people has been stolen, and will be doled back to the taxpayer in infinitesimal amounts, while the bureaucrat keeps getting fatter.  Think Reich (1964) is wrong, here are some examples.

  • The government went to war against poverty, the poor have become poorer, poverty’s blight has spread, but the government offices “fighting” poverty are fat with people and taxpayer dollars.
  • The government went to war against drugs, the only winner so far has been the government.  The drug infestation has only gotten worse, and now states have begun selling harmful and illicit drugs for the tax money.
  • The government got into student loans, to “make the lending field fairer.” Students were harmed, colleges and universities tripled, or more, their tuitions, and students are saddled with increasing levels of debt.  But, the government officers in charge are living high on the debt and interest.
  • The government allowed labor unions to represent government workers, now the taxpayer is abused, treated like scum, taxes went up, but responsibility and accountability under the “Rule of law,” that all citizens are expected to live by, have all but disappeared for government workers.  Ever tried getting adjudication or remediation from a government worker?Government Largess 4
  • The government and some private citizens decided black health needed improvement. Planned Parenthood and the Tuskegee Syphilis Study are but two of the disasters that hit the black communities and have destroyed their community’s legacy, honor, and power, all for government largess, and the lining of private pockets.

Choose to stop being the property of the government; the US Constitution declares the government works for us, and we control them, not the other way around!

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

 

Relieve the Suffering – I-CARE: Shifting the VA Paradigms

I-CareDuring my tenure as a medical support assistant (MSA) in the emergency room of the Albuquerque, NM VA Hospital, I took a class being offered on the new direction the VA customer service was going to embody called I-CARE.  I-CARE became my objective, as a customer service professional. As a dual-service/service-connected disabled veteran, I saw the abuses prevalent in the VA Hospital and wanted to change myself and provide mentoring to my co-workers in adapting I-CARE principles into their daily efforts.  Unfortunately, because of labor union interference, leadership failures, and supervisor efforts to counter I-CARE implementation, my efforts were discounted, denigrated, and derided until I was discharged from VA employment.  But, I-CARE remains a part of my commitment, my professional outlook, and personal commitment to customer service was forever changed by implementing the principles of I-CARE.

Leadership CartoonI write harshly about the crimes of the VA because I-CARE and deeply desire to see the VA bureaucracy changed, to witness the adoption of I-CARE into the daily efforts of every VA employee, and to see the VA leadership teams develop policies and procedures that will benefit the veterans, and relieve the suffering of veterans, their spouses and children, and live the VA mission of bearing up those who have born the pains of battle.

ProblemsI have seen veterans blithely refused prompt care because of the frequency that veteran had been seen, the lifestyle choices of that veteran, or simply because a charge nurse or doctor did not like the politics of the veteran as displayed by their clothing.  I have seen illegal actions taken to turn people away from care at a VA Hospital Emergency room by VA Police officers, charge nurses, and other nursing staff, and been powerless to stop these crimes because the hospital leadership refused to act, and became hostile to the employee’s reporting the problems.  I have witnessed leaders delete emails reporting problems as those emails were proof and evidence of crimes cannot be allowed to remain at the VA.  I-CARE about these issues; I report these problems, but because I-CARE I also provide solutions, easy fixes that could be applied and adapted for the relief of suffering and reduction of risk to the hospital.  My reports all were ignored while an employee, from the team leader to the director of Hospital Administration Services (HAS), to the hospital director’s suite, all sorts of deaf ears and crickets were in attendance.  I reported issues to the Veterans Integrated Service Network (VISN) which is a geographic group of VA Medical Centers under common leadership; also, to no avail, crickets, and deaf ears.

I-CareYet, I-CARE; still, I-CARE drives me and motivates me to see change occur at the VA.  To right the wrongs, and rebuild the VA.  One of my early leaders at the NM VA Hospital said something very prescient, “If a civilian hospital did half-the things the VA Hospitals get away with, they (the civilian hospital) would have been shut down and the leaders imprisoned.”  Having witnessed a year of crimes personally, seeing the inability for change to occur due to leadership, watching talent wasted, and monitoring the revolving door of employees in the VA, I concur with that statement.  The leader who spoke had 25-years of civilian hospital administration experience, before coming to the VA, and the VA would only hire this well-educated, highly experienced person as a GS-7, an entry-level employee.

