Case Study: Achieving Results
Putting the customer first: How Barbara C. Morton helped transform the way our government serves veterans
In 2014, a major crisis hit the Department of Veterans Affairs.
Explosive reports claimed that the Phoenix Veterans Affairs Health Care System had for several years falsified data showing how long veterans were waiting to receive medical care. Internal data samples showed that wait times for some lasted an average of 115 days—well above the 24-day wait time officially reported by the Phoenix VA—and that at least 40 veterans died while waiting for appointments in the local VA system.
The coverup soon became a national scandal. President Barack Obama called the reports “dishonorable” and “disgraceful,” while former Sen. John McCain proposed significant reforms to veterans health care.
The VA is still making headlines today—but for different reasons. Thanks to its Veterans Experience Office and productive partnerships across and outside the VA, the agency has become a leading customer experience organization in government.
Launched under the leadership of then-Secretary Bob McDonald and in response to the Phoenix VA crisis, the office has transformed the way the VA serves veterans, as well as their families, caregivers and survivors. In turn, veterans have gained better access to critical support services and trust in the agency has skyrocketed.
At the heart of this transformation stood the VEO and Barbara C. Morton, the office’s indefatigable deputy chief veterans experience officer. In her nearly six years in the office, Morton has embodied the highest forms of public service leadership, navigating the federal system, using new types of customer-focused data analysis and human-centered design, and leveraging digital technology to design and implement innovative services that meet the needs of all veterans.
“My leadership style is rooted in my stalwart belief in the purpose of government, which is to serve the people first. I am always focused on making sure that government keeps its focus on those it serves,” she said.
“The best of both worlds”
Morton’s early work at the VA laid the groundwork for her to emerge as the agency’s chief customer experience champion.
She spent ten years at the Board of Veterans’ Appeals working across different career levels that allowed for both face-to-face contact with veterans and systems-level policy and operational design.
Early in her tenure, Morton got a “firsthand look at how challenging and frustrating it could be for veterans to navigate the appeals process” as a staff attorney. As director of operations, she eventually developed an appreciation for “creative problem-solving and cross-departmental, enterprise-wide challenges.”
A stint as an acting veterans law judge also required Morton to travel across the country to hold in-person hearings with veterans about their appeals—a role that enabled her to stay connected with veterans the board served.
The various roles provided her with “the best of both worlds.”
“I aspired to make a profound difference in these individual veterans’ lives, while simultaneously seeking to impact a larger scale of policy,” she said.
A formative moment came toward the end of Morton’s tenure at the board when she received a phone call from a World War II veteran lost in the appeals process. Rather than refer the call to another employee, Morton decided to personally handle the request, sensing the veteran’s anxiety and frustration with the status of his appeal.
“I could tell he was very anxious and just really didn’t understand what was going on in the process,” she said.
After taking his name and number, she conducted weeks of research into his case, working with partners across the department to rebuild his paper file with important records until the appeal could be properly processed. During this time, she also reached out to the veteran to provide periodic updates to respond to his concerns.
Eventually, the appeal was put back on track thanks to Morton’s work. During a final phone call with the veteran, he shared a sentiment that would deeply impact and stick with her: “I trusted you because I knew you would take care of me.”
From the story: How did Morton’s prior experience set her up for her new role?
For reflection: What drives you to stay accountable to all of the people your agency serves?
For action: How might you improve customer experience opportunities with your eligible customers—either internal or external—based on their needs or wants?
“A flash in the pan or a fad”
That sentiment stuck with Morton and would inform the trajectory of her work at VA.
After the Phoenix scandal, former VA Secretary Bob McDonald realized the agency needed to revamp the way it served veterans. To do so, he aimed to put the veteran first in everything the VA did—from providing outpatient care and processing appeal claims to scheduling appointments and enabling digital access to key resources.
In January 2015, the Veterans Experience Office launched to implement this vision. The office—a central customer experience bureau tasked with working across the VA’s three large subcomponents and serving the agency’s more than 400,000 employees—was an entirely new type of organizational setup in government. Rarely, if ever, had an agency built such a prominent platform dedicated solely to improving the customer experience.
