THE DEADLY SINS OF COMMUNITY HEALTH CENTERS - PART 6. HAMSTER WHEEL AS STRATEGY

The Deadly Sins of Community Health Centers - Part 6. Hamster Wheel as Strategy.

Continuing our postings on the Deadly Sins of Community Health Centers (CHCs); yesterday we discussed Part 5 – Resistance to change and denial. Today, we’ll look at the sixth sin: Hamster Wheel as Strategy.

6. Hamster Wheel as Strategy

In the face of consistently declining reimbursements and disappearing grants, many community health centers adopt the "hamster wheel" strategy in which the centers run harder and faster to stay in the same place financially. Ultimately, there is a limit to how much can be done before that community health center and patient care begin to suffer.

Since personnel is policy, and since policy decisions, by the Board and implemented through the Executive Director, are the drivers of the operations and success of the community health center, effective people decisions are critical:

Selected suggestions for CHC Boards and Executive Directors:
1. If you put a provider or staff member into a job, and they do not perform, you have made a mistake. Don’t blame the person. Do not invoke the “Peter Principle”. Stop complaining, and fix your mistake.
2. Every employee has the right to a competent manager and leader. It is the Executive Director’s duty to make sure that the responsible people in their community health center perform (contribute effectively).
3. Of all the decisions an Executive Director makes, none are so important as their decisions about people. Those decisions determine the performance capacity of the CHC. It is your duty to make those decisions well.
4. The single “don’t”: Don’t give new people major assignments. This will only compound the risks. Put hat person into an established position where the expectations are known, and help is available.
5. Give major assignments to someone whose behavior and habits have been observed by you. Give those assignments to someone who has earned trust and credibility within the community health center. Make sure you know that person by performance, not by reputation.

The decision steps are few and basic:
1. Think through the assignment.
2. Look at a number of potentially qualifies people.
3. Think hard about how to look at these candidates.
4. Discuss each of the candidates with several people who have worked with them.
5. Make sure that person understands the job.

While community health centers cannot afford to ignore the political and market forces impacting them, they would be wise to focus their energy and resources on those internal forces which inhibit progress, and which they can control. Then they will be able to compete successfully in today's changing health care marketplace. Then they can continue serving the underserved.

Next post: The Deadly Sins of Community Health Centers: Part 7 - Repeating the Same Mistake and Expecting Different Results …