Image - Eagle & FlagIn the coming days and months, I will continue to write about the VA.  Using personal experience, patient experiences related to or personally witnessed, and the Department of Veterans Affairs – Office of Inspector General investigation reports, as the reasons for the solutions I propose.  I-CARE, enough to stand as a witness that the VA in its current form cannot, and should not, be allowed to thrive any longer.  Change must come to the Department of Veterans Affairs (VA), including to the Veterans Health Administration (VHA; hospitals and clinics), the Veterans Benefits Administration (VBA; compensation and pension claims), and the National Cemeteries.  Thus, I witness my commitment to I-CARE and the VA.

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Department of Veterans Affairs – Xray Follies – Shifting the Paradigms

I-CareDuring the COVID-19 pandemic, I have been trying to give the benefit of the doubt to the VA; I was wrong to extend this kindness.  The Clement J. Zablocki VA Medical Center in Milwaukee, Wisconsin, was investigated by the Department of Veterans Affairs-Office of the Inspector General (VA-OIG) due to reports of leadership failure and manipulation of radiology reports.  The VA-OIG found gross errors in treatment delays, misleading reporting in records, and the leadership both knew and were tolerating this behavior.  From the report, we find that the VA-OIG, “… found evidence of manipulation and vulnerability of the electronic health record and mismanagement of the Medical Imaging Service. Facility leaders failed to successfully manage or address the impact of interpersonal conflicts within the Medical Imaging Service that included intimidation of staff radiologists.

Sadly, I am not surprised at the findings in this investigation; for a considerable time now, the VA has suffered from leadership irregularities, poor leadership, mismanagement, and over management in the majority of the local hospitals.  This situation remains highly frustrating to the veterans cursed with needing the VA’s services, and this madness must cease!  If it were not for another VA-OIG report declaring follies and leadership failure specifically in the radiological department, the dire situation would not have been so egregious.

The VA-OIG began their report of the VA Illiana Health Care System in Danville, Illinois, stating the following:

This report is compelling because it discusses significant patient safety issues including a radiologist’s error rate, the facility’s radiology quality assurance program, and a recommendation to the Under Secretary for Health regarding adopting national radiology guidelines.”

The VA-OIG inspection began due to radiological concerns and a high error rate.  The VA-OIG discovered such a poor error rate, a second investigation was required to expand upon the issues found in the first investigation.  A radiologist had an incredibly high error rate, and the facility leaders did nothing.  Does this not initiate a leadership cleaning of the house to remove the rot and begin to build community trust; if not, why?

To be clear, both the local hospital leaders and the Veterans Integrated Service Network (VISN) leaders are at fault for poor leadership decisions.  From the VA-OIG report, we find, “Veterans Integrated Service Network and facility leaders failed to conduct a thorough and impartial review related to the OIG request to evaluate the original allegations.”  Leading to another question, actually repeated now for multiple years, why are the local leaders, who created the problems, “conducting a review” during the VA-OIG investigation?  Isn’t this akin to placing a bank robber in charge of the criminal investigation into the bank robbery?

X-RayThe primary care doctor, emergency room doctors, and more all depend upon the radiologist report as the VA doctors no longer read x-rays, MRI’s, CT Scans, due to the complexity of the imaging.  Thus, any error in the radiological report causes significant patient care delays, harm, or death.  Yet, at two geographically separate VISN’s and Hospitals, the VA-OIG is reporting poor QA and high error rates in radiological reporting.  Compounded by leadership failure at both the local hospital and the VISN level.  The VA-OIG reports do not relate that anyone was fired, forced to change jobs, or other remedial actions taken beyond making “suggestions” for improvement at the federal, VISN, and local hospital levels.  What significantly increases the problem, these same radiological records form the backbone of the compensation and pension decisions.  Downstream issues were not in the scope of either radiological investigation. Still, every error in the VA bureaucracy has a significant downstream impact that always seems to be forgotten or overlooked.

Secretary Wilkie, lacking a downstream review from the VA-OIG investigations, places patients at significant risk and incredible harm.  Consider the following; the VA-OIG reported last year (2019) that radiological reports on spinal problems were not adjudicated correctly in compensation and pension claims from 2002-2006 roughly.  No downstream review occurred, and thousands of veterans’ claims are locked in the appeals process for decisions that should have triggered an automatic analysis and new radiological reports ordered immediately upon the conclusion of the VA-OIG’s investigation.  Where is the culpability and responsibility to the veterans harmed and suffering all because the VA did not do their collective job?

