An Entrepreneurial Response to Organizational Change

1
An Entrepreneurial Response to Organizational
Change

• Christina Trenton LCSW-C, CAC-AD
• Executive Director, W House

2
Wicked Problems
Some problems are so complex that you have to be
highly intelligent and well informed just to be
undecided about them
-Laurence J. Peter
3
What in the world does this mean?

• Addictions treatment programs have wicked
  business practice and systems problems
• We dont have a consensus in the field as to what
  these are
• The journey we are about to take requires that we
  understand the rules

4
Problem Solving Rules

• 1-You dont understand the problem until you have
  developed a solution!
• 2-Wicked problems have a no stopping rule
• 3-Solutions to wicked problems arent right or
  wrong
• 4-Every wicked problem is essentially unique and
  novel

5
Recent Research

• The Journal of Substance Abuse Treatment
  (October 2006 ) published McClellan Kimberlys
  article The Business of Addiction Treatment A
  Research Agenda which discusses the challenges
  facing the nations substance abuse treatment
  system

6
Recent Research .

• Corredoira and Kimberly wrote Industry
  Evolution through Consolidation Implications for
  Addictions Treatment . They cite major
  realignments in other industries to argue that
  the business of addictions treatment is likely to
  be transformed by a period of consolidation, in
  which a number of small, independent programs
  will be acquired by larger, better-capitalized
  and managerially more sophisticated enterprises.
  Not known is whether an industry-wide
  consolidation will lead to quality improvement
  through increased competition among larger
  providers, or if the larger providers are
  publicly traded quality will be subordinated to
  pressures to maintain or increase earnings and
  share price.

7
A Change in mindset.

• How does a small public or private treatment
  agency respond strategically to the market forces
  discussed in the research?
• First and foremost we must change the way we
  think of ourselves!
• We MUST think like a BUSINESS

8
Conditions Existing Currently (wicked problems)

• Limited resources
• Cost containment
• Diversification of funding streams
• Workforce shortages

9
How do we do this?
A change in mindset

• Be confident that what is done on the management
  level is going to help at the client level
• In the field of addiction we have succumbed to
  the lazy undisciplined search for a silver bullet
• Be relentlessly curious!

10
What if ?

• Core Values and Core Purpose is retained?
• Cultural and Operating Practices change?

11
What if ????

• Partnership models were blended to create an
  entrepreneurial way of doing business?

What is an Entrepreneur?

• Asks what if
• Works hard, take risks
• Step out on faith
• Wind up creating a vision and doing things that
  have not been done before

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What if ????

• The risk of program closure could be minimized if
  collectively treatment programs worked together
  to create a co-opt business model. This model
  can be mixed and matched to create both regional
  and statewide consortiums

13
What if ???

• Business practices were re-engineered for
  collaboration? This could include collective
  purchasing of
• Health Insurance
• Liability, Directors Officers, Workmans Comp,
  Vehicle Insurance
• Criminal Background checks
• Purchasing-Food, Office Janitorial Supplies
  (negotiation of prices, triple the volume for the
  vendor)

14
What if ??

• A region created a labor pool of counselors (PRN)
• Could plug gaps regionally in service delivery
• Could be used during times of high census
• Could be used during times of illness, vacation
• The nursing and social work field have done this,
  why havent we?

15
What if ?

• A labor pool of specialty positions was created
  to serve a region
• Clinical Supervisor
• Family Counselor
• Trauma Specialist
• Vocational Specialist

16
Addiction Treatment and Chinese Fast Food

• FailureQuality problems
• SuccessStandardization
• Can Addiction treatment be compared to the
  Chinese fast food industry?

17
Implementation of Entrepreneurial Exploration

• Identify processes for change and re-engineering
• -Look at key problems
• -Mystery shopper
• -Forms

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Re-engineering Forms
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Implementation of Entrepreneurial Exploration

• Convene a work group with other Levels of Care
  within your county or your region
• A group CAN bring creative resourcefulness to a
  problem

20
Implementation of Entrepreneurial Exploration

• Explore and develop collaborative business plans
  and strategic partnerships
• -Health Educators
• -Womens Commission/SCORE
• -DORS
• -Community Colleges
• -Local Children and Youth Partnerships

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Implementation of Entrepreneurial Exploration

• Identify areas for technical assistance
• Create clinically relevant protocols
• Create economically relevant business practices

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Conclusion

• Treatment programs can implement entrepreneurial
  change through the creation of collaborative
  business practices.
• This can include the coordination of
  administrative and fiscal functions which would
  allow small treatment programs to qualify for
  contracts that usually go to larger, more
  diversified vendors.
• This model also gives participating agencies a
  broader reach greater service impact in terms of
  continuity of care and wraparound services.
  Overall, the creation of an entrepreneurial
  business model will increase competitiveness in
  the behavioral health care market.