Archive for the ‘ Linear Service Model ’ Category

Virtuous Leadership and a Linear Service Model (LSM) Part 2

What are the primary virtues of an effective leader and why is virtue in a leader so crucial to a linear service model?

In our initial attempts to ascertain what it was that drove executives that led organizations that performed better than others, what made them so different, we noticed that there were no obvious answers.  It was not education or fundraising ability.

Virtuous Leadership and Effective Organizations

We realized that it is not enough that the executive be passionate about helping woman that find themselves in the unfortunate position of having to face an unplanned pregnancy unsupported and alone.  Furthermore each executive represented very different levels of management skill compared to other executives who enjoy similar success.

The one thing that emerged that appeared common among executives that lead organizations drastically more effective at reaching and serving women facing unplanned pregnancy is their personal character, the level of mature Christian virtue manifesting in the mundane life of the leader.  What also became clear was that system or services do not matter as much as character.  The reason for this is because all systems are developed and driven by the innate character of the executive.  In thinking about the specific character traits or virtues that represent an effective PRC executive we began to notice that the character traits or virtues were similar.  And to a greater or lesser extent these executives manifested the same virtues which influenced virtually all of their behavior thereby setting the tone and expectations for the organizations they lead.  This executive influence over time caused the organizations themselves to become more virtuous and consequently more focused, more effective at accomplishing the mission.

Virtue is the basic building block to an effective PRC and emanate from the executive director’s personal commitment to virtuous living.  I am speaking of virtue in the classical sense of the word.  Those virtues are informed by the Bible and fall into five categories; wisdom, empathy, courage, temperance, and justice.  Each virtue has great depth and it is the intention of the following posts to only focus on those aspects of each virtue that make it valuable to the pregnancy center organization.

Check out the results a pregnancy center in Lakeland, FL after the Executive Mary Rutherford implemented a Linear Service Model by clicking here.

Virtuous Leadership and a Linear Service Model Part 1

Virtuous Leadership and a Linear Service Model (LSM) Part 1: As goes the Executive so goes the organization.

Virtuous Leadership=Focused Organization

In the process of both running a medical PRC and helping others to develop and operate their medical PRCs it occurred to me that there are certain questions all of us PRC Executives need to have answered.  Questions like:
-How can we get more abortion-minded women to call our center?
-How can we get more abortion-minded women who call to schedule an appointment?
-How can we get more of those who schedule an appointment to show?
-How can we get more of the women we see to have their babies?
-How can I as an executive get more control over the organization and out of the daily grind of wondering just how effective our counseling methods really are and know for sure?
These questions are linked to each other and often if you answer one you solve another.  The good news is that the answers to these questions are available.  Even better than that many center executives are experiencing the freedom and comfort that comes with knowing that their organization is accomplishing the mission of reaching and effectively serving women at risk for abortion better than they ever dreamed they could right now.  The next few posts are written to address these questions.  It is my hope they will help propel you as an executive as well as the organization which you lead to a higher level of effectiveness than you ever let yourself believe was possible.

In the process of thinking through how to convey the answers to the most pressing questions every PRC executive seems to share, something occurred to me; there is only one guarantee for success.  I have seen many organizations face the difficult questions, make difficult decisions about how to answer those questions, and go on to greater effectiveness at reaching and serving women facing unplanned pregnancies, while others do not.  At first glance the organization that ultimately succeeds at that worthiest of all goals versus the one that does appear the same.  But after having observed and worked with both types of PRCs over the years, a key difference began to emerge between them.  But that key difference was not manifesting as the usual suspects such as a specific type of operation.  It was not that one offered a specific service like ultrasound technology and the other did not. Nor was it dependant on access to money.  It was not even that the successful organizations had developed a strategic plan, because unsuccessful ones had too.  What we began to notice was that while the organizations that were effective and gained greater effectiveness at reaching and serving women at risk for abortion were the ones that were committed to sticking to their strategic plan and creating systems of service to intentionally improve (LSM), there seemed to be an underlying driving force to that commitment.  These organizations had the fortitude to do the really, really hard work of facing their brutal reality and creating a new reality through focused action.  Incidentally it is difficult to have consistently focused activity without a strategic plan driving the development of the approaches that are taken to accomplish the mission. But the specifics of a strategic plan seem to be secondary.

