Google ‘Employee Retention in Behavioral Health’ and you’ll find a lot of stats regarding turnover, retention, engagement and recruitment. Bottom line is that employee turnover is high in behavioral health, employee engagement is low, and recruiting is tough. Read more to learn 3 strategies to increasing employee retention at your agency!
By Laura Couch, Business Intelligence Developer at Remarkable Health
You’ve most likely heard the saying “you never know what you have until it’s gone.” It is even truer in the business world: that without analytics in some form or fashion, you never know something is wrong until it’s really, really wrong. Running a business without a smart team of people digging through data and providing directional and actionable feedback is like driving at full speed with a blindfold on – hoping you will not drive off a cliff.
Setting the Scene
Imagine owning a medium sized behavioral health center. Financially, things are going smoothly and there is no shortage of clients.
You begin to hear some potentially unsettling talk from the therapists regarding the overwhelming number of clients with low functioning levels and severe mental illnesses. Working in behavioral health, those two bits of information are not alarming in and of themselves, except for the fact that the therapists also note the dearth of clients improving to a more maintenance mode in their mental health journey. Even more disturbing, you are told that a few therapists are so overwhelmed and frustrated they are considering leaving your company.
What happened? When did it happen? What is the actual problem behind their frustration? How can you fix this before you lose your employees?
What’s the Problem? Life without Data!
Without proper analytics or even simple data visibility into your business, it can be difficult to diagnose these issues on the fly. Using just your knowledge of past events, you can speculate on what got you here. You might remember one of your strongest therapist mentors, Oliver, moved out of state about eight months ago. He was replaced with another trusted therapist, Jennifer, who has worked for you for ten years. And approximately six months ago, you saw a huge influx of clients and had to quickly hire additional therapists to meet the demand. For better or worse, one of the three therapists did not yet have her certification and the other two have been practicing solo for under two years.
In your assessment of your company, nothing changed from a finance perspective. In fact, by hiring newer therapists – you saved money – seemingly a positive outcome. Well, you never know something is wrong until it’s really, really wrong. Unbeknownst to you, trouble has been brewing. Now your therapists want to quit and your clients are not showing improvement.
Because there was a lack of a data-driven view of your business available, you did not see the cliff ahead. You have just now pulled off your blindfold with mere seconds to jerk the wheel and steer your car to safety.
Revealing the Cliffs Ahead! Data Delivers.
With an analytical view of the ins and outs of your agency, you would be able to identify the trends over the past few months, serving as red flags. For instance, a simple visualization would highlight that overall client progress took a downward turn after Oliver moved out of state and was replaced with Jennifer. Although your number of clients increased with the hiring of new therapists, their clients have not seen any progress at all.
A quick staffing view would reveal that all three new therapists were assigned to a mentor who had only a few more years of experience than themselves. In addition, a client visualization would highlight that the new therapists were immediately assigned a hefty number of clients, resulting in less experienced therapists shouldering an above average client load.
While these events, when thought through as a narrative of doom, point distinctly to a downward spiral, you just did not put it together as it transpired. On the surface and according to the books, everything seemed fine. With just these few metrics of client progress over time, staff tenure by mentor, and number of clients per therapist, you can take action and implement solutions such as smarter client assignment, additional training for therapists, and a few conversations to figure out why Jennifer may not be as effective as Oliver.
Take off the Blindfold through Insights
While this was just a simple scenario, it demonstrates how much value your data has and how crucial it is to monitor data even when you think the road is clear. Data analytics and visualizations can keep you far from cliffs and even see around the curves of the road up ahead. To learn how our Insights product can help you monitor data within your EHR system, please schedule a 30 minute meeting with one of our specialists.
According to the Joint Commission, 57% of compliance issues discovered in 2017 were Treatment Plan related – amounting to the #1 ranked compliance issue. The best step is to proactively prevent a redesign of your Treatment Plans. But how do you accomplish this?
By Jodi Fadrigon, Implementation Manager at Remarkable Health
If we want to improve the lives of people with mental illness and their families, we must shift to a culture that embraces engagement as a new standard of care. How do we as providers better serve people with mental health conditions who are not engaged in care? We need to better understand the process of engagement and explore how the quality of relationships and interactions affect outcomes for people with mental illness. We must also have an understanding of the factors that contribute to effective engagement in mental health care.
What is engagement?
Engagement is the strengths-based process through which individuals with mental health conditions form a healing connection with people that support their recovery and wellness within the context of family, culture and community.
Engagement is built and sustained on the foundation of hope, mutual trust, respect, effective communication, and overall rapport and recognition of the strengths and resources people experiencing mental illness bring to their own recovery.
Encouraging a client’s willingness and commitment to engage in treatment can be very challenging. It is common for a client to disengage if he/she senses treatment is not working, he/she lacks trust in the process, or he/she has difficulty accessing treatment for reasons such as transportation. Given each client’s situation will be unique based on their social determinants, it is important to look at solutions to improve engagement that target any and all presumed roadblocks for the individual.
How Can We as Providers Help
As providers it is our job to find effective and creative ways to build and maintain relationships in order to improve client engagement. Some ways we can do that are as follows:
- Meet the client where they are at. Listen, observe, and ask the right questions at the right time. Do your best to speak the language of your client, listen without judgement and be mindful of when to confront.
