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Using HCD to Reimagine Veteran Healthcare

Breaking the Status Quo

In the wake of the global COVID-19 pandemic in 2020, the “Reimagining Veteran Healthcare” project set out to not only study what has changed about health care for Veterans during the pandemic, but also investigate what might change to better anticipate Veterans’ needs of the future. This inflection point was an opportunity for VA to drastically rethink how to meet evolving patient expectations and a changing population of Veterans.

This vision for the 20-year future of VA emerged from research with Veterans, Caregivers, front-line staff, healthcare experts, and VA leadership. Starting with the core users of VA services yielded a web of opportunities spanning from discovery and design to technical development, prototyping, piloting and implementation —utilizing the full range of Human-Centered Design (HCD) methodologies, tools, and approaches. 

While VA has several ongoing and near-future transformational programming in the works, there is a large gap when considering truly transformational future opportunities. This is where Reimagining Veteran Healthcare stepped in. Our team from Technical Assent and Deloitte had a goal of developing breakthrough, nonlinear innovations of service delivery models to create or capture markets, services, products, and customer segments that have yet to exist.

Putting Veterans at the Center

To keep Veterans at the center of our work, the team conducted ethnographic research with 100+ stakeholder interviews (virtually and in-person) with Veterans, clinical providers, familial caregivers, subject matter experts, and other key VA staff members. These helped the team ​​uncover pain points, bright spots, and/or validate our assumptions about the current state of Veteran healthcare, understand the post-pandemic priorities and behaviors of different populations of Veterans, and inform several transformational opportunity areas. 

“[I define health as] having the ability to accomplish all the things that I want to do in my life […] without any hindrance from medical or monetary or any of those things that naturally get in the way. The quality of things I am consuming in life. It’s the total of all those things.”

“If I could just visit one entity, one website, have everything available to me on ONE Dashboard or profile. If it was tailored to me and what I went through it would be so much more helpful.”

“It’s symptoms first, then based from symptoms, give prescriptions that alleviate those symptoms. The immediate question is always ‘What can I give you?’ Well, I don’t want a medication. I want to solve why it’s hurting in the first place.”

Developing Customer-Driven Solutions

Based on the insights that emerged from conversations with 250+ stakeholders –including Veterans, caregivers, and front-line staff, consensus was found around three critical priorities for VA’s future:

  1. Redefine Veterans’ initial encounter with VA – VA has a critical opportunity to elevate health as a priority with Veterans during and following transition. Connecting proactively with personalized tools can create a seamless transition for Veterans to join the VA following active duty.
  2. Deepen ongoing customer service efforts and engagement – Veterans feel the fragmented nature of the VA. By creating a backend system that puts Veteran health records, feedback, and preferences in one place, VHA can provide a more seamless front-end experience while empowering employees to own each individual interaction and overall health journey.
  3. Extend the envelope of care – More than ever, Veterans expect care when, where, and how they want it. COVID-19 highlighted an opportunity for VA to extend care beyond its walls and broaden its definition of health and healthcare delivery.

Across these three central opportunities, 11 solution concepts were developed that allow VA to create transformational change for Veterans. These solution concepts are rooted in the Veteran experience, taking an outside-in look at what’s needed for VA healthcare delivery. Currently, the team is partnering with VAMCs to pilot and iterate on the solution concepts and help Veterans access VA care when and where they want it in the future.

How do you keep your customer at the center of your work? What opportunities are there to think outside the box to anticipate future customer needs?

A man looks at a bulletin board of ideas

Three Companies Proving Agile is Successful Outside of Software

Agile is often referred to as a project management framework, methodology, or a mindset and is widely used throughout software development companies. You may have heard about some of the benefits of Agile like increased productivity, higher success rates vs. traditional project management, and boosts to customer satisfaction while simultaneously decreasing time to market, costs, and waste.

With results like these, you might be asking if Agile could also work for your organization, even if you’re not in software development. Unfortunately, I often encounter the mindset that “Agile is only for software, its principles don’t apply to us.” I think that’s just plain wrong. As a Certified Scrum Master and Product Owner myself, I often see Agile principles in practice beyond their perceived scope of software development, even using Agile in government work.