Problems

Now, at least two VA facilities are hindered by radiological errors and poor leadership at the hospital and VISN level.  Thus, the veterans need to know, can any radiological reporting be trusted with this blemish on the VA record?  Quality assurance (QA) is the backbone of the radiological imaging and reporting processes to assure the patient that proper diagnosing is happening.  Yet, QA is the problem in two different VA-OIG investigations of the radiological departments, and how many other VA Medical Centers have the same problem but have not been caught?  Where is the accountability for preventing these issues in other VA Medical Centers?

Here are five suggestions for rebuilding the reputation in the community, and in the VA Health Care System (VHA):

  1. Downstream investigations are critical and need initiation upon discovery by the VA-OIG of wrongdoing. Downstream investigating includes compensation and pension decisions, patient medical record discovery, and fixing the problems in the healthcare record.  Build an internal team of various professionals who can investigate and initiate these reviews.  Doing so will build trust, save millions of dollars in wrongly adjudicated compensation and pension claims, and saves lives in the VHA.
  2. Since the leadership failures are so common, so prevalent, and creating such an incredible talent drain, all while risking patient health, it is time for the VA to begin growing leaders through a VA University program. Do not allow leadership currently working for the VA to apply without good reasons; allow open applications where students can learn, can graduate with a degree, and can work in VA leadership roles as they gain a formal education.
  3. Begin weeding the leadership for the most disingenuous, detestable, and despicable leaders, replacing them with people who have never worked for the VA but are capable and willing from other industries. The VA needs new ideas, new leaders, and new methods if they are to fix the current problems.
  4. Put teeth into the VA-OIG investigations. These problems as so egregious and widespread that the VA-OIG needs tools to demand compliance and insist upon remediation.  In three VA Medical Centers in Albuquerque, NM., Salt Lake City, UT., and a VA Clinic in Ashtabula, OH., I have heard the following, or something similar, from employees regarding VA-OIG investigations, “Don’t worry.”  Never again should any VA Employee not worry about being investigated by the VA-OIG.
  5. ISO9001Start using an ISO 9001 for healthcare as a QA program where processes and procedures are written down and followed. QA should be a program that fits holistically and improves people.  Quality assurance should be a constant learning evaluation that never ends.  Yet, somehow the VA, including the VBA, the VHA, and the National Cemeteries, always seem to not have a quality program.  Implement the ISO 9001 one VA Medical Center at a time until a whole VISN is working under the ISO program.  This allows the VA to learn and use these learning moments to build anew that which has fallen into disrepute.

Leadership CartoonSecretary Wilkie, some will suggest these ideas are expensive, but how expensive has the revolving door in human resources been for talent drain?  How costly has failed training programs been?  How expensive is the appeals process to compensation and pension decisions both in green and blue money?  The short answer, too bloody expensive.  Thus, it is time to begin looking for innovative ideas, using new ideas, employing new talent, and demanding higher returns for the taxpayer investment in the Department of Veterans Affairs.

©Copyright 2020 – M. Dave Salisbury

All rights reserved.

The author has used images in the Public Domain and holds no copyright or intellectual property rights to the images used.

Please contact the author through LinkedIn for permission to reuse or reprint:

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Communication: The Devil is in the details – Shifting the VA Paradigm

I-Care23 January 2020, I wrote about how a medical support assistant (MSA) was negatively influencing communication between my primary care provider and myself.  Today, I discovered the Department of Veterans Affairs – Office of the Inspector General (VA-OIG) is reporting the same problems in several other VA Medical Centers across the country.  One veteran waited 36-calendar days for a positive test result notification; yet, because there were no “adverse patient events as a result,” the lack of communication is not considered an issue.  Another example involves a patient and do not resuscitate (DNR) orders, along with family concerns and end-of-life home hospice care.  The VA physician/hospitalist in charge had four incidents raising concerns the VA-OIG investigated, where the need to improve communication is the problem with no solution, support, or quality controls.

I guarantee, if there is a 36-day lag in a positive test result notification to me, there would be an adverse patient reaction.  While the VA-OIG made communication recommendations, I would bet dollars to doughnuts that the problems in communicating remain a significant customer service issue.  Why, because the majority of comprehensive inspections the VA-OIG conducts include failures in communication, and the amount of communications issues resemble bunny rabbits in a field with no predators.

The “I-Care” customer service program at the VA reports the following in every I-Care class:

“How we treat veterans today determines if the veterans choose the VA tomorrow.”