- Instill Trust. As providers we do not always know how/what our client is feeling when beginning treatment. It is important to use our training, empathy and compassion to build trust with our client.
- Include them in all decisions. A sure way to effectively achieve buy-in, is to include the people who will be impacted in the decision. This would be no different for a client/therapist relationship.
- Establish concrete goals. A client can often feel discouraged when he/she does not have clear and concrete goals to measure progress. It is also important to meaningfully include the client in the development of these goals.
- Identify barriers and create solutions. It is important to be sensitive through the process with your client – remain curious and non-judgmental and always attempt to be a part of the process. This will keep you mindful of any barriers – cultural, attitude-based, or environmental – that will present themselves.
In conclusion, promoting a culture of engagement will require change in how we, as a society and providers, view mental illness and the individuals who live with mental illness. Providing a safe connection to care for behavioral health clients is essential for improving client treatment and increasing client engagement, ultimately building excitement for the client to participate in and follow through with services.
About Remarkable Health
For over 25 years, Remarkable Health has pioneered innovation through technology for behavioral health and DD providers. Our integrated suite of outcomes management, EHR and mobile technology arms providers with the tools they need to improve client outcomes by spending less time on documentation and inefficient workarounds and more time delivering value-based care and engagement. To learn more about the CT|One EHR and the CT|One Mobile app, contact us at (480) 550-8077 or visit our website at www.RemarkableHealth.com.
Medicaid managed care for the I/DD population is sweeping across the country, along with other funding changes from grants and fee-for-service, to Medicaid waivers and value-based payments. These new oversight and funding models are putting pressure on I/DD providers, forcing executives to think outside the box in terms of financing, managing performance, and technology. Oftentimes, many providers may be focused more on the features of the software than how they are going to implement it into their workflow. The result is while the software works, it might not be used or used to its fullest because the implementation was lacking.
A lot of what goes into effectively using new technology happens before you make your purchase. So be sure you don’t make these mistakes when selecting and implementing your EHR for your I/DD organization.
You need the buy-in of clinicians and staff in your organization to be successful at choosing and implementing new EHR software. One of the most common mistakes that organizations make is letting one person choose the software without buy-in from everyone else. The result is often resistance to the final choice and providers or staff who fight making the change. We recommend you gather feedback and requirements from you staff through surveys and focus groups before looking for partners and communicate progress to your staff at key milestones in the project. This will help keep staff involved and informed but allow the decision makers to determine best product fit and scope of implementation at a much quicker pace.
Before you select a partner, you have to set clear expectations around what you want in an EHR, what your agency needs, and what resources are available. Because an EHR will sync your entire organization around the client story, this will need to be tailored to each department. This requires input from everyone so that it will work for the whole business and not just the clinicians or agency director.
Not Assessing Workflows
It’s important to realize implementing a new EHR may mean you need to change intake, assessment, billing or documentation workflows – just to name a few. It’s important to evaluate your current workflows across the entire client lifecycle before you make a change. The fact is that the workflow will change and those changes will vary depending on how you do things now. To make the most of the EHR, you have to be open to change. By mapping out your current workflow, you can work with your new technology partner to identify areas that will need adjustment. Then, you can prepare for and manage those changes successfully.
Lack of Objectives
Objectives are not the same as expectations. Objectives are specific goals. Setting goals allows you to make sure that the solution you choose and processes you put in place are designed to help you reach certain objectives. You need to ask some basic questions. Do you want to make more money? Provide better client care? Improve documentation costs? Expand your services? For each service, these essential goals are unique. It’s important to make your goals S.M.A.R.T. (specific, measurable, attainable, relevant and time-tracked).
Be sure you have the right infrastructure in place for your EHR. A lack of necessary bandwidth can slow down every process in your agency when you launch. Make sure you have the connectivity and speed to complete all your tasks and choose the right hardware for your needs.
Once you are ready to start your implementation, don’t forget to set some clear milestones for success with your technology partner. Set realistic dates for achieving specific items like training, billing, etc. Then, don’t get derailed by implementation challenges. Stick to your schedule!
If people are not trained adequately it will slow down your transition to an EHR. So don’t skimp on the training! Get as much training as you need for everyone on your staff, and select staff to train as super users to support the rest of the staff after your training is over.
No matter how well trained and prepared your staff are, the change to EHR will slow things down initially. Tell your clients what is going on and ask for their patience and understanding.
Bad Customer Experience
Many providers don’t think about how the EHR will impact their interaction with clients. The fact is that using technology to document while you are with a client does affect that experience. Awareness is the first step to addressing this. Think about what type of device will work best and how you can use it to engage the client instead of letting it come between the provider and the client. Always be thinking of the client – and make sure your workflow and system configuration ensures the interaction provides a positive experience.
Thinking You’re Done
When it comes to managing your agency and improving your business, you are never done. Whether it’s EHR or billing, there is always something new. And you should expect your partner to have a robust plan for ongoing product development. These new tools and features will help you continue to improve the quality of your client care and the management of your business.