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Addressing Government Backlogs Requires Measurable Goals

Just about every government department or agency has a backlog of work. Many just accept government backlogs as a way of life and do not try different approaches to address their operations. The Department of Veterans Affairs (VA) has a large backlog of cases but to its credit they are establishing big measurable goals to achieve the “right recipe for success”.

Goals established by the VA include:

– Zero backlogged cases by 2015
– 98% accuracy in processing claims

Some of the initiatives undertaken by the VA to achieve these goals are:

1) Undertaking a new approach for processing claims

2) Moving to a paperless claims process

3) Increasing training for employees

A New Approach For Processing Claims

Through a new “intake processing center,” claims are routed to one of three segmented lanes:

Express: Claims that have only one or two medical conditions, or have all the supporting documentation, medical evidence and service records needed for an expeditious rating decision—referred to as “fully developed claims”.

Special Operations: Claims requiring special handling because of the unique circumstances of the Veterans. These include financial hardship; homelessness; serious wounds, injuries or illnesses; Post Traumatic Stress Disorder associated with military sexual trauma; and former prisoner of war status.

Core: Claims with more than two medical conditions, or those that will need additional evidence to make a compensation decision.
The segmented-lanes approach helps increase speed and accuracy because the claims specialists become familiar with processing claims of similar complexity.

The VA estimates the core lane will contain 60 percent of claims, with 20 percent of claims going into each other lane. The system will improve the claims process by ensuring it addresses critical cases promptly, while also prioritizing the completion of simple claims. Case workers will work in one of the three categories and will increase in efficiency and accuracy as they become familiar with claims of similar complexity.

Through this new model the VA hopes to process an additional 150,000 to 200,000 claims annually. “This new model is a part of our comprehensive plan to eliminate the compensation claims backlog,” said Under Secretary for Benefits, Allison A. Hickey. “Our redesigned model follows comprehensive planning and testing to ensure we have the right recipe for success.”

Moving To A Paperless Process

The VA has teamed up with the National Archives and Records Administration by signing a deal to use the archives agency’s high-speed, high-quality scanners to digitize the huge quantity of paper records the VA currently uses to make benefits decisions.

Increasing Training For Employees

Increased training has improved the productivity and accuracy of employees. Employees who have completed a new training program process 150 percent more claims per day, with a 30 percent increase in accuracy, when compared to employee performance under the previous program. To date, more than 1,300 employees have taken the training, which is now in place for all newly appointed or reassigned employees who handle disability claims.

What do you think about the efforts being utilized by the VA to reduce their case backlog? Can the approach utilized by the VA be applied to governmental agencies and departments at the local level?

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David Dejewski

I managed the help desk (among other things) at Bethesda Naval Hospital (The National Naval Medical Center) back in 1997-1999 time frame. Service calls were recorded in technician’s notebooks and on stickies attached to their computer monitors when I took over. No central database. No dispatch or prioritization. The way to get something done was to grab a tech by the arm as he came in to work in the AM.

After setting up a Remedy system (now called BMC Remedy) and collecting all the calls, we discovered literally thousands of back logged requests. Our next move was to set out to tackle them.

I started a program I called “Going for the Goose.” Goose was a nice was of saying we were shooting for Zero – a Big Fat Goose Egg – back logged calls. The program was a tremendous success and we hit zero just a few months later. My teams remained in control of the work flow for the balance of my time there.

A few things we learned in the process:

  1. People appreciate communication more than speed. It’s not enough to get things done faster. We need to communicate with our customers along the way. I used to teach my staffs to keep a big government calendar by their desk. When talking with customers on the phone have them circle the date you promise to follow up with them on. The job doesn’t have to be done, but you better not ever miss that date. Set aside a portion of every AM to make follow up calls and let people know what’s going on. Their tolerance is exponentially greater when they get regular contact. Later, we added automatic email alerts to tell a customer when status of a job changed.
  2. Prioritization needs to be done on customer terms. It’s not enough for us to prioritize without the customer: A server is more important than a printer, for example. That’s based on assumptions that may or may not be accurate. In the case of one old printer in the pharmacy – it printed pharmacy labels for prescriptions. If that puppy went down, a line of patients would extend around the corner and down the hall in 15 minutes! Prioritization rules need to be synchronized with the priorities of the business supported. In the VA’s case, with the patients as well as with the other parts of the system.
  3. Front line employees need to feel some connection to the goal. It’s not enough for management to have a goal – even a stated measurable goal. The employees involved in completing the work need to have a stake in the success. They need to feel motivated to do the little things necessary to connect with customers, to walk something through, to follow up, etc. Financial bonuses might work, but I found fun and good-natured competition go a long way. Holding my fingers up and hollering “Going for the Goose!” brought smiles to people’s faces and got them involved in the process. Simple, but effective.