It’s true that many software development companies have adopted Agile and been greatly successful with its implementation, but why couldn’t professional services like Management Consulting, Human Resources or Marketing use the same principles to reach success? That very question was the focus of the recent Business Agility Conference in NYC. In a first of its kind event, 300+ agile professionals, consultants, and business leaders participated in a series of short presentations and facilitated workshops to discuss how applying Agile can, and is, innovating and disrupting current markets while increasing organizational success outside of software development.

While there were several great presentations focused on successful Agile implementation outside of software development, I think the following three presentations did a particularly great job:

David Grabel – VistaPrint

VistaPrint, a marketing company for small businesses, conducted an evaluation of their waterfall methodology revealing that the teams were taking more than 60 days to take a new idea to a deliverable. However, the 60-day cycle amounted to only about 40 hours of actual work.

Why, if the actual life-cycle takes only 40 hours of actual work were they seeing the process take two months to deliver? A root cause analysis revealed they were suffering from feedback “swirls”, blaming, unclear decision rights, and long creative lead times.

VistaPrint made the decision to switch to Agile, focusing on decreasing project lead time. They began by promoting team environments, information sharing, and transparency. They implemented team building activities, daily stand-ups, Kanban boards, an idea pipeline, more informational touch points, and retrospectives to review what went well and what didn’t to improve their processes for the future.

In five months, they saw their Lead Time decrease from 40 days to 15 days. Five months later, they would see this drop further to 7 days, an 83% improvement overall.

Dan Montgomery – AgileStrategies

Dan Montgomery was hired as a consultant and coach to help 5Acres, a not-for-profit orphanage placing children with permanent loving families, improve their business model to increase the number of children placed with permanent families each year.

The current system used a waterfall methodology and a hierarchical management framework. The control was tightly coupled and often failed in cascading down to the appropriate levels for execution. The organization also found that there were far too many initiatives being worked simultaneously further affecting their ability to successfully plan, execute, and deliver results.

5Acres began the transition to Agile by conducting team building activities and deep dives to define the organization’s initiatives. One key outcome was implementing the use of Objectives & Key Results (OKRs). They committed to taking on only 1-5 initiatives at a time to improve the likelihood of success. The teams focused on the mantra “start less and finish more.”

In doing so, 5Acres took over 30 strategic initiatives and prioritized them to set five clearly defined, measurable, organizational goals to reach by 2020. The clearly defined goals helped 5Acres hone in on their key objectives and desired outcomes over a short 3-5 year horizon resulting in a focused, attainable plan.

Isabella Serg – AgileIBM

Agile is not necessarily new to IBM. The technology company has been using Agile across IT programs for years. The novelty was implementing it in their Human Resources department.

IBM was facing challenges in recruiting and retaining top talent including the difficulty of attracting STEM talent, an expanding global workforce, and a need to better manage high and low performance across the organization. To improve their employee services, HR conducted an evaluation of their current practices and identified two areas that would benefit from an Agile approach: its hierarchical organization and implementation of a specialized work force within HR; and managing work in progress (WIP).

IBM started by identifying their Big Hairy Audacious Goals (BHAGs) which fed into the creation of cross-functional, self-selected teams. Making the change from specialized, management assigned teams to cross-functional, self-selected teams increased employee feelings of empowerment, purpose, and collaboration ultimately resulting in better work products.

The teams implemented a backlog to manage their WIP. This provided transparency and focused employees on finishing a task before starting a new one. The teams were then able to measure their work and end results providing them further insights into their strengths and identify areas for improvement.

As we can see from these three examples at the Business Agility Conference, Agile is not only successful in software development, it’s just the first industry that really proved it works. Creating cross-functional collaborative teams can lead to employee empowerment and boost team performance while delivering better client results. Developing measurable, attainable, time-boxed goals can lead to a higher likelihood of successful execution: start less and finish more. Implementing transparent work practices, measuring end results, and evaluating strengths and weaknesses can lead to process improvement and increased efficiency.

