Improving Access at VA Case Review at Harvard Business School

The case for improving access to care at Veterans Affairs (VA) was recently reviewed by students at Harvard Business School (HBS).  The second section of the case review may have been the best discussion of the case ever in the class because of the thought provoking topics.  Students in both sections were inspired by presentations and commentary from Bob McDonald and Scott Blackburn and were deeply reflective about the case when the course wrapped up.

In particular, they were struck by how fully employees believed and ultimately invested in the turnaround, which they noted was especially impressive given our political climate. When we dug into how you were able to achieve this, they noted how the idea of running to the gunfire and exhibiting full humility in owning the challenges and embracing divergent perspectives about the organization struck a chord with them.

Applying Private Sector Experience to VA

Students were inspired to think about how their experiences in the private sector could potentially prepare them for work in the public sector. Several students shared how they aspired to follow in the footsteps of Bob and Scott and were heartened that their near-term experiences in business could prepare them for such a path.

They reflected more deeply on the idea of learned helplessness – and were struck by how poor system design contributed to the crisis – rather than the typical narrative of bad actors making bad choices.

The students also discussed a comment made by Bob that if you could be faulted, it was for not moving fast enough. Given how many of the top leaders were replaced, they grappled with the tension between going faster and potentially risking making poor, destabilizing choices in the assignment of new people to new roles and moving more slowly and deliberately with those assignments.

Turnarounds…A Relay Race

The analogy of the turnaround being a relay race led to another pasture of discussion, and they marveled at the persistence of the improvement, even after several leadership changes at the top. That topic ultimately inspired the students the most – the idea that a leader can make lasting change that extends beyond their tenure.

Time Provides a More Valuable Perspective

The VA case was presented back in 2016, and at that time it could only be speculated as to whether it would endure at HBS.  Now, having the benefit of time the evidence is very clear. Given the many challenges the students invariably will face in their careers, the VA case serves as a capstone for their experience at HBS.

(A very special thank you to Professor Ryan Buell for leading the HBS class and writing the VA case).