Admittedly, I was a little surprised at the revelation that the specific details of a strategic plan were secondary to just simply having and religiously sticking to that plan.  The end result is almost always some level of a step by step Linear Service Model. You must forgive my bias toward the value of the CompassCare LSM.  However, once my proverbial eyes adjusted to the light of this new revelation we started asking ourselves:  “What made some organizations able to pursue a strategic plan while others seemed content to let their strategic plan, if they had one, sit on the shelf?”

Over time we began to observe a common element in pregnancy centers that continued to get better and better at their mission.  At the heart of the organizations that were able to purse a strategic plan and enjoy the resulting benefits of a more or less linear service process for reaching and serving the high risk abortion-minded woman was the activity of a particular person; the executive.

We began to realize that the activity of a PRC, over the course of time, reflected the behavior and expectations of the person who occupied the  executive director position.  In fact this realization became so obvious that we began using the following phrase in all our PRC Linear Service training:  “As goes the executive so goes the organization.”

In part 2 we will discuss the role of personal virtue in executive leadership and what its practical implications are for developing and implementing an effective linear service model (LSM).

Check out the results of a pregnancy center in Omaha, NE after their executive, Michelle Sullivan, decided to implement a Linear Service Model by clicking here.

Linear Service Model vs Global Service Model Defined

After developing the first and only repeatable Linear Service Model for the pregnancy resource center movement many have asked me where the terms came from and what the differences are between a Linear Service Model or LSM and the traditional way a Pregnancy Center operates. Essentially, we started applying the terms in 2004-05 in an attempt to distinguish between what CompassCare had been doing and what we were now doing.

What is the difference anyway?

The definitions in the context of a Pregnancy Center are as follows:

  • Linear Service Model (LSM): An approach to serving women that focuses on solving the common problem of unplanned pregnancy each woman faces by taking each woman through a consistent, chronological, scripted, step-by-step decision-making process in an effort to answer the right questions in the right order. One of the key assumptions in a good LSM is that the manner in which services are provided is just as important as the services themselves. An LSM standardizes services to women and ensures that those services are provided the same way with each and every patient for the purposes of accountability (which safeguards the organization from attack), and for measurability (which allows for targeted changes to keep the organization on the cutting edge of service). This LSM can also accurately be termed the “Problem-focused Model” as it allows the organization to be an expert at solving a particular problem without having to be an expert at the individual circumstances of each patient/client. This is a more Biblical approach because it is the approach that God in Christ took by solving each person’s sin problem through solving the issue of sin itself on the cross.
  • Global Service Model (GSM): An approach to serving women that focuses on developing a relationship with each individual client using several different types of services in an effort to provide a place of “unconditional positive regard” an idea first developed by Carl Rogers. This model places the client in the driver’s seat by providing her with a menu board of services from which she can choose, also based on one of Carl Rogers’ ideas known as “Client-centered Therapy.” Each client is served differently at the discretion of client advocate or counselor usually beginning with a client-driven conversation lasting up to an hour. Often the counselor defers to the client as to her abortion-vulnerability rather than an objective assessment of her socio-economic situation which actually is the basis of the pressure to drive a woman to terminate her pregnancy. The counselor then attempts to provide certain types of information to dissuade her from having an abortion. The GSM is based on an unbiblical, modified, secular humanistic counseling model and is difficult to improve primarily because there is no way of accurately assessing the overall performance of the organization when each patient is served differently. Another term that could be used for the GSM is a “Client-centered Model.”

For case studies on centers implementing CompassCare’s Linear Service Model called the Optimization Tool go to prcoptimizationtool.com.

Optimized Linear Service Conference Review

Thank you to all the Executives that attended the April conference!