 

The basic principles of Agile center on collaboration, transparency, and the creation of self-organizing cross-functional teams. Almost any organization can build on those basic principles to achieve success.

Three business women talking

Expertise as a Service: Emotional Intelligence in Consulting is Crucial

Consultants – including myself –love to talk about how emotional intelligence in consulting is a critical skill in our industry. But why is that?

Our Technical Assent team spent some time thinking through this question during one of our regular professional development sessions; the idea we kept coming back to is that emotional intelligence (also referred to as EQ) is critical to a consulting firm skillset because it supports our ability to deliver expertise as a service.

Even if you don’t know what emotional intelligence is, there’s plenty of literature now on the subject and why it’s important in the workplace. It’s popularly defined as “your ability to recognize and understand emotions in yourself and others, and your ability to use this awareness” (Bradberry 2009).

Emotional Intelligence in Consulting: More than Empathy and Communication

What I don’t see a lot of are specific reasons explaining WHY our emotional intelligence is so especially helpful in consulting. We often use words like “communication” and “empathy” to describe the connection, but that’s not terribly precise or helpful. If we understood the linkage better, maybe we could exploit it more effectively, too.

Let’s stop and think about what consulting is really about. As a consultant, it’s not enough to have the answers. What distinguishes a good subject matter expert or analyst from a good consultant (and you certainly can be both) is the ability to effectively provide expertise to help another achieve their goals – it’s expertise “as a service”. And services are fundamentally about supporting customers – their goals, in their operating context, in terms that make sense to them.

Connecting these ideas – provision of knowledge as a service and focus on the customer – I can see a few distinct and specific linkages between emotional intelligence skills and excellent provision of expertise as a service.

    • Ability to not only listen, but understand. Effective consulting starts with understanding a client’s goals. However, it’s often hard for folks to understand their own goals well enough to articulate them. It’s harder still to articulate them well enough that another person understands them. Consultants with well developed emotional intelligence can meet their clients halfway on this; emotional intelligence in consulting helps us understand the client’s desired outcome more easily. And when it comes time to diagnose the root cause of a problem, the cycle repeats itself.
    • Ability to translate understanding to our recommendations. We’ve all been there at least once: we present a well-reasoned and logical recommendation to a client and the client rejects it. There’s many reasons this can happen; it’s often tempting to say the client just “doesn’t get it”. The truth is that a staff member who leverages good emotional intelligence in consulting firms to really understand their client will generally be able to construct recommendations that support their client’s goals in the client’s context – avoiding these situations altogether.
    • Ability to separate personal emotions from recommendations. If you do run into a truly difficult situation with a client, a professional difference of opinion can easily become an argument because we take pride in our work, and pride is an emotion that begets other (not so productive) emotions. There is no way to avoid disagreement 100% of the time, but facilitating outcomes in spite of disagreement requires an effective response. A consultant with well-developed emotional intelligence will be able to control their emotional responses in these situations and use the disagreement as feedback to improve the client’s outcome rather than letting it become a roadblock.

What do you think? Are there other specific conclusions can we draw to explain this concept of emotional intelligence in consulting to non-consultants, students, and new practitioners? I’d love to hear your thoughts.

eli whitney innovation in muskets

What Eli Whitney’s 1798 Gun-Making Contract Can Teach Us About 21st Century Defense Innovation

In 1798, faced with potential war against France, President John Adams directed a threefold increase in the number of ready army soldiers.  At the time, gun-making was a complex craft; skilled gunsmiths worked by hand to create each distinctive weapon.  The young government didn’t have the capability to manufacture the weapons it needed, so Adams turned to private industry for support.

Eli Whitney, the famed inventor of the cotton gin, won one of the 28-month contracts to produce 10,000 “stands of weapons,” enough to outfit 80% of the army with new muskets. As the story goes, after two years of contract performance, Whitney had produced exactly zero guns. Instead, he had focused his attention on building a better system for building muskets. He built the factory and the machinery, trained a labor force for how to use it, and developed repeatable assembly process.  The result was the first weapons system where one musket behaved similarly to another and used interchangeable parts.

