Posted August 03, 2017

Creating a Solid Foundation for Community Health Centers

By Jackie Gaines, MS, RN

I worked inside community health centers (CHCs) for more than a decade, so I know firsthand just how tough the job is—and just how dedicated the people are who are called to do this work. (Hint: They’re not in it for the money!)

Not only do the providers who work for CHCs offer a comprehensive array of physical, emotional and practical care in a single location, they go far above and beyond to meet the unique (and often humbling and even heartbreaking) needs of their patient base.

CHCs have always operated on shoestring budgets. But today they find themselves on especially shaky ground. They face the same regulation uncertainty that affects the healthcare industry in general. Government funding, both state and federal, is more vulnerable to cuts. There’s not as much philanthropy as there once was.

This means that CHCs must function at the highest possible level if they are to survive, let alone thrive. They must become efficient, effective and streamlined in all their operations, and they must attract and retain the very best clinicians and staff. It’s a tall order, but it can be done.

Through our coaching partnerships, we have seen CHCs make huge improvements after we’ve helped them put the right practices and processes in place. Columbia Basin Health Association (CBHA) and Choptank Community Health System (CCHS) are two notable examples.

CBHA, which was awarded Studer Group’s Physician Service Line of the Quarter Award in January 2017, has shown incredible improvement under its People pillar. For instance, as of that time:

  • Staff Turnover
    Target <18%
    Performance YTD: 12.59%
  • Top Box Employee Satisfaction
    Target 55% Top Box
    Performance YTD: 80%

CCHS, named Studer Group Community Health Center of the Quarter in April 2017, has also seen dramatic results in key pillar goals over the past year.

  • Patient Experience (Likelihood to recommend your provider)
    Target 90%
    Performance YTD: 96.85%
  • Employee Engagement
    Target: Achieve 89th percentile employee engagement rank by the end of 2017
    Performance YTD: 88th national percentile

Both organizations stand as proof that despite all the challenges CHCs face they can still produce quality outcomes and exceptional patient experiences.

If you are a CHC leader, I urge you to embrace the following must-haves: 

Make sure you create an annual strategic plan. This will guide your leadership and board decisions. The one-year length is long enough to provide some stability and structure, yet short enough to allow you to nimbly change course when circumstances necessitate.

Get the right board in place. Board members are the fiduciaries who steer the organization toward a sustainable future by adopting sound ethical and legal governance and financial management policies. They are there to make sure you have adequate resources to advance your mission. It’s important to appoint the right people with the right training and make sure they’re willing to ask tough questions and hold leaders accountable for adhering to strategic plans.

Of course, this is true for all physician boards. But it’s especially crucial for CHCs to have a great board since at least 51 percent of them must be patients of the organization. They integrate the voice of the customer at the board level.

Start from scratch building a strong leadership infrastructure. This is the single most important factor that differentiates high-performing CHCs from their lower-performing counterparts. Having a strong framework in place enables you to set objective, metric-based goals for leaders, hold them accountable for meeting those goals and consistently deliver quality outcomes and patient experiences over time.  

Studer Group’s Evidence-Based LeadershipSM methodology creates a strong foundation for CHCs. I invite you to read more about EBL, but in general EBL is comprised of the following components:

Objective evaluation system
Leader development processes
Key leader behaviors that are hardwired across the organization
Performance management

Hold regular leadership development sessions. Note that leader development is the second piece of Evidence-Based Leadership. There’s a good reason for that. A strong healthcare organization invests in its leaders and trains them well. For example, at Studer Group we recommend our CHC partners hold one- to two-day Leadership Development Institutes (LDIs) once a quarter for intensive training on skills or strategies identified as needing improvement to meet organizational goals. This training is not theoretical but is tailored to very specific needs/problems you are currently facing.

Make clinician, staff and patient engagement a priority. Creating a culture that fosters highly engaged leaders, clinicians, employees and patients always leads to better care. In fact, we see over and over that CHCs with high engagement also experience better, more sustainable results in the financial and quality arenas. There is way too much to say about engagement for me to begin to do it justice here. I recommend that you read The E-Factor by Craig Deao, MHA, which explains how to make engagement a core competency inside your organization.

Remember, CHCs are some of the most mission-driven organizations out there. They naturally appeal to clinicians and staff who deeply care about doing their job and doing it well. That’s why you must have not only a strong, well-developed mission, vision and values, but also have a solid operating system in place so your team can carry them out. Both pieces matter. And both will allow you to recruit—and just as important, retain—the kind of high-caliber team that makes CHCs successful.

Finally, I want to offer a sincere thank you to all community health center care providers and the army of volunteers who help them. Over the years, your passion, commitment and resourcefulness have made a huge difference for some of the most vulnerable members of society. We at Studer Group are grateful for your service.

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