Charlene Ehret set to retire Jan. 2

By Jeff Keeling

She brought private sector-type “lean” principles to her not-so-little corner of a huge federal bureaucracy. She dealt with a burgeoning service-connected population, partly thanks to wars in the Middle East and partly to expanded eligibility criteria. She endured on the local level what has nationally been “a really tough year,” such that she agonized over whether to stick around awhile.

But Charlene Ehret, who started out as a secretary with just a high school degree and rose to become director of the Mountain Home VA Medical Center, is retiring effective Jan. 2 after 43 years with the Department of Veterans Affairs.

“I have loved my job, loved every minute of it,” Ehret said during a Nov. 3 interview with News & Neighbor during which she teared up a few times. “Everybody says, ‘aren’t you excited, aren’t you excited?’ I am excited, but I’m struggling a little.”

The 67-year-old Ehret, who grew up in a blue collar family in Cincinnati suburb Covington, Ky. – “I could hear the Reds games from my neighborhood” – came up through the VA the hard way. She and high school sweetheart Barry Ehret, also from modest means, each saw the world for a couple of years – Charlene while singing with “Up with People,” and Ehret in college and then the military.

“It (Up with People) introduced me to diversity, to different opinions and how valuable it is to know where people come from and what they think,” Ehret said.

Barry Ehret, had made officer in the Army after being recruited while still in college, and after service he finished school while she worked. He was in TV advertising, and after his graduation, she was working and going to college part-time while they moved from Lexington, Ky., to Nashville and then Memphis.

Ehret had low-level secretarial and administrative jobs in each city after starting with the VA in Lexington in 1972. Just as she was finishing her bachelor’s in Memphis, Barry Ehret died of cancer. Ehret moved on to a VA in Salt Lake City, where she spent 12 years and earned her master’s degree. Stints in Denver, Prescott, Ariz. and Richmond, Va. followed before she took the directorship at Mountain Home in July 2006.

By then, she was a disciple of lean principles, and of the Baldrige performance management system. In the case of the VA, doing those elements well provided paths not only toward the highest level of quality, it helped the center improve safety. Doing them well, though, all came down to Mountain Home’s employees, who now number close to 2,400.

“I’m smart enough to know that if you don’t have engaged employees you’re not going to have good customer satisfaction,” Ehret said. “We’ve really focused on getting employees engaged into improving the work they do every day.”

That process started with introduction of lean principles and initiatives to reduce waste in the organization. It has grown from there, and the most recent year’s focus tied in directly with an issue that has been front and center nationally at the VA for more than a year: patient access. Mountain Home clients have had long waits to get appointments, and those statistics have been scrutinized at all VAs since an expose over wait times broke last year.

The most recent monthly tracking of wait times shows Mountain Home’s slightly above the national VA average in most categories.

“I’ll say right out, we have an access problem,” Ehret said. “Most of our access issues are in Knoxville (home to numerous outpatient clinics). We have limited space, and it really does all revolve around space – you can’t hire more teams if you have no place to put them.”

To that end, she said, Mountain Home recently began offering six 10-hour days weekly of clinic availability, and additional space is leased and under design. That should allow for extra teams and more mental health staff starting next spring.

As Mountain Home continues to grapple with access needs – not made any easier by growth in patient numbers that exceeds the national average – Ehret said the organizational principles have helped it be the only VA in its region that lives within its budget. Most years, that has allowed Mountain Home to add programs and invest in infrastructure. Ehret credits what she called “an interesting culture” here.

It was one that was fairly quick to embrace her commitment to performance excellence and lean principles. Beyond the budget discipline, that approach has helped Mountain Home garner the VA’s equivalent of the Malcolm Baldrige award, be noted as a top performer in key quality measures by The Joint Commission, which rates hospitals, and earn the highest VA annual inpatient satisfaction scores twice.

“This was a good hospital when I got here,” Ehret said. “I’ve been in eight hospitals. In this hospital you have a group of people who want to do the right thing. When I came here I asked the service chiefs, the clinical leaders, ‘what do you want from me,’ and they said, ‘we want leadership.’”

Ehret believes that leadership starts with listening.

“It’s important to know your organization, know what questions to ask, listen to your people, take as much input as you can and then just do the right thing. It sounds very simple, but it does take knowing where the pitfalls are. And one thing is, I’ve come up through the ranks. I know the organization pretty well.”

Ehret said she eventually received so much good feedback about her own story of climbing the ladder that she now uses it in new employee orientations.

“I know that if you work hard the VA system will support you in your career goals.”

Ehret, who married Steve Adcock in Mountain Home’s gazebo eight years ago after a lengthy relationship, said she and Adcock will probably do a lot of biking, distance walking, swimming, skiing and kayaking. She said it’s hard to leave a job she loves – doubly so because she’d love to see the access issue resolved on her watch.

Ehret said last year’s inclusion of additional dollars for veterans to seek out-of-VA care – something that was happening in a way that worked – hasn’t reduced waiting lists as much as was hoped. Now Mountain Home is trying to serve veterans who have tried to take that route without success.

“We’ll make it work,” she said. “We’re calling all of those patients anyway. We just brought 600 back and put them on our waiting list, because they were just stuck out there. There aren’t a lot of those providers in the community.”

Whatever Congress does and the media report, the VA’s mission will remain support of America’s veterans, Ehret said.

“My father was a veteran. I just think that what we do is provide a service to some very deserving people. I think everybody here is very proud of that and recognizes the importance of what they do. Clearly I do. I know every one of our constituents is important. I don’t know how many know me or not, but I have been here long enough to know many of the veterans and feel a lot of commitment to providing them service.”