Outputs Vs. Outcomes in Defense Innovation

While there are certainly some starting points here for a conversation about acquisition reform, I’m focusing on a different, larger issue: how a narrow focus on outputs can distract us from pursuing the right outcomes.  Our military faces similar challenges today as they did in 1798, sharing  a need to rapidly scale its capability and evolve to multi-dimensional threat. Back then, they did it with more soldiers and more muskets; today we do it with much more sophisticated, integrated weapon systems.

We’re living in a new era for innovation in the Defense industry.  Defense Secretary Ash Carter is shaping and expanding an innovation unit in Silicon Valley (DIUx)—and the Department of Homeland Security is following suit.  Professors at Stanford University have students and soldiers collaborating to identify “hacks” for the way DoD does business. Groups like the Defense Entrepreneurs Forum (DEF) are facilitating discussions about major issues the Third Offset, Force of the Future, and Goldwater-Nichols Act Reform.  Earlier this month, the Senate Armed Services Committee released its draft of the 2017 Defense Authorization that splits the Pentagon’s largest office in an effort to improve management of research and development  efforts.

These examples suggest a consensus that fostering innovation in our defense machine is imperative to retaining our “edge” over competitors and obstacles—whether we are providing disaster relief and humanitarian support, or fighting large ground wars.  What government and defense leaders  don’t seem to agree on is where to start. What we really need is a system where we are continually getting better at getting better, where real change can happen faster than in 15-20 year increments.

Disrupting the Dominant Cycle of Thinking

Whitney’s brilliance is that he disrupted the dominant cycle of thinking at the time.  Instead of cranking out thousands of hand-crafted rifles, bayonets, and ramrods, he focused on building a system where new technology could be produced faster.  However, our current collective efforts to increase our technological advantages (e.g., Third Offset) seem more focused on buying better muskets—drone muskets, cyber muskets, nano-muskets, human-musket collaboration, inter-continental ballistic muskets—than building a system of innovation.  That needs to change.

Here’s a DoD-specific analogy for what that actually means.  Consider Innovation as an organizational capability gap.  DoD evaluates these gaps across Doctrine, Organization, Training, Muskets (i.e., Materiel such as equipment, tools, systems), Leadership, Policy, Facilities, and Policy (DOTMLPF-P).  Rather than looking first to innovative Materiel (“better muskets”) as we usually do, let’s first actually sit down and think hard about how we can innovate the way the department trains and equips our personnel to solve the problem in the context of the environment in which they must solve it.

Evolving Faster and More Effectively than the Competition

The ultimate strategy to counter competitors’ advantages (real or perceived) is a sustained, organic ability to improve and evolve yourself faster and more effectively than your competitors—rather than building a new portfolio of technologies.  If our objective is to create a system to get better at being better, there are two logical places to start:

Make the “Ability to Adapt” a factor for readiness.

Being ready to meet the demands of a mission is not simply a matter of assessing whether or not you have the right “kit” for the operation.  There is too much variation in the types of environments, the types of missions, and the circumstances surrounding those factors for you to assess readiness on equipment alone.  You have to assess whether or not the people and processes who will use the kit have the ability to adapt what they have (and don’t have) to fit the needs of the operation.

We need personnel who are ready to integrate themselves and their kit into the operation and be successful.  We need processes that allow them to do that—both in the field and in the headquarters functions that support them.  One way to do this might be to re-purpose some of the procurement budget for exercises. Don’t just assess readiness, test it.  Make these exercises faster to plan, less cumbersome to host and participate in, and cover more mission scenarios.  The more frequently we test ourselves, the better we understand our abilities, our needs, and the more we are inspired to innovate with real purpose.

Make non-materiel adaptability and innovation a tenet of the highest level guidance and plans.  

