Behavioral Health Staff Productivity and Utilization: Is Overproduction a Good Thing?

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You recognize the value of data to drive innovation  within your agency, but you aren’t sure where to begin. The data has yet to expose your current state of business and guide future decision-making opportunities. You may be asking yourself, “how do I analyze the data I have?” or “what data should I be looking at to begin with?”. In this blog, we are going to take a deep dive into data as it pertains to your staff – arguably the most important asset at your agency. Specifically, how has COVID-19 impacted staff productivity and utilization and how does this affect the future sustainability of your agency?

How Has COVID-19 Impacted Staff Productivity & Utilization?

What data should you monitor when analyzing the effects of COVID-19 on staff productivity and utilization? Examining the three metrics below will help ensure the time and productivity of your providers are optimized, to ultimately safeguard against increased employee turnover.

  1. Progress Notes Submitted by Staff: Monitor the number of completed progress notes by staff to expose potential burnout, gaps in staffing, or availability to allocate staff to suffering programs.
  2. Billable Hours by Staff: Evaluate the schedule of your staff to understand how much time is being spent on billable hours of service in a day or week.
  3. Time Utilization by Staff: Validate your staff is spending time most effectively across clients and programs.

Implications of Data on the Future Retention of Your Team

Now that we know what metrics to monitor, what trends should we be looking for? What questions should we ask ourselves? The answers to these questions are ultimately where the value of data is found. Data transitions from numbers to a story formed about the health of your staff.

Progress Notes Submitted by Staff: What changes do you observe in the number of progress notes submitted by staff member when comparing date ranges of January – March to April – June? Have completed progress notes increased? Decreased? How has an increase or decrease in number of full-time and part-time staff effected this number? For instance, if your staff size has increased in the past 3 months, you should see an increase in completed progress notes. Ultimately, analyzing progress notes should reveal two key areas that drive future decisions for your agency:

  1. Through comparative analysis are you able to verify consistency between the number of completed progress notes with the revenue trends of your agency in regard to total services being provided as a result of COVID-19?
  2. Will an influx in services needed sustain or drop off post-pandemic? Will your agency be able to sustain the current number of progress notes being submitted over the long-term? What implications does this have on your future staffing needs? If there is contradiction in the number of completed progress notes you forecast with the number of staff needed to complete those notes, will your staff become burnt out? Or will your staff be under-utilized?

Billable Hours by Staff: If a remote clinician is now providing ten billable hours of service in a day as opposed to six billable hours of service (which you are able to validate through an increase in created claims volume) and doing concurrent documentation, it is evident that staff member has become more productive working from home during quarantine. But, as a result, will this staff member become over-worked? Knowing what your data says about the productivity of staff can have huge implications on retention. How can you encourage providers to block off time in their schedules to eat and take needed breaks between virtual sessions? It is vital to set new expectations with staff. Production data can help guide you in the best ways to support your staff and what new expectations may be appropriate.

Time Utilization by Staff: Based on your providers’ schedules, are providers making the most of their time? Are each of your team members currently utilizing 50% of their schedule capacity? 115%? How does the increase in demand for specific service types dictate how you allocate your staffing resources to match this demand? It is up to you to ensure schedules are being maximized by each staff member and reallocated as necessary for both the health of your agency and the health of each staff member.

Another consideration is travel time. You are likely seeing a decrease in travel time if you have seen virtual services increase. With a decrease in travel time, should come an increase in services provided by staff. If comparative analysis between January – March and April – June reveals less time in the car, are you seeing an increase in progress notes? If not, are you seeing an increase in the quality of completed progress notes? Or are you seeing a quicker turnaround time of progress notes submitted? All of these will help you to understand the past and current state of that employee’s productivity and how it relates to their overall engagement?

Bottom Line Impact: Engaged Staff Leads to Sustainable Services for Clients

Ultimately, each agency must read the story their specific data is telling through looking at key metrics and asking the correct questions. From this data, it is imperative to understand the implications it has on optimizing the time and productivity of your providers, while increasing engagement of staff.  If your team becomes disengaged due to burn out and overproduction, turnover will skyrocket. If your agency experiences high turnover, the individuals you serve may experience negative effects in the quality of services provided. If the individuals you serve are not benefiting from the services provided to them, those individuals may begin to no-show or transition to a new provider altogether. Without increased and quality billable services being provided to these clients, the future ability of your agency to help additional clients may be compromised.

Join us next week as we continue to explore the effects data has on key areas of your agency!

Does your data drive innovation?

Develop a Mind for Innovation: Is Your Behavioral Health Agency Driven by Data?

