Spoiling Good Goals with Bad Metrics

Posted Monday, June 9, 2014

The Veteran’s Health Administration exists to give the best possible medical care to America’s military veterans. One way to do this is to set goals for standards of care. But the VHA’s good goals were spoiled with bad metrics. According to the Washington Post:

The agency has made it a goal to schedule appointments for veterans seeking medical care within 30 days. But the interim IG report found that in the 226-case sample, the average wait for a veteran seeking a first appointment was 115 days, a period officials allegedly tried to hide by placing veterans on “secret lists” until an appointment could be found in the appropriate time frame.

“We are finding that inappropriate scheduling practices are a systemic problem nationwide,” the report stated. “We have identified multiple types of scheduling practices not in compliance with VHA [Veterans Health Administration] policy.”

The goal to schedule timely appointments was important to the VHA’s mission. It was specific, measurable and time-bound. Yet, the behavior it triggered was not better healthcare for veterans. Instead, multiple leaders and employees at multiple VHA sites cheated the system by distorting the metrics. Why? And, what can leaders do to avoid making a similar mess of their good goals? 

A Recipe for Goals

Goals done right can elevate the performance of your team. Recently, I proposed a recipe for leaders to make goals more effective:

Set SMART goals. Smart goals are specific, measurable, actionable, realistic and time-bound. Part of being realistic is making sure none of your employees have too many goals.

Coordinate goals. Use management by objectives to ensure goals are coordinated between people and organizations.

Provide metrics. Create goal-specific metrics to further shape and refine behavior.

Avoid goal blindness. Goals can focus attention and energy too much, causing people to miss other important issues. Use principled leadership, shift your focus periodically and resource goals properly to avoid goal-induced blindness.

If your take steps to avoid goal blindness, and you help your team create goals that are SMART, coordinated and backed by metrics, what could go wrong?

Missing Ingredients Spoil the Dish 

Forgetting the yeast will waste a batch of bread, and skipping the sugar will ruin a pitcher of lemonade. The VHA scheduling goal seems to have been missing a few ingredients. The goal was specific, measurable and time-bound, but was it actionable and realistic?

For a goal to be actionable and realistic, those accountable for the goal must expect to succeed if they take the right action. The demand for VHA services has increased with the influx of new veterans and the aging of Vietnam era veterans. In many cases, demand for services has exceeded capacity. There just aren’t enough doctors, nurses, therapists and facilities to care for the patients.

If you set impossible goals, expect failure. The failure may show up right away in the form of missed goals and demotivated employees. Or the failure may be hidden for a while by gaming the metrics. But the failure is inevitable if the goals are not actionable and realistic.

Avoid the Mess

What could can leaders do to avoid making a mess with metrics?

Trust but verify. Metrics must be valid and reliable. Leaders should be trusting, but they should also audit metrics to make sure they are working.

Plane panelGet experts to review your metrics. Verify metrics with other data, such as checking quality data with customer surveys. Be especially vigilant if people provide their own metrics.

Treat missed goals as a signal. It is tempting for leaders to blame poor performance on their followers. Yet, when goals are missed, they can signal a system failure. 

If an employee misses a goal, don’t just reprimand, threaten or punish. Instead, trigger intelligent change. Talk about the causes of performance and help create an action plan to make a difference.

Don’t assume all the actions will be by your employees. As the leader, you may have to create a more realistic goal or provide the resources to make success possible. To fix the VHA mess, Congress should demand action by the Veterans Administration. They should also fund the employees and facilities needed for success.

Bottom Line: As a leader, your job is not done when you set goals with your team. You have to provide resources to your employees so the goals are actionable and realistic. You have to make sure the metrics are valid and reliable. And, you have to respond to missed goals with dialogue and insight. Otherwise, your metrics can make a mess of good goals.

Dedicated to Joseph W. Slade, Sr. and Dallas Wiggins
U.S. Army Veterans
Patients of the Hampton VA Hospital
All veterans deserve the level of care these soldiers received. 
In Honor of Joseph W. Slade, Sr. (350x288)

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