Strategic planning, policy, and doctrine provide a foundation on which much of the DoD’s ’s operations rest.  Like the mindset of our innovation efforts to date, these high level guidance and plans can also become too focused on “muskets.”  This is problematic because these high-level documents take years to formally update.  What’s published is often “behind the times”—describing situations and solutions that occurred in the past rather than enabling future success in what may be a completely new environment.  Fixing the strategic foundation that guides the way we “do” defense requires: 1) moving guidance, policy, and doctrine away from 3-5-year update cycles; and, 2) maintaining focus on enabling adaptability and innovation rather than focus on musket-based (“Materiel”) solutions.

 

John DiLuna and Danielle Wiederoder wrote this with me.

acquisition innovation will yield better outcomes for government services

So you’re an Acquisition Innovation Advocate – now what?

The new initiative announced by the White House to encourage the establishment of Acquisition Innovation “Labs” in Federal Agencies is a great step towards facilitating a culture that facilitates ingenuity and innovation.  One aspect of the initiative urges Departments and Agencies to appoint Acquisition Innovation  Advocates as a means to foster greater innovation, to stand up Innovation “Labs“, — really just a commitment to experiment with better ways to solve mission challenges through procurement, but I’m going to stick with Lab for the rest of this post — and to participate in an established council.  If you find yourself named as your agency’s Acquisition Innovation  Advocate or otherwise leading an Acquisition Innovation Lab, I offer a sample roadmap that has an excellent track record in innovation efforts, especially those with the sense to run like a start-up.

If you want to move your Agency’s Lab forward from “good idea” to “real impact”, you need to overcome inertia: on Day 90, you need to have at least 3 pilots launched. This means you need to have something of value to offer to willing customers with active requirements and procurement problems to solve.  Which means you need a thorough understanding of the requirements in the pipeline, the missions of the owner of each requirement, what they are trying to accomplish with each requirement, and the specific procurement challenges most impactful to each.  And you have to do all of this in the context of your agency mission and strategy.

This probably sounds like a lot.  You might be anxious.  An important way to minimize stress will be to minimize the spin/churn cycle.  If you change an experiment while you’re running it, it’s impossible to assess the result.

Start in a green field.  The FAR isn’t a labyrinth; it’s a giant prairie with some critical fences and some occasional giant rocks.  OFPP and the federal CIO told you to focus on technology procurements.  I wouldn’t limit your opportunity for innovation to just IT.  Focusing on IT and digital is good – these have gotten a lot of attention in recent years – but looking at services more broadly is the biggest opportunity: 2/3 of the federal government’s $437 billion in contracts during Fiscal Year 2015 were for services – and IT/Communications products weren’t even half of the 1/3 that was product/supplies spend (FPDS-NG).  Look at the entire procurement journey – from requirement concept to contract closeout – and be open to trade-offs.  Look at the three major groups of participants – the customer, the procurement shop, and the prospective vendor.

First, lay a strong foundation by setting out to make your innovations a win-win-win for each of the three types of participants – your customer, the procurement office, and the vendors who will offer solutions.  Try to do this in your first two weeks.  Be clear about what your agency wants from this effort.  Is it the cheapest, fastest solutions? Or more about the quality of the service or product (utility & warranty)?  How does the customer experience factor into acquisitions (both from the government program manager and the vendor perspectives)?  This will drive what you measure and how.  Calling in support from an artificial intelligence system that lives in the cloudcan’t help you here.

Take this opportunity to spend a few days re-learning your agency as a buyer. What does your agency really buy? What does the requirement pipeline look like?  Based on this discovery and learning, identify major areas of opportunity.  If these are still IT, great. Run with it.

Second, recruit early adopters as customers for your Lab.  To do this you need to craft your value proposition – why these customers should take a chance on the Lab: be explicit, be objective, and be honest.  Aim to do this by the end of Month 2.  If you want to end up with three strong pilots, you need to start with 20-30 prospects.  An email announcing the experiment is one way to raise awareness.  You should also consider a road show among the customers who already have requirements in the acquisition forecast.  Use these early adopter prospects to build a pipeline of upcoming customer requirements for the Lab.  From this pipeline, you will draw your 3 pilot procurements.  There may be some back-and-forth with customers as you recruit them to participate.