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“Crises, especially the one we are experiencing now, have a significant financial and human toll, stranding assets and human capital and causing significant social and economic dislocation. However, many of these dynamics are ingredients for disruption from which new business models emerge.” – Innovation in a Crisis: Why it is more critical than ever, McKinsey & Company

Many of us read this quote and understand what is being communicated explicitly. There isn’t much to argue in the above statement. But how do these words translate into a reality where data can truly drive innovation for behavioral health providers? Have you considered all that has taken place with COVID-19 and the effects on our industry as innovative ingredients to create a new or revised agency model? A model that can sustain future crises? If not, it is likely due to one of two reasons:

  1. You are currently still operating your agency from a state of crisis due to the effects of COVID-19. You are simply trying to keep your agency afloat, devoting each resource to essential needs of today.
  2. You are uncertain of the first steps to take in becoming an innovative agency. This has impacted your ability to create an adapted and thriving business model.

Then what is the first step in becoming innovative? Without data, innovation will be misplaced and misguided. Efforts, resources, and changes will be applied to unaffected areas of the business. More than ever, right now is the time to look at data. Not tomorrow. Not in a few months. But right now. Because tomorrow may be too late. That over-worked service provider may decide she will submit her two-week notice tomorrow. All of which could be prevented by analyzing billed amount and units by clinician today to reveal potential burnout. To ultimately lead you to ask the right question and reveal the burnout you believe is taking place (likely as a result of overproduction due to COVID-19). Today you could speak to that service provider to create a plan for her sustainability and engagement, and prevent the two-week notice from being submitted in the first place.

So if data is the first step to becoming an innovative agency, what is keeping you from analyzing and utilizing it? Again, two major components are at play here:

  1. You don’t have the proper tools to analyze your data.
  2. You don’t know how to analyze the data. You are unsure of what data to look at and what the data tells you about your current state of business and future decision-making opportunities.

Having the tools to make decisions just as fast as our current environment is changing, is essential. In this upcoming blog series, we will explore the tools needed and points of data to analyze within three major aspects of your agency’s operations:

  1. Behavioral Health Staff Productivity and Utilization: Is overproduction a good thing?
  2. No-Show Rates in Behavioral Health: Can you explain your agency’s no-show rates?
  3. Service Types: Has your response to increased demand in Behavioral Health services actually lost your agency money?

Join us as we take a deep dive into each one over the coming weeks to understand how data can drive innovation in the behavioral health and I/DD fields.

 

For the entire article of ‘Innovation in a Crisis: Why it is more critical than ever’, click here

remote workers on video call

Giving You One Day Back – Quick Resources To Help Your Agency Survive COVID-19

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Our mission has remained steady: we want to remove any obstacles that get in the way of a behavioral health or I/DD provider impacting the life of another person. Our goal is to create one extra day a week for every role in your organization. Amidst the sudden changes and drastic impacts your agency has recently experienced due to COVID-19, our goal remains the same. One way we believe we can give you one day back during this unprecedented time is to create a central hub with the most essential and consistent resources available for the success of your agency – regarding both the services you provide and the staff that make it all possible.

Essential Resources to Provide Services

Telehealth & Reaching Isolated Populations

As you transition to providing most or all of your services through telehealth, here are the most important resources to monitor. Please keep in mind your agency can use any non-public facing remote communication product, even if you haven’t entered into a HIPAA business associate agreement (BAA) with video communication vendors. For more details of the announcement from the US Department of Health & Human Services regarding HIPAA and Telehealth during COVID-19, click here.

  • American Telemed has many resources, pertinent webinars, community groups, and recent news in one place at your fingertips. This resource is great for an agency that has never conducted telehealth services or has been doing it for years!
  • This Provider Telehealth and Telemedicine Tool Kit put out by the Centers for Medicare & Medicaid Services (CMS) outlines detail on the expansion of telehealth with the 1135 Waiver and Medicare’s coverage (along with billing codes). This also includes essential state statute guidance and telehealth implementation resources.
  • Medicaid.gov has put out a Coronavirus Disease Response Tool Kit with tools & checklists for states, state waiver approvals, billing & coding guidance, Medicare and other coverage guidance, and much more. This is a great one-stop shop for resources no matter where you are at in the process of transitioning to providing telehealth services through your agency.
  • Doxy.Me is a free, simple, and secure telemedicine tool for providers. Doxy.me has a goal to remove any barriers that may be preventing your agency from conducting telemedicine visits. Please note, doxy.me is a HIPAA-compliant video communication product and is willing to enter into a HIPAA BAA for the longevity of your telehealth services.
  • For those of you navigating video conferencing and calls as a means of communication for the first time, take a look at these Meeting & Webinar Best Practices and Resources from Zoom (these can be applied to any video conferencing application you are using).

General Resources

  • For timely industry-specific news, ongoing webinars, mental health first aