COMMUNITY HEALTH CENTERS – Taking Action - The Fourth Practice – c. Focus on Opportunities

COMMUNITY HEALTH CENTERS – Taking Action - The Fourth Practice – c. Focus on Opportunities

We have reviewed the practice of an effective community health center Executive Director in Taking Responsibility for Communicating. Let’s look at the practice of Focusing on Opportunities:

Successful Community Health Center Executive Directors focus on opportunities rather than problems. Problems have to be taken care of; they must not be swept under the rug. But problem solving does not produce results. It prevents damage. Only exploiting opportunities produce results.

Change as Opportunity

Effective Community Health Center Executive Directors treat change as an opportunity, not as a threat. They look for changes, and ask: “How can we exploit this change as an opportunity for our community health center and its patients?”

Executive Directors also make sure that problems do not overwhelm opportunities. Effective Community Health Center Executive Directors scan these seven situations for opportunities:

1. An unexpected success or failure;
2. A gap between what is and what could be (a highly under-utilized situation in community health centers);
3. Innovations;
4, Changes in structures;
5. Demographic changes and gaps;
6. Changes in mind-set and perceptions;
7. New knowledge or new technology.

Best People on Opportunities

Effective Executive Directors and Senior Managers put their best people on opportunities rather than problems. They ask their staff to prepare two lists every two months:
A list of opportunities, and
A list of their best performing people.

Then they meld the two lists putting the best people with the best opportunities.

Next post: COMMUNITY HEALTH CENTERS – Taking Action - The Fourth Practice – d. Making Meetings Productive

COMMUNITY HEALTH CENTERS – Taking Action - The Fourth Practice - b. Taking Responsibility for Communicating

Taking Responsibility for Communicating

We have reviewed the practice of an effective community health center Executive Director to take responsibility for decisions. Now, let’s look at the practice of Taking Responsibility for Communicating:

Action Plans and Information Needs

Effective Executive Directors of Community Health Centers make sure that both their action plans and their information needs are understood.

They share their plans with, and ask for comments from, all their colleagues.

They let each person know what information they need to get the job done.

They identify the information they need, ask for it, and keep pushing until they get it.

Next post: COMMUNITY HEALTH CENTERS – Taking Action - The Fourth Practice – c. Focus on Opportunities

COMMUNITY HEALTH CENTERS – Taking Action - The Fourth Practice – a. Taking Responsibility for Decisions

COMMUNITY HEALTH CENTERS – Taking Action - The Fourth Practice – a. Taking Responsibility for Decisions

Yesterday we reviewed the practice of effective community health center Executive Directors to Write an Action Plan. Today, let’s take a look at the practice of Taking Responsibility for Decisions:

When Community Health Center Executive Directors translate plans into action, they need to pay attention to:

1. Decision-making,
2. Communication,
3. Opportunities (as opposed to problems), and
4. Meetings

Let’s review one at a time: Taking Responsibility for Decisions.

A Decision Is Not Made Until

A decision has not been made until people know:
1. The name of the person accountable for its execution;
2. The deadline;
3. The names of the people who will be affected by the decision, and have to know about, understand, and approve it – or at least not be strongly opposed to it;
4. The names of the people who have to be informed of the decision, even if they are not directly affected by it.

Many community health decisions run into trouble because these bases are not covered.

Review Decisions

It is just as important to review decisions periodically, at a time agreed to in advance. That way, a poor decision can be corrected before it does significant damage. These reviews cover the results, and the assumptions, underlying the decision.

Such a review is especially important for that most crucial of decisions: hiring or promoting people.

Review Hiring Decisions

Only one-third of promotions are successful, the others are either draws or failures. Effective Community Health Center Executive Directors know this, and check up within 3-6 months.

If that decision is not as effective as expected, they don’t blame the employee. They look at themselves, and admit their mistake. The people who fail at jobs may not be the ones to blame. The Peter Principle is merely an excuse for senior managers to avoid making adult decisions and taking adult responsibility.

Community Health Center Executive Directors owe it to their community health center and to their staff not to tolerate non-performing individuals – people have a right to competent management. It may not be that employee’s fault, but that employee must be removed or reassigned.

Next post: COMMUNITY HEALTH CENTERS – Taking Action - The Fourth Practice - b. Taking Responsibility for Communicating

COMMUNITY HEALTH CENTERS - THE THIRD PRACTICE - Write an Action Plan

COMMUNITY HEALTH CENTERS - THE THIRD PRACTICE - Write an Action Plan

Yesterday we reviewed the practice of effective community health center Executive Directors in asking the question: Is This the Right Thing for Our Center and Our Patients? Today, let’s take a look at the practice of Writing an Action Plan:

Write the Action Plan

Effective community health center community health center executive directors are doers; they execute. Knowledge is useless to them until it has been converted into effective behaviors and deeds. However, before springing into action, the effective community health center executive director needs to plan the course. The community health center executive director needs to think about:
1. Desired results
2. Probable restraints
3. Future revisions
4. Check-in points
5. Time expenditure implications

Define Desired Results

First, the community health center executive director defines desired results by asking:
1. What contributions should the community health center expect from me over the next 18 months?
2. What results will I commit to?
3. With what deadlines?

What Are The Restraints?

Then the community health center executive director considers the restraints on action:
1. Is this course of action ethical?
2. Is it acceptable within the organization?
3. Is it legal?
4. Is it compatible with the mission, values, and policies of the community health center?

Affirmative answers will not guarantee effective action, but violating these restraints does make it wrong and ineffectual.

Note that the action plan is a statement of intentions, not a straight jacket.

Check Results

Also, action plans need to create a system for checking the results against the expectations. Finally, the action plan has to become the basis for the community health center executive director’s time management. Time is the community health center executive director’s scarcest and most valuable resource; and, community health centers are inherently time wasters. The action plan will prove useless, unless it’s allowed to determine how the community health center executive director spends time.

Without an action plan, the community health center executive director becomes a prisoner of events. Without check-ins to re-examine the plan as events unfold, the community health center executive director has no way of knowing which events really matter, and which are only noise.

Next post: COMMUNITY HEALTH CENTERS – Taking Action - The Fourth Practice – a. Taking Responsibility for Decisions

COMMUNITY HEALTH CENTERS - Getting Needed Knowledge – Is This the Right Thing for Our Center and Our Patients?

COMMUNITY HEALTH CENTERS - Getting Needed Knowledge – Is This the Right Thing for Our Center and Our Patients?

Yesterday we reviewed the first practice of an effective community health center Executive Director, by asking, and answering, the question: What needs to be done? Today, let’s take a look at the second practice, asking the question:

Is This The Right Thing For Our Center And Our Patients?

An effective community health center executive director's second practice is to ask: “is this the right thing for this community health center and its patients?”

They do not ask if it’s right for an individual board member, the network, their own status. They know that the board is an important constituency that needs to support a decision, or at least acquiesce in it, is the choice is to be effective. But effective executive directors also know a decision that is not right for the patients will ultimately not be right for any of the stakeholders.

Asking: what is right for this community health center and its patients?” does not guarantee that the right decision has been made. Even the best are prone to mistakes. Failure to ask this question guarantees the wrong decision will be made.

Next post: COMMUNITY HEALTH CENTERS - The Third Practice - Write an Action Plan

COMMUNITY HEALTH CENTERS - THE FIRST PRACTICE - GETTING NEEDED KNOWLEDGE – WHAT NEEDS TO BE DONE?

COMMUNITY HEALTH CENTERS - THE FIRST PRACTICE - GETTING NEEDED KNOWLEDGE – What Needs to be Done?

What Needs to be Done?

To overcome the mistake of failing to hire an operationally strong community health center executive director, the first practice for the Board is to ask the Executive Director “what needs to be done?” The question is not “what do you want to do?” Asking what has to be done is critical for the Community Health Center Board and for the executive director’s success. Failure of the Board to ask will make a community health center executive director ineffectual.

The answer to the question “what needs to be done?” always contains more than one urgent task. However, Boards must acknowledge that effective community health center executive directors do not divide themselves. They concentrate on one task – one primary-cause-task (that, which when accomplished, will cause other events to occur).

First Things First and Second Things Not At All

If Executive Directors work best with a change of pace during their working day, they pick two tasks. Even the most seasoned executive director cannot remain effective doing more than two tasks at a time. The operating phrase is: “do first things first, and second things not at all.”

Other tasks, no matter how appealing are postponed. After completing the first priority, the effective community health center executive director re-sets priorities rather than moving to number two. The community health center executive director asks: “what needs to be done now?” this new question will result in new and different priorities.

Next Post: COMMUNITY HEALTH CENTERS - Getting Needed Knowledge – The Second Practice – Asking: Is This The Right Thing For Our Center And Our Patients?

The Tragic, Yet Avoidable, Mistake Made By Community Health Center Boards - 1. Failing To Hire an Operationally Strong Executive Director.

The Tragic, Yet Avoidable, Mistake Made By Community Health Center Boards - 1. Failing To Hire an Operationally Strong Executive Director.

1. Failing to Hire an Operationally Strong Executive Director.

This single tragic mistake, and this mistake alone, is not only the Community Health Center Board’s biggest mistake, but also it will lead to the following major errors:
a. Failing to define the mission and purpose of the Community Health Center (CHC).
b. Giving the CHC tasks that are not consistent with its mission.
c. CHCs using weak providers as its cornerstone.
d. Ineffective finances and financials.
e. Over-reliance on consultants.
f. Failure to develop management staff.
g. Expecting the CHC to handle work without getting paid.
h. Choosing an inappropriate computer system and software.
i. Maintaining the status quo.

During this next series of posts, we’ll discuss the above issue and its causative sub-issues.

Let’s begin with the number one issue: The failure of Community Health Center (CHC) Boards to hire an operationally strong executive director.

Why does this occur?
Is it really that difficult to hire a competent manager and leader?
What should a Board look for? How?
What are the factors necessary for an operationally strong Community Health Center Executive Director?

CHC Boards of Directors are often eager to hire a perceived “heavyweight” to run their operation. However, that heavyweight may not have sufficient top-level management experience, and little understanding of the operating basics, that are critical in a CHC. CHC Executive Directors must demonstrate that they can run the CHC more effectively than the physicians, the senior staff, or the office managers – not just more effectively that their predecessor.

Easily said, but what constitutes an effective Community Health Center Executive Director?

CHC Boards need to address the following in a series of interviews, spread over several weeks, involving all Board members, senior management, and a few outsiders. This is the most important decision the Board will make.

An effective community health center executive director does not need to be a stereotypical leader in the sense that the term is now used. As Peter Drucker outlined in “What Makes and Effective Executive”, leaders are all over the map in terms of personality, attitude, values, strengths, and weaknesses.

What makes community health center executive directors effective is that they follow these eight practices:
1. They ask: what needs to be done?
2. They ask: what is right for the CHC?
3. They develop action plans.
4. They take responsibility for their decisions.
5. They take responsibility for communicating.
6. They focus on opportunities rather than problems.
7. They run productive meetings.
8. They think and say “we” rather that “I”.

Does this sound familiar? Is this what exists in your community health center’s Executive Director? If so, you are quite fortunate. If not, this series of posts could help your community health center and its underserved patients.

Next Post: Community Health Centers - The First Practice - Getting Needed Knowledge.