To narrow the list, you first establish criteria for what constitutes a good pilot candidate – measured against the utility, warranty, and experience objectives you laid out in the first two weeks.  Next, you and your team do a first round of scoping these potential pilots.  What mission outcomes is the customer trying to accomplish or enable with this procurement? What’s the customer particular procurement problem, how might you solve it, what would it take, what are the obstacles, etc.?  Force-rank these potential pilots, and then take a couple of weeks to refine the scope of the best half with the customer.  Repeat this down-select process toward the end of month two.  As part of selecting your first three pilots, be sure that you can measure what you need to measure for each in a timely and accurate manner.  You can reduce angst by keeping this part simple; just focus on how each furthers your acquisition innovation outcomes.

Third, select the top three pilots, execute, and “land the plane”.    By Day 90, launch your pilots.  Measure your results. Listen to your customers, the acquisition professionals involved in each pilot, and the vendors who offering solutions (and those who aren’t).  Read between the lines.  Measure impact and perceptions on both sides of the acquisition equation (government and industry).  The people involved will make or break any innovation.

As you think about the pilots, understand what behavior you incentivized or disincentivized?  Are procurements appealing only to well-funded, established companies that can afford to take the risk?  Does the approach encourage competition?  What are the costs to bid on work relative to the award?  What is the impact to the market?  “If my agency continues this behavior…”

This roadmap should get you started on building and measuring your experiments with better ways to solve your agency’s mission challenges using procurement.  Next you need to feed what you learn back into more experiments and start scaling what works.

I love thinking about this stuff, and I’d love to hear what you have to say.

Revisiting the Doctrine of Completed Staff Work

Early in my career, a respected boss and mentor left an article on my desk about the doctrine of “Completed Staff Work.” The author’s thoughts on followership were presented in a memorandum from the early 1940s and present a relatively straightforward concept;when presenting a solution, the only remaining action should be approval or disapproval of the completed action. Your views should be placed before the decision maker in finished form so they can use them to achieve results.
While the language of the original version appears a bit crass (I have included it below for its dramatic effect) by today’s standards, it is largely accepted as appropriate guidance for staff-level professionals and appears to be equally entrenched in both military, government, and commercial best practice. If otherwise inappropriate, the tone certainly reflects the frustration and exasperation of the author, a senior military officer, at the moment he put pen to paper and fits into the hierarchical military structure of World War II.

In my particular case, we were not at war, per se, but I guess my boss was equally frustrated with the amount of additional research and rework that was needed in order for him to make a confident decision. The article was a subtle way of educating the staff into a change in behavior. Unfortunately, the article never sat well with me. Instead of the intended effect, it only served as a reminder of the formal power relationship between a supervisor and subordinate. The challenges we faced were too big for any one of us to handle so we naturally faced them as a team. To suddenly be reminded of my place in the organization was not the kind of empowerment I become accustomed to and I was left feeling that the doctrine was severely out of touch with our reality. But as I reflect back on the experience, I wonder if we can recast the principles of this forlong doctrine to teach the trained initiative that is highly regarded but apply it to today’s team- oriented atmosphere.

Let’s start with the basic premise that a) everyone is busy, b) resources are tight and c) our team trusts us because of our knowledge, experience, and expertise. We were hired to shoulder the responsibilities expected of our position. Even if the decision- making authority formally resides somewhere else on the team, that person or group is relying on us to provide a recommendation for how to proceed as if it were our decision to make. To present a recommendation, the following objectives must first be met:

      • The issues are clearly articulated in a fair, balanced way.
      • Issues are thoroughly analyzed including internal and external influences.
      • Several alternatives have been considered.
      • The solution is complete. It accounts for resources, staffing, time, & risk.
      • The recommendation has been coordinated with stakeholders.
      • The final product is prepared in final form for signature and requires simple approval.

 

The figure below outlines a process for meeting these objectives in a logical framework. If we expect someone to make a decision, this format helps them understand the full context, complexity, and impact of the decision at hand.

