I’ve been asked many times about hospital administration and the notion of needing to scale up amid crisis and policy change. I am then reminded of the story of the night watchman.
Some time ago in an urban community there was a used car dealership that was bearing the brunt of local crime. After trying several remedial approaches (locks on the gates, surveillance cameras and signage) the board of directors became frustrated that nothing worked. The hindsight committee quipped that the thieves didn’t read the signage nor gave any credence to the camera systems. After further discussion they unanimously voted to hire a night watchman.
Crime had stopped immediately. However, after several weeks the vandalism and stolen property started again. With an unannounced night visit, the night watchman was found sleeping. He was so apologetic and pleaded his case of working 2 jobs to support his family. He vowed it would never happen again. The board met once again and voted unanimously to hire a supervisor to be responsible for the night watchman. This worked well for a few weeks and when unfortunately the night watchman took ill and the supervisor asked the board to consider a part-time employee to fill in as needed. The board unanimously voted to approve a part-time employee.
Now with several employees they found the need to create a sick and vacation policy. The board agreed that a human resources person was needed to create policies and procedures, as well as, address any other issues that arise including payroll. After several weeks the board met yet again to hear a report from the supervisor that crime in the parking lot was almost non-existent but reluctantly shared that they were now over budget. After careful deliberation the board unanimously voted to fire the night watchman.