On the I-Care Patient Experience Map, how communication is used influences how the veteran feels about choosing the VA for their needs.  Yet, the VA continues to communicate like the veteran has no choice, no options, and does not matter.  Here are some communication tips, tailored specifically to the VA; may they find application quickly in VA customer operations.

  1. The VA claims that the primary care provider, the nurse, the MSA, and the patient are a healthcare team.  If this is the case, then the first step in improving communication is a technical fix opening as many channels of two-directional communication as possible.  Including email, voicemail, text messaging, telephone, fax, and instant messaging.  If the patient has all these channels, and they do; why can’t the nurse, the doctor, and the MSA use all the same technology to communicate?
  2. The VA has improved on this issue, but there is considerable improvement still to make; when test results come out, copy the patient on the results, automatically. But, where the patient’s results are concerned, explain the results.  Have the nurse or a physician assistant write some comments about the results, before sending them onto the patient.  Currently, I receive bloodwork results and have to Google/Bing my way through the results and guess when discussing the results with my spouse.  I received bloodwork results from UNM, the results came in digitally to my email box, with hyperlinks to explanations by doctors in the UNM system.  I received X-Ray and MRI results that claimed “all normal;” this does not tell me anything and increases the problems in understanding what was observed in the X-Ray and MRI.
  3. Face-to-face customer service is a skill that requires training, quality assurance, and monitoring. Yet, the MSA’s at the VA, who do the most customer influencing communication, are not trained, monitored, or quality assured.  The result, patients are treated horribly or are treated amazingly well, based solely upon the individual.  Unfortunately, the leadership in charge of customer service are often the worst offenders for poor customer service.  This must change; implementing a quality assurance program is not difficult, or expensive, and provided the quality assurance does not become the stick to beat people into submission, will provide positive fruit.  But, everyone who communicates with a veteran needs training and needs methods for improvement.
  4. Stop active listening as the standard for communication. In a hospital environment, especially, the standard should be reflective listening to achieve mutual understanding.  Active listening skills can be faked, thus inhibiting proper communication.  As an example, review the physician hospitalist who was able to fake care for patients sufficiently to fool the VA-OIG, but the patients and their families were left without feeling they had communicated sufficiently to act with confidence.
  5. “I-Care” is a good program; why has it not become the standard for all customer interactions? There is no reason for this program to not be a mandatory baseline standard of employee behavior from Secretary Wilkie to the newest new hire.  Yet, hospital directors can dismiss “I-Care,” refuse to implement “I-Care,” and disregard “I-Care.”  To grow the “I-Care” culture, every employee needs to onboard and commit; where is this being insisted upon?

Too often, the root cause analysis is either poor communication as the issue, or a substantial sub-issue; yet, even with the insistence of the VA-OIG, communication failures remain.  No more!  The VA must implement “I-Care” for every employee, implement a quality assurance program for communication, hold communication training, and design communication goals for every classification of employee.  Most importantly, every single leader must exemplify the customer standards they want to see in their employees.  There are no valid excuses for failing to communicate!

 

© 2020 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.

The Department of Veterans Affairs: The Liars and Thieves Edition

I-CareIn December 2019, I witnessed an employee of the Department of Veterans Affairs, Hospital Administration, create rules to inconvenience a veteran, lie to a veteran, obfuscate, and generally mock a veteran.  The incident included the employee threatening the veteran with throwing away documentation, the primary care provider needed because the veteran was not mailing the forms to the doctor as the employee demanded of the veteran.  The veteran must travel and thought dropping off the forms would be acceptable; until he met this employee.  23 January 2020, I was the veteran being lied to, and my “cherub-like demeanor” evaporated faster than dew in a July sun.  For the December incident, I signed my name to a letter going to the Hospital Director Andrew M. Welch, written by the abused veteran, and testified that I witnessed the treatment this veteran received.  To the best of my knowledge, no action was taken by the hospital leadership where this employee is concerned, I asked.  A copy of this article will be sent to hospital leadership.  If any additional information comes available on this issue, I will write an addendum and update this article.

23 January 2020, 1505-1510, I went to my primary care provider’s clinic at the Albuquerque, New Mexico VA Hospital.  I had another appointment, was early, and went to ask why I am receiving letters claiming the primary care clinic is “having difficulty” contacting me.  The employee is titled “Advanced MSA,” which means they are a Medical Support Assistant who has been promoted.  For my other appointment, I have received two text messages, one automated call, and three appointment emails.  For my next appointment, 24 January 2020, I have received two text messages, one automated call, and three emails.  For my appointment in December 2019, I received two text messages, one automated call, and three emails.  I regularly receive calls from other clinics in the VA Hospital.  My cellphone has voicemail, and the voicemail is regularly checked and responses made.  Yet, the MSA claims, “I have tried calling you, and you do not have voicemail.”  I checked my recent calls, and showed the MSA where I had not received any calls from the VA on the days indicated, and asked why I can receive all these other calls from the VA, including the text messages, but only his calls are not showing up.  The MSA then became intransigent, resolute, and adamant, raised his voice, and told me our conversation was done.  After observing the ways and means of this VA employee over the course of many months previously, I wonder, “how many other veterans are not being contacted in a timely manner, while this person lies, cheats, and steals?”

Quality of FindingsUnfortunately, this is the standard, not the exception for the MSA’s in the HAS (Hospital Administration Services) Department, led by Maritza Pittore, at the Albuquerque VA Hospital.  I have witnessed multiple MSA’s committing HIPAA violations through record diving, gossiping about veteran patients, acting rudely, ignoring veteran patients and their families to complete conversations, and refusing to do their jobs.  As a point of fact, one assistant director one told me, “if what the VA does was replicated by a non-government hospital, they would be closed down and sued.”  While employed from June 2018 thru June 2019, I brought this to the attention of the leadership, including multiple emails and voice conversations with Maritza Pittore, Sonja Brown, and several other high-ranking leaders and their assistants, all to no avail.  I have had nursing staff tell me confidentially that they cannot do anything where the MSA’s are concerned because “it’s none of their business and outside their job duties.”  Yet, the VA continues to proclaim the MSA, the Nurse, and the doctor, along with the patient, are a “healthcare team.”  Upon being discharged, without cause, reason, or justification, I brought this information to the OIG, my congressional and senate representatives, among many others, all to no avail.  The level of customer service, especially at this VA Hospital, is far below the pale because the leadership refuses to engage and set standards for customer service, with enforced penalties. I-CareMore to the point, the employees mimic the customer service they receive from the leadership team.  Thus, even though the Federal VA Office has launched “I-Care” as a customer service improvement initiative, the customer service in this hospital continues to fall and will continue to fail until the leadership exemplifies the standards of customer service expected.

As a dedicated customer service professional, I have offered multiple solutions to the continuing problems veteran patients experience in the Albuquerque VA Hospital at the hands of the MSA’s and other front-line customer-facing staff; but the suggestions all continue to fall upon deaf ears.  I do not paint all the MSA’s and staff as liars, thieves, and cheaters, because there are some great people working at this VA Hospital.  Unfortunately, the rotten apples far exceed the good workers by multiple factors and powers, to the shame of the leadership team who continues to ignore the problem, deleting emails, and generally lying when placed on the spot about the problems.

An example of this occurred recently where a member of the staff of a congressional representative asked about communications sent from an employee to the Director of VISN 18, with carbon copies being sent to Maritza Pittore HAS Director, Ruben Foster MSA Supervisor, and Sonja Brown Associate Director of the Hospital.  None of those emails “magically” exist when asked for, and the verbal conversation included outright lies, misdirection, and complete fallacies.

Since the VA-Office of Inspector General (VA-OIG) continues to appear disinterested, I can only ask, “what does a person do to see action taken to correct the problems, right the abuses, and bring responsibility and accountability to the employees of the Federal Government?”  President Trump is providing great leadership, VA Secretary Wilkie is doing a good job and needs more help, but the elected officials in the House and Senate refuse to do their job, and the middle management of the VA is entrenched, obtuse, and inflexible.  The US Media treats veterans’ issues as a punchline to a bad joke.  Still, the problem worsens; still, the abusers maliciously treat people abhorrently; and still, those placed in leadership positions stall, obfuscate, and hinder.

My treatment at the VA Hospital in Albuquerque includes being physically assaulted by an employee, my medical records perused by, and then gossiped across at least four separate clinics, and still that MSA remains employed.  In fact, this employee was promoted for her “good work and dedication to helping veterans.”  I am sick and tired of the poor treatment, the harassment, and the vindictiveness served to veterans of all types, sizes, and colors, at the hands of petty bureaucrats as they visit the Department of Veterans Affairs.  The Albuquerque VA Hospital is one of the most egregious examples of bad behavior and nepotism in the country and it is past time the leadership was replaced and the assaults and crimes brought into the sunshine for some “sunshine disinfectant.”

cropped-snow-leopard.jpgUpdate to this article, 10 May 2020: By the first week in April 2020, the Advanced MSA in the clinic was moved to a less customer-facing post and a new MSA hired.  The quality of that individual was never experienced due to relocating.  The supervisor of the MSA was not very interested in correcting the problems and that showed when I visited with them while trying to obtain an appointment that the Advanced MSA refused to schedule.  Change must come to the VA!