DecisionSupport

 

If this process is followed, the goal for the final presentation is to formally walk the decision-maker through the thought process. We are well-equipped to respond to leadership questions and concerns and with practice will learn about the dominant issues facing leadership. Over time, team trust is enhanced as the decision-maker understands the rigor applied to recommendations in this format. The table below can be used to format the recommendation whether through a presentation, white paper, or even a verbal briefing.

DecisionSupportMemo

This approach contributes to the professional development of junior staff members, as well. It opens an opportunity to understand the context and consequences (both intended and not) of challenges faced by the leadership team. Additionally, it provides unique access to different thought processes of experienced decision-makers – how they weigh various factors, how they perceive the environment, and how they rationalize their decision. Working through solutions in this manner exposes us to the senior leadership thinking that most professionals aspire to and is a great way to demonstrate that ability to the leadership team. There is no better evidence of problem-solving than real decisions applied to challenges faced by the organization.

 

Original Memo Text

NOTE: The full Completed Staff Work doctrine is presented below. As you read it, don’t let the tone of the memo distract you from the real lessons in leadership that are presented.  The following memorandum has been reproduced countless times by military and civilian organizations since World War II. The original source of the memorandum is unclear. Some reports indicate that the memo was issued in January 1942 by the Provost Marshal General, U.S. Army. It has also been attributed to Brigadier G.E.R. Smith, a member of the Royal Canadian Army, who released it in 1943, while he was serving as Deputy Director of Supplies and Transport, First Canadian Army. It can be found here.

 

SUBJECT: Completed Staff Work

The doctrine of “completed staff work” will be the doctrine of this office.

  1. “Completed Staff Work” is the study of a problem, and presentation of a solution, by a staff officer, in such form that all that remains to be done on the part of the head of the staff division, or the commander, is to indicate his approval or disapproval of the completed action. The words “completed staff action” are emphasized because the more difficult the problem is the more the tendency is to present the problem to the chief in piecemeal fashion. It is your duty as a staff officer to work out the details. You should not consult your chief in the determination of those details, no matter how perplexing they may be. You may and should consult other staff officers. The product, whether it involves the pronouncement of a new policy or affect an established one, should when presented to the chief for approval or disapproval, be worked out in finished form.
  2. The impulse which often comes to the inexperienced staff officer to ask the chief what to do, recurs more often when the problem is difficult. It is accompanied by a feeling of mental frustration. It is so easy to ask the chief what to do, and it appears so easy if you do not know your job. It is your job to advise your chief what he ought to do, not to ask him what you ought to do. He needs your answers, not questions. Your job is to study, write, restudy and rewrite until you have evolved a single proposed action – the best one of all you have considered. Your chief merely approves or disapproves.
  3. Do not worry your chief with long explanations and memoranda. Writing a memorandum to your chief does not constitute completed staff work, but writing a memorandum for your chief to send to someone else does. Your view should be placed before him in finished form so that he can make them his views by simply signing his name. In most instances, completed staff work results in a single document prepared for the signature of the chief, without accompanying comment. If the proper result is reached, the chief will usually recognize it at once. If he wants comment or explanation, he will ask for it.
  4. The theory of completed staff work does not preclude a “rough draft”, but the rough draft must not be a half-baked idea. It must be completed in every respect except that it lacks the requisite number of copies and need not be neat. But a rough draft must not be used as an excuse for shifting to the chief the burden of formulating the action.
  5. The “completed staff work” theory may result in more work for the staff officer, but it results in more freedom for the chief. This is as it should be. Further, it accomplishes two things:
      1. The chief is protected from half-baked ideas, voluminous memoranda, and immature oral presentations.
      2. The staff officer who has a real idea to sell is enabled to more readily to find a market.
  6. When you have finished your “completed staff work” the final test is this: If you were the chief would you be willing to sign the paper you have prepared, and stake your professional reputation on its being right? If the answer is negative, take it back and work it over because it is not yet “completed staff work”
transformation of government services

Services at the Tip of the Spear

We got through “WHY”, now let’s talk “WHAT”

In our last post, we argued that the government is foremost a service organization. While the statement itself may not seem particularly revolutionary, accepting government as services has some important implications.

