final fiesta brodhead
TRANSCRIPT
Increasing Data Completion in a Group Home
By Matt Brodhead
HomeLife, Inc Based out of Battle Creek Owns 6 group homes in Southwest
Michigan Mostly funded by Community Mental Health
(CMH) agencies Your tax dollars at work
Behavioral systems program designed to maintain, and sometimes modify, behavior Most residents suffer from traumatic brain injury,
or They engage in risky behavior and cannot live
without supervision
The Problem Staff do not complete data sheets Why is this important?
CMH offices use data to asses HomeLife’s services
For every error, a CMH office can refuse pay HomeLife for that entire day of care
Three errors = $300 in fines Staff fill out approximately 100 data points
every eight hours 300 data points each day 9,000 data points each month 27,000 data points every 3 months
Reason to Intervene Errors are costly
Fixed rates for care of residents stays the same for years
Fines take away from resources necessary for the organization to succeed More training for staff Better opportunities for residents Repairs to the home Other modifications that increase the quality of
life
Ineffective Natural Contingency
Staff fills out one data
sheet
Given amount of
data completed
Infinitesimally more data completed
Natural Competing Contingency
Staff fills out one data
sheet
Given time to monitor
safety
Less time to monitor safety
Staff fills out one data
sheet
Given time to distribute medication
Less time to distribute
medication
Natural Competing Contingencies
Priorities: Monitor for inappropriate behavior
Sexually inappropriate behaviorAggressive behavior
Medication Appointments
Data Completed (Baseline)
90
95
100
1 2 3 4
Weeks
Perc
en
tag
e o
f D
ata
C
om
ple
ted
Performance Objectives
Staff Complete data
before end of shit
Home Managers Consistently review
data completion every day
Implement performance management contingencies for staff every week
Input-Process-Output Model
(Data sheets completed) [Output]|____ Filling out data sheets [Process] |_____ (Data sheets not
completed) [Input]
Goal Specification FormOutput
Data sheets completed
Standards
Quality
Current Ideal
N/A N/A
Quantity99% of data 100% of data
TimelinessAfter end of shift Before end of shift
CostN/A
$360/three months10 minutes/week for each staff60 minutes/week for Home Manager
Process Filling out data sheets
Production: X Distribution R&D
Input Data sheets not completed
Design the Intervention
Staff On the job training “Buddy system”
Supervisor monitors subordinate staff
Weekly drawing for bonus of $5.00 for 100% completion
Home Manager Look over previous
day’s data before end of shift
Supervise “buddy system”
$100 bonus for every CMH evaluation with no errors in data sheets
Design the Intervention
Staff fills out one data
sheet
Will lose opportunity for $5.00
bonus
Will not lose opportunity for $5.00
bonus
SD: Before end of shift
Home Manager
reviews data
Will lose opportunity
for $100 bonus
Will not lose opportunity
for $100 bonus
SD: Before end of day
Data Completion
80
82
84
86
88
90
92
94
96
98
100
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Weeks
Perc
en
tag
e o
f D
ata
C
om
ple
ted
Baseline Intervention
Evaluate the Intervention
Hypothetically Staff enjoy their $5.00 bonus Managers enjoy their $100 bonus
Social validity is a huge factor due to the inherent nature of “high turn-over” in group homes
Hypothetical Recycle
The company removed the $100 bonus for Home Managers Because “they should want to do it”
Data Completion
80
82
84
86
88
90
92
94
96
98
100
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Weeks
Perc
en
tag
e o
f D
ata
C
om
ple
ted
BaselineIntervention Recycle
Evaluate the Recycle
Obviously, the bonus for the Manager was crucial
The bonus should be reinstated