I've seen this sort thing inside my own corporation. Managers set goals, that they don't understand and then everyone underneath, figures out how to get around the goal to "engage" success. The fall out is always the same, we spend time after the initiatives, fixing the mistakes and realize that it takes two weeks instead of a week to do the job.
Unfortunately, the managers of the VA were playing with peoples lives...I wonder if such goals have ever occurred in private hospitals or public clinics? Rather, than spending a few minutes thinking about risk they proceeded without anyone's opinion.