If you accept government as a service provider then you also accept that governments have customers and those customers have expectations. This implies that customers make a choice whether or not to engage with the services provided by government. As a program manager and leader, it is important to understand these principles whether you provide a public-facing service or an internal service within a specific Department or Agency.  In this article, we survey the aspects of a public sector organization that could benefit from a service-oriented approach.

The operational component of an organization is almost always the best candidate for a service-oriented approach; improvements in core operations are the best way to drive better mission outcomes. This is the tip of the spear, if you will, for organizations and should have the most direct connection with carrying out the core mission of the agency. They benefit from having a clear service definition and direct contact with their customers.

For many (but not all) agencies, the people that support operations carry out their work in the public view – federal law enforcement officers, judges, diplomats, or job safety inspectors – can more easily name the direct beneficiaries of the services they provide. Continually operating in the public eye is not always glorious – it means that bad customer experiences are immediately scrutinized and business processes are continually measured for consistency, reliability, and fairness. For these reasons, the operations that execute the core mission of the organization present tremendous opportunity to focus on how what these services actually are and how they are designed and delivered.

As an operational program manager, you should assess how your organization is structured to deliver a positive service experience in line with your Congressional and Executive charters:

  • Charter. What is the essential mission in our charter and what outcomes (outside the program) will indicate how well we are accomplishing this mission? Everything begins here.
  • Workforce. People are the essence of every service business – they conceive and design the services for customers and they are also the primary means of delivery. Service businesses have substantially different needs from manufacturing or resource extraction businesses because your people must be equipped to interact with one of the most complex systems inexistence – another person! The talent that you are able to attract, develop, promote, and retain are the advocates of your organization’s culture. As operators, these are the truest representations of your brand to your customers and therefore, the recruiting, hiring, training, promoting, and retaining this talent must be grounded in the culture and business needs of the organization.
  • Business Processes. Service-oriented processes should be designed to produce outcomes, not outputs. An outcome has value associated with it that will benefit the end user. This requires that you have an ongoing appreciation for the customers’ needs. Understanding the journey that your customer goes through when they interface with your business processes and noting the points where they are truly delighted and the points where they get frustrated is a key first step.
  • Internal Partnerships. In our next piece, we will dive into some of the enabling activities that work in the background to keep the operations afloat. In these cases, the operator is their customer and you should have the same service expectations as your customers. In this case, manage the relationships with those service providers to ensure that your needs are sufficiently articulated and that you are providing sufficient input to their services to give them the opportunity to serve the broader mission more effectively.
  • Portfolio, Program, and Project Management. Individual successes of service-orientation should certainly be celebrated but are not necessarily the end-game. Developing a service-oriented experience for customers across all platforms where you do business authentically represents that being service-minded is permeating your culture.
  • Performance Management.  As an experienced operator, you inherently know the operational indicators that drive success on a specific mission or project.  Understanding what makes that service sustainable over the long-term and how to deliver repeatable results requires a broader focus.  Correlating measurements of customer outcomes to measurements of internal operations to measurements of workforce development is critical to effective service delivery.  This approach requires that you balance objective operational metrics equally to the softer, qualitative elements of innovation, professional development, and customer intent to transact.
  • Stakeholder Outreach and Engagement.  This is a node for listening and for projecting.  When an organization understands itself as a service business, it naturally becomes more sensitive and responsive to customer needs and input.  If your mission is too complex to easily understand, then as yourself what you are doing to demystify it for the consumption of the broader population.  This also brings clarity and focus to strategy and operations, allowing agency messages become easier to articulate and communicate.  Organizations should be able to discuss in detail what it is doing for whom and how well it is doing it.  This ultimately allows citizens and their elected representatives to make better judgments about the value delivered for specific portions of our social contract.

 

In our next piece, we will explore some of the enabling activities that work to keep operations rolling.  As always, we welcome your thoughts in the comments below or to getstarted@technicalassent.com.