Morton joined the office in July 2016 and recalled the early challenges it faced.
She said the VEO felt initially like a “startup” and was a “little bit undefined.” With the office still an unproven entity, people had doubts about whether the VEO would even survive.
“There were question marks about what the value of the office was or could be,” she said. “We needed to understand our organizational needs to make the office viable in the long term so it didn’t feel like a flash in the pan or a fad. Connecting the dots for people to show why the office was relevant was really important.”
From the story: How might feeling like a “startup” have helped Morton and her growing team start their work? How can this culture be replicated?
For reflection: When have you had to take over a project, role or assignment that had not previously succeeded? How did you navigate your environment to gain support from stakeholders?
For action: What new or ongoing initiatives are you or could you be part of in your agency? What principles, like “veterans first,” could you apply to keep focused on the end result?
“Sprinkling the seeds everywhere”
Given these factors, Morton realized that she needed to quickly demonstrate the proof of concept for the VEO’s impact to VA leadership and employees.
To do so, Morton and her team sought to bake the VEO’s customer experience goals into the VA’s core mission. She knew that would require navigation and understanding of the internal workings of the organization and its culture.
“Particularly in government, understanding the ecosystem around you is really a critical skill set for instituting any transformation initiative,” she said.
An early key was to “meet the organization where it was” and plant customer experience goals into its existing offices, strategies and structures, rather than create anything that would be imposed upon the organization. Ultimately, Morton said that working within the structures of the VA’s existing organization and culture made it easier to demonstrate to leaders and staff why the VEO was so critical to their work.
“We’re not the office that comes in and says, ‘You need to do this, that and the other thing.’ We work with our VA siblings and teams that we’re connected with,” she said.
For example, Morton collaborated with the Office of Enterprise Integration—which is responsible for developing agencywide VA policy and strategy—to include veterans’ experience metrics and the Veterans Journey Map in the agency’s strategic plan.
She also made sure that the agency’s Senior Executive Service performance plans include a metric related to the customer experience, and also codified customer experience principles in VA regulations as part of the agency’s core values.
On a higher level, the VEO has also worked to ensure that the customer experience is an official agency priority goal—something set in concert with the White House every two years. Morton said the strategy has helped “keep the VA on the hook” for emphasizing the customer experience.
Along with the Office of Management and Budget, she and her team also led the President’s Management Agenda priority goal of improving customer experience with federal services.
These strategies helped bake what many had seen as an abstract concept or idea into VA operations.
“We knew in the early days that people weren’t necessarily enamored with this office, so we just started planting and sprinkling the seeds everywhere by collaborating with our VA brothers and sisters and bringing the abstract concepts of customer experience from ideas to tangibles,” she said.
“Good ideas are great, but we had to operationalize CX at VA by hardwiring and anchoring it into the mechanisms of government and by delivering concrete tools, products and capabilities that demonstrated measurable impact to veterans and their supporters.”
From the story: Why was it important for Morton and her team to understand and work within the confines of the VA’s existing processes and organizational structure?
For reflection: In what ways have you observed government leaders effectively building transparency and accountability into the operating systems of the agency as Morton did?
For action: How might you strengthen accountability by planting seeds that root themselves into your organization’s key processes, strategies, reporting systems and regular planning?
“That’s what the data is telling us”
Morton also demonstrated the office’s immediate impact by seizing upon opportunities to use new qualitative and quantitative data, including human-centered design, to better understand the needs of all veterans. These insights lent further credence to the idea that the VEO had no intention of imposing itself upon the VA and its subcomponents.
“We met everybody where they were and offered the perspective of, ‘Hey, here’s what human-centered design and other experience data is telling us and these are the unique capabilities VEO can offer to support your mission,’” she said.
Using the Veterans Experience Journey Map—a foundational document that helps visualize and tell the story about how the VA fits into the life journeys of veterans, their families, caregivers and survivors—Morton and her team recently developed the agency’s first women veteran’s health journey map and its first tribal veterans journey map.
“We’ve done dozens of journey maps for specific veteran cohorts that have allowed us to dive deeper and deeper into the customer experience, understanding the moments that matter most to them, the bright spots and the pain points to address,” she said.
The VEO has also used the maps to hold the VA accountable to design plans with the explicit goal of better serving veterans. For example, Morton said that the office has mapped VA Secretary Denis McDonough’s larger strategic goals onto the journey map to show how his priorities align with the agency’s customer experience work.
“We have been able to elevate customer experience as a co-equal measure of our performance and that has been really transformational,” she said.
From the story: How does Morton use the VA’s listening strategy to build support and credibility for her team’s work?
For reflection: What are key pieces of information your agency needs to understand about its customers and how might you start to access this information? What kind of customer, operations or performance data exists in your field? When have you seen it used to enhance decisions and outcomes?
For action: What would a journey map look like for your customers? Are there specific communities among your customer base for whom you might develop specialized journey maps to ensure that you are best representing all possible customers?
“Research to insight to program to impact”
Morton and her team also took advantage of eagerness and like-minded thinking within the Veterans Health Administration to use journey mapping to understand how patients experience VHA medical services. She said this work emblemized her team’s opportunistic approach to making an impact.
“We recognized strategic opportunities with like-minded thinkers, grabbed them and then connected them to our mission—even if we didn’t anticipate them initially,” she said.
This human-centered design research yielded a surprising finding: Among the biggest frustrations veterans shared that they faced was navigating large and complex physical space of VA facilities and hospitals—a moment that would not naturally appear on a traditional operational performance dashboard.
In response, Morton and her team worked with the VHA to brand and scale the nationwide Red Coat Ambassador Program. Today, veterans entering any VA medical center are greeted by volunteers who offer directions so that veterans can find the service provider or resource they need.
Since the program launched in 2018, ease of navigation scores have increased by 4% on post-service surveys—a significant jump given the 9 million veterans the VHA serves each year.
Today, the Red Coat program is part of a larger package of patient experience initiatives that have transformed service at VA medical centers.
After consulting with leading customer experience experts, Morton and her team deployed an “Own the Moment” CX training workshop using a scalable train-the-trainer model to over 300,000 employees. The workshop has helped VA staff provide better customer experience by leading with empathy and developed standardized processes that enable agency personnel to more easily connect with those they serve, such as uniform phone greetings and hospital rounds.
Morton said the Red Coat program, in particular, demonstrates the tangible benefits that come with collecting human-centered design insights on aspects of service that matter most to veterans, rather than only relying on more standard operational metrics like number of appointments booked.
“If I’m a medical center director, my operational dashboard probably would not have shown me anything about ease of navigation,” she said. “It’s a great demonstration of the power of experience and human-centered design research to gain insight into what matters most to veterans to inform program solutions and generate positive impact for our customers.”
New insights have also enabled Morton, her team and partners across the VA to make the agency’s web presence more accessible for veterans.
In 2018, the office started hearing from veterans that they found it challenging to find what they needed on the multitude of VA websites. With so many companion sites and sections, veterans were unclear how to access critical information and benefits.
Morton and her team worked with the VA’s chief technology officer to designate the agency’s “digital front door” under the banner of VA.gov based on veteran feedback and build a more user-friendly site. The key was organizing a human-centered design sprint based on customer feedback and they found that most veterans looked to VA.gov as the central site for accessing key resources and transacting with the VA.
“That was the first time in my recollection that an organizational level, strategic decision was made that VA.gov would be the digital front door based on direct feedback from veterans. That was incredibly transformational,” she said.
The team then codesigned a new VA.gov experience with veteran input. As a result, the site went from a “very bureaucratic” reflection of the VA’s complex organizational structure to something far more intuitive for veterans themselves.
As a result, veteran satisfaction with their ability to navigate the website has increased by about 20% since 2018.
“When you design with, for and around your customer, you will always every time produce better results for them,” she said.
From the story: How did leveraging the use of technology for both employees and veterans impact the VEO’s goals and the VA’s mission?
For reflection: In what ways does your agency struggle with adopting new technology that promotes delivery? In what ways does your agency thrive with using new technology that promotes delivery?
For action: What might you do differently now to design products and services with the customer in mind based on insights about your customers’ needs and challenges? How might technology support you in making those changes?