THE DEADLY SINS OF COMMUNITY HEALTH CENTERS - PART 5. RESISTANCE TO CHANGE AND DENIAL

The Deadly Sins of Community Health Centers - Part 5. Resistance to Change and Denial
Continuing our postings on the Deadly Sins of Community Health Centers (CHCs); yesterday we discussed Part 4 – Meaningless Networks. Today, we’ll look at the fifth sin: Resistance to Change and Denial.

5. Resistance to Change and Denial

Community health centers usually exhibit resistance to change — it is part of human nature. In community health centers, resistance to change is often accompanied by a very significant and well-articulated denial, i.e., protecting themselves from perceived threats by blocking knowledge from their awareness.

As a suggestion –
Executive Directors need to make sure that problems do not overwhelm opportunities. Instead of constantly putting-out fires, effective senior management staff will take care of the pyromaniac. They will put into daily practice Pareto’s Principle of 80/20; and immediately address the 20% (or less) who set those fires.

During periods of change, rather than using those periods to solidify their position and their status, Executive Directors need to scan these seven situations for opportunities:
1. An unexpected success or failure, in their CHC, or in another CHC;
2. A gap between what is and what could be in community health;
3. Innovation in a process, technology, service, whether inside or outside the community health center field;
4. Changes in practice structure, appointment structure, market structure;
5. Demographics (often missed by CHC senior management);
6. Changes in mind-set, values, perceptions, meaning, and/or expectations; and
7. New knowledge or newly acquired knowledge.

CHC Boards, at the monthly meetings, need to ask the necessary questions, and to think through the answers they receive:
1. Is their community health center effectively serving the underserved with direct patient-care services to which they would not otherwise have access?
2. Or, is the CHC merely doing what it has done in the past? With the same results.
3. Are the answers they are receiving actually excuses?
4. Have there been direct, measureable results for the patients recently?
5. If not, why not?
6. Is the Board accepting excuses from their senior management?
7. Are they accepting the same statements and rationale they received last month, last quarter, last year?
8. Have patient access and care improved? How? Is it measurable?
9. What will the community health center Board of Directors demand from their senior management?
10. What are their expectations for improved patient services?

These are some of the things that can be done by both the Board and senior management to continue improving their service to the underserved.
Next post: The Deadly Sins of Community Health Centers: Part 6 - Hamster Wheel as Strategy