© 2020 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Leadership and the Department of Veterans Affairs – Shifting the Paradigm on Killing Veterans (Part 2)

I-CareAs a new decade and year begin, the Department of Veterans Affairs Office of Inspector General (VA-OIG) reports continue many of the same themes from 2019 and earlier, specifically the failure of leadership.  There is an axiom in the US Military, applicable to the Department of Veterans Affairs (VA), “When leadership fails, soldiers die!”  Well, leadership at the VA faile,d and veterans are dying and this is an inexcusable trend requiring immediate rectification.  Leadership at the Minneapolis VAHCS, Minnesota failed to communicate, and a veteran struggling with suicide ended their life while admitted to the VA Hospital.  While the VA-OIG brought several issues to bear on the leadership team, I noticed a blatant irregularity, from the report comes the following:

The internal review team identified many lessons learned for which the Veterans Health Administration (VHA) does not require action items. VHA does not provide written guidance on the identification of lessons learned, related action expectations, and how to distinguish lessons learned from root causes.”

Why perform an after-action review (AAR) and not require action items to be identified, actions to be taken, and methods to measure change?  Why does the Veterans Health Administration (VHA) not provide guidance on how to conduct an AAR?  Leadership communication is a root cause in many of the blunders the VA generally, and the VHA and Veterans Benefits Administration (VBA) specifically, suffer on a regular basis in VA-OIG reports, yet the oversight teams in Washington D.C. cannot be bothered to provide written guidance; this is a perfect example of designed incompetence, and the veteran continues to be abused by the bureaucracy.

Designed incompetence is the term for establishing a bureaucracy where excuses can be automatically made, problems never addressed, and people not held accountable as a system benefit, not a system flaw.  The VA-OIG report held another gem, “During an internal review, the facility’s root cause analysis team did not interview staff members involved in the patient’s care.”  Designed incompetence protected the leaders, allowing for excuses to lead to a dead veteran, and the bureaucracy protected their own by not properly investigating.  At my local VA Hospital in Albuquerque, NM., not talking to staff members directly involved in an issue is a well-worn game, where employees have been arbitrarily dismissed and the leadership protected, veterans have died, staff and patients have attacked patients and staff alike, and more, all because the investigations are conducted without ever talking to people involved in the issues.

The VA-OIG raises a final issue, “The Patient Safety Committee and the Quality Management Council meeting minutes did not document deliberations and track actions to resolution.”  Leading to the final question, why conduct an AAR if you are not going to act to rectify a problem?  Failure to change means the veteran who died in a hospital is disrespected more in death than in life, and this is utterly and completely reprehensible conduct by the VA.

The VA-OIG conducts Comprehensive Healthcare Inspection (CHIP) of various VA Medical Centers, I remain fascinated at the trends that continually and regularly are commented upon, and I would ask the VA-OIG, do you have trend lines for certain occurrences of issues in CHIP inspections?  For example, in doing a rudimentary review of the VA-OIG reports in my email box, I find a total of eighteen (18) CHIP reports from the VA-OIG from 12/01/2019 through 01/15/2020 and not surprisingly there is a regular problem arising in every single report, “Implementation of corrective actions from root cause analyses.”  Thus, not only is the CHIP regularly citing problems with conducting and implementing action items from root cause analysis, the same issue is killing veterans, and the designed incompetence was displayed in the comments from the VA-OIG, “… the Executive Leadership Board was not following actions until completion.”

Department of Veterans Affairs Office of Inspector General, when regular comments are found, who tracks and works on the nationwide issues?  Where does your data go once collated into trend lines?  Are you receiving support from the elected officials to which you report performance?

Elected officials in the House of Representatives and the Senate, you and your staff have access to these same reports, what are you doing to hold the VA leadership accountable?  What are you doing to support change in the VA Bureaucracy to stop the veterans from dying at the hands of designed incompetence?  When will you be as ambitious about veterans as you are about getting re-elected?  You were elected to do a job, you are part of the leadership problem at the VA, when will you act?

© 2020 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.