After some time to process the executives that attended CompassCare’s high impact conference in Rochester, NY came away with some valuable tools for continuous improvement when using a linear service model. How to know if doing something new is the right thing for the pregnancy center (A.K.A. innovation) is an extremely important part of keeping our pregnancy centers on the cutting edge.

Conference attendees were given principles and tools including a hands on workshop to help them navigate the sometimes difficult waters of knowing what to do next, how to go about doing it, and assessing whether or not it is helping the organization accomplish its mission of reaching and serving more efficiently women at risk for abortion. The tools included how to effectively:

  1. Assess
  2. Plan
  3. Do
  4. Reassess

Executive attendee Becky Wood made the following comment: “Regarding the OT Conference, it was more than I imagined, not just professionally, but also spiritually where it counts for eternity.

I loved the actual hands on experience of putting into practice the things we discuss about innovation, research, etc.”

Thanks, Becky and all!

For more information about CompassCare’s Linear Service Model call the Optimization Tool go to www.compasscaretraining.org

CompassCare Pregnancy Center Optimization Conference

CompassCare has trained many medical pregnancy centers in several States to “Optimize” their services in order to reach more women seriously considering abortion and help them have their babies more effectively. The results have been staggering. For last couple years the Executives of those pregnancy centers have been requesting CompassCare to host a conference just for them in Rochester, NY where it all started. This year we gave in and said yes. We decided to open it up to other Executives so that they could get a glimpse of the inside of the CompassCare network of high-performing medical pregnancy centers. The conference will be held on April 20-22.

If you are interested in more information go to www.compasscaretraining.org

Part IV: Ethical Standards for Serving Abortion-minded Women

Transparency, Integrity, and Full Disclosure:

Due to the political, passionate and divisive nature of abortion women facing unplanned pregnancy are often the

Every woman has 3 Choices

victims of biased information and sales tactics at abortion clinics and elsewhere. It is our belief based on serving thousands of abortion-minded women across the country every year that women need to be insulated from these added agenda driven pressures. Furthermore, if they are insulated and at the same time given all the information and about all their options (abortion, adoption, and parenting) as well as the medical support needed at the moment more often than not she will choose to have her baby. Not a sane woman alive actually wants to have an abortion. They feel trapped, like abortion is their only way out. It is the job of the pregnancy center to provide support and security such that she realizes that she can actually pursue other options, a real choice.

So, in the interests of fairness and the desire to avoid non-exploitative behavior, organizations should:

1. Fully disclose the financial profit they stand to gain if the woman chooses one option over another.

2. Refrain from manipulation and coercive tactics such as inflaming irrational fear and panic.

3. Ask and obtain permission at each stage of the consultation process.

4. Conduct anonymous paper-and-pencil exit surveys to assess client/patient satisfaction with the organization. (See Attached Sample Exit Survey Here Client/Patient Exit Survey)

10% of All Client Appointments Are At Risk for Abortion Is Average?

At the average medical PRC, why is it that only 10% of the entire client load actually pregnant women seriously considering abortion? We have found that it has to do with how services are provided . . . based on a secular humanistic model of counseling. Can those Pregnancy Care Centers reverse that trend to 90% or more? The bad news is that we have only found one way to fix this problem and it cannot be done in less than 4 months and with nothing short of changing the way services are offered. To read a more detailed history of the pregnancy resource center model and why it is not working click the following link: Analysis of Why the PRC Is Not Working and How to Fix It

Let me clarify. Ultimately we need to have a trend reversal in the mission critical areas of the pregnancy center. This number of just 10% of all clients seen as at risk for abortion represents a deeper problem. For example, let’s say that your organization schedules an average of 200 appointments per year that actually show up. And of those 200 only 20 are considered pregnant and at risk for abortion. Furthermore lets say that you have the capacity to see 500 more clients this year. Since the typical PRC service strategy affords you the opportunity to see approximately 10% of your entire client load at risk for abortion (20 out of 200) you need to find a way to increase that.

Is this a marketing problem or is it deeper?

Let’s explore that question. To increase your client load to 700 using your same service strategy will only get you 105 total pregnant women at risk for abortion assuming you get all 700 women in the door. If the annual number of women in the market for an abortion in your area is 2,000 and you want to reach them all you immediately have a problem. To reach 2,000 using your current strategy would mean you would have to serve a little under 14,000 clients per year. I don’t know about you but our organization could not afford that. We had to find another way.

While advertising may be a valid concern it is not the primary problem. Women respond over time more to what an organization does and less to how it advertises. The real challenge for us is to come up with a model of service delivery that is laser focused on that one type of woman who is seriously considering abortion in our respective communities (i.e. 18-24 year old, college or young professional, single woman who is predominantly Caucasian). If you can reach her you can reach anyone else who may be considering abortion. But to do that you will need to re-engineer the services you provide as well as how you provide them. Building an organization that consistently reaches pregnant, at risk women requires 1) adopting a new more Biblical philosophy of service, 2) re-engineering your service to be consistent with that philosophy of service, and 3) time for news to spread into the population (6-18 months after re-invent).

I have uploaded a position paper Analysis of Why the PRC Is Not Working and How to Fix It providing more historical background on these issues. Also, consider exploring some of the case histories of PRCs that have made the jump to a new model of service and have seen a dramatic shift in their patient load on CompassCare’s Training website at www.compasscaretraining.org.

Imagine 95% of Your Clients At-Risk for Abortion

Imagine 95% of the pregnant clients that walk through your doors at risk for abortion. What if I told you that there are pregnancy centers currently operating for whom this is happening. What if I told you that there are medical PRCs right now for whom 80-90% of their client load is actually pregnant?

There is a saying I use in our executive training OT training, “Strategic Marketing is everything you do.” It is important to note that it really does not matter how large of a population you are attempting to reach, the population of women is fairly connected and the group of women you need to reach is always a very small percentage of that larger population of women and perhaps even more connected to one another due to their close age (18-24). Essentially this means that word gets out fast about an organization in terms of what is provided and how it is provided even in fairly large towns.

The average pregnancy resource center spends less than 10% of its resources on pregnant women who are seriously considering abortion. The following graph represents typical trends seen in the average PRC. Note that with each step there is approximately a 50% reduction in the number of women who actually qualify to go to the next level of service. Whether your organization is scheduling 1000 appointments or 100 take a look at your trends and see if they are in the ball park with the trends shown in this graph.

Advertising outlets and messaging is only as effective at reaching the abortion-minded woman as your service delivery strategy is at over delivering on her expectations. In fact advertising that hits your target of at risk women will work against you over time on a bell curve if the services provided do not match with her expectations. If an organization has a reputation for not providing relevant services or providing those services in a relevant way, even if that reputation is outdated or untrue, it will take at least a four year cycle to reinvent that reputation through re-engineering the services that are provided and the manner in which they are provided to better match with the expectations of the woman who is considering abortion.

What every PRC executive wants is to move their organization from the trend shown in the graph above to the one shown below. But we cannot get there by doing more of what we are currently doing. To save 1000 lives with the current service process used in an average medical PRC they would have to schedule over 25000 appointments every year. I don’t know of a single organization that has the resources to do that. We have to be willing to understand what is not working and change it to see more lives saved using fewer resources.

Increased PRC effectiveness requires a shift in the way we do things

Imagine seeing more at risk pregnant women and more of them having their babies while having your overall non-pregnant or not-at-risk client load decrease to less than 5% of the total clients your serve. The best way to optimize the results your center is getting is by re-engineering your services, moving from a traditional or client-focused model to a linear or problem-focused model of service. You can read more about it at www.compasscaretraining.org.

Part III: Ethical Standards for Serving Abortion-minded Women

What do therapy dogs have to do with pregnancy care centers? Therapy dogs have proven to raise morale of long term hospital patients which in turn improves the patient’s overall health. But are their times when there are NO DOGs ALLOWED? If you don’t know your ethical standards anything goes and it will become increasingly more difficult to determine what should and should NOT be done when serving clients/patients. Without know your ethical standards and how they apply it is very easy for good intentions to degenerate into poor or unethical performance.

Dogs in a Hospital? Where to draw the line.It is the same way with serving women facing unplanned pregnancy. There are things to do and things not to do. There are times to do them and times not to do them. This post is the third of a four part series of knowing your pregnancy center’s ethical standards of care.

Informed Decision-making:

To promote informed decision-making organizations should help to answer the 3 basic questions every woman needs to have answered in order to determine the outcome of her pregnancy:

A. Am I really pregnant? It is possible to not have a viable pregnancy and have a positive home pregnancy test.

  • A woman needs a medically definitive diagnosis of pregnancy confirmation using ultrasound technology or blood tests.

B.  How far along in the pregnancy am I? The further along in the pregnancy a woman is increases the complexity of her options.

  • A woman needs an ultrasound scan to determine the exact gestational age of the baby. Gestational age determines the type of abortion procedure she would be eligible to receive.
  • All abortion procedures are medical procedures. Therefore each abortion procedure has different costs and different risks associated with them.
  • Gestational age is important to know in terms of providing medically accurate information about fetal development.

C.  Is it important to know if I have a sexually transmitted disease (STD)? STDs can negatively impact future reproductive health if left untreated.

  • Some STDs if left untreated prior to an abortion procedure increase the risk of infection which can put a woman’s reproductive health in jeopardy.
  • Testing and treatment for the most common STDs, Gonorrhea and Chlamydia, is essential to prior to an abortion to safeguard a woman’s reproductive health.

To learn more about how to apply ethical standards through a linear service process that holds all staff and volunteers accountable to those standards go to www.compasscaretraining.org.

Update:  See Part IV:  Ethical Standards for Serving Abortion Minded Women.

Part II: Ethical Standards for Serving Abortion-minded Women

The only way to ensure that your pregnancy help medical clinic’s good intentions actually are provided in a way that is consistent and ethical requires that we as Executives know what our ethical standards are and that those ethics are applied with every step of a client/patient interaction. Just because we believe in the good intentions of our volunteers and staff does not necessarily mean that they are interacting with our clients in an ethical manner. Being a Christian is not enough for ethically delivering services medical or otherwise to women facing unintended pregnancy.

Upholding Ethical Standards of Care

Sadly, you and I know that a woman’s decision about the outcome of her pregnancy is so often fraught with irrational fear, inadequate information, little to no counseling, sales tactics from financially vested interests, and coercive pressure from self-interested others that a woman does not feel like she has any other choice. In a 2004 study published in the Medical Science Monitor 84% of the American sample of women said that they did not receive adequate counseling before receiving an abortion. Additionally 64% felt pressured by others which would include boyfriends, parents, spouses, etc (Medical Science Monitor, 2004; 10 (10): SR5-16, Induced abortion and traumatic stress: A preliminary comparison of American and Russian women; Vincent M. Rue, Priscilla K. Coleman, James J. Rue, David C. Reardon).

Given these considerations and the importance of insulating women facing an unplanned pregnancy from intentional or unintentional negative influence, all organizations seeking to assist these women should employ 3 categories of ethical standards in their delivery of services: A) Supportive Decision-making, B) Informed Decision-making, and C) Transparency.

A.  Supportive Decision-making:

To respect and enhance a woman’s ability to make decisions regarding pregnancy outcomes, organizations should help by using these important pregnancy decision-making tasks:

Assessment of woman’s current social situation including relationship support structures (i.e. father of the baby, parental involvement, etc)

  1. Assessment of woman’s current social situation including relationship support structures (i.e. father of the baby, parental involvement, etc)
  2. Identification of circumstantial pressures (i.e. finances, education, unsupportive relationships, medical care, child care, age, long-term goals, etc)
  3. Careful exploration of the full range of available options including abortion, birth, and adoption.
  4. Careful consideration of potential short and long-term physical, social, and emotional outcomes of each available alternative.
  5. Maintain a safe environment that helps a woman firmly resist pressure from self-interested parties.

Update:  See Part III:  Ethical Standards for Serving Abortion Minded Women