How I Stopped Being the Bottleneck and Built a Team of Heroes Instead — Sara Wilson

In this episode of Home Care Hindsight, David Knack sits down with Sara Wilson, CEO and President of Home Assist Health, to discuss her lifelong journey in home care and the biggest lesson she's learned while scaling her organization. Sara shares her unique origin story, raised in the industry as her parents helped establish one of Arizona's first Medicaid waiver agencies, and how she eventually found her way back to the family business after a brief stint in corporate America.

The conversation pivots to the core mistake that many successful founders make: holding on too tightly. Sara openly discusses her identity as an "organic growth entrepreneur" and how her need to be involved in every detail became a liability as the company grew. She explains the difference between being the "hero" in the early stages and creating "heroes" on her team during the growth stage. They explore the vulnerability required to let go, the importance of hiring people who are better than you, and how data-driven dashboards can provide the confidence needed to step back and let your team run.

Lesson Takeaways:

1. In the early stages of a company, being deeply involved in everything is necessary. However, to scale, you must transition from being the sole problem-solver to developing your team to hold the strings for the organization. This builds capacity and prevents you from becoming the bottleneck.

2. The belief that it's "faster to do it myself" is a trap. While it might be true in the short term, it caps the team's growth and creates a culture of dependency. Long-term success requires the patience to delegate and develop others, even if it's slower initially.

3. It can be vulnerable to hand over responsibilities that have become part of your identity, especially when someone else might do them better. True leadership requires the humility to say, "It's not about being perfect, it's about building something that doesn't require you to be perfect."

4. Implementing performance dashboards at the individual, department, and corporate levels provides objective facts. Seeing that key metrics are trending in the right direction gives leaders the peace of mind and confidence to let go and trust their team's execution.

5. While financial metrics like census and gross margin are essential for business health, they shouldn't define your value. True success is measured by impact metrics: client satisfaction, hospitalization rates, employee retention, and continuity of care. This focus keeps the organization rooted in its purpose, not just a transaction.

Timestamps:
00:00 - Welcome to Home Care Hindsight powered by Zingage
01:45 - Sara's origin story: Growing up in the industry during the 1980s
03:30 - Leaving for corporate America and realizing she felt like a "cog in a wheel"
04:15 - Finding her way back and falling in love with home care professionally
06:30 - Connecting the dots: How human communication drives outcomes in home care
07:10 - The big mistake: Being a founder who over-functions and caps growth
08:55 - The three reasons we hold on: Speed, ego, and vulnerability
10:55 - The lesson: "Early stage, be the hero. Growth stage, create heroes."
11:55 - The constant challenge of stepping back and letting new programs grow
13:55 - A playbook for transition: Using revenue triggers to hire and build teams
17:10 - What's overrated in home care: Default metrics like hours and census
18:15 - What's underrated: Outcome data and the true impact on community and health systems
22:20 - The little mistake: Leaders getting in their own way by forgetting their purpose
23:35 - Practical tactic: Using data-driven decision making to find peace and let go
24:40 - Celebrating wins: Using dashboards to incentivize both quantitative and qualitative success
26:05 - What Sara is proud of lately: Achieving CHAP accreditation for home health

Quotes:
Sara Wilson: "Being very honest... I had to stay close to everything early on and that was necessary. But it becomes a liability at scale. It's founder over-functioning, and at some point you have to let go."

Sara Wilson: "It's faster to do it myself… But what if somebody comes in and they can do it better? It requires some humility to say it's not about being perfect."

Sara Wilson: "We need to know our margins, but they shouldn't define our value. What should define our value is the impact we're having in our communities and in the lives that we're touching."

Sara Wilson: "If we swing too heavily into efficiency and we swing too far away from the people, we're not able to effectively engage our workforce. If we become a transactional industry, we're going to get a transactional workforce, not a compassionate, purpose-driven workforce."

Resources:

1. Connect with Sara Wilson on LinkedIn: https://www.linkedin.com/in/sara-wilson-85095266/
2. Home Assist Health Website: https://homeassisthealth.org/
3. Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/
4. Powered by Zingage: https://zingage.com
5. Watch this episode on Zingage's YouTube: https://www.youtube.com/@Zingage