Turnaround at the Veterans Health Administration (A)

By: Amy C. Edmondson and Brian R. Golden and Gary J. Young

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Synopsis: Investigates the challenges that Dr. Kenneth W. Kizer confronted in seeking to create organizational change at the largest integrated health care system in North America, the Veterans Health Administration (VHA). Kizer was appointed as the Under Secretary of Health, to oversee the VHA, in 1994. Upon Kizer's arrival, it was immediately apparent that the management style that pervaded the VHA was ineffective and out of date. At the same time, the VHA faced inefficient health care delivery systems coupled with a steadily increasing number of patients. Kizer started to make plans to change the VHA into a modern, responsive, efficient, and effective health care organization. However, success in executing on his plans would require challenging a bureaucratic system with a long history. Documents progress, including organizational efficiencies gained that include consolidation of health care facilities, and illuminates leadership actions that facilitate this progress. Clearly, many challenges still lie ahead. Near the end of the case, Dr. Kizer awaits news from Congress on his reappointment for another four-year term.