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The VA Scandal and Deming's Points 11 and 12

The VA scandal is an excellent illustration of what Dr. W. Edwards Deming was warning us about in Points 11 and 12 of his 14 Points. Point 11 reads, "Eliminate numerical quotas for the work force. Eliminate numerical goals for management." Apparently, VA managers established an unreasonable quota of a maximum of two calendar weeks' waiting time to get an appointment and/or treatment.

Most VA offices aren't open on weekends. Even at a "good" private hospital, how often does one get in to see a specialist in less than two weeks? So, a goal outside the capability of a process can be achieved -- but only at the expense of other components of the system (including accurate and honest record-keeping!).

Deming's Point 12 reads, "Eliminate barriers that rob people of their right to pride of workmanship. Eliminate the annual rating or merit system." The VA evaluation and merit bonus system -- as it always does -- fostered short-term thinking and behavior. Anything to get a high rating; anything to get the annual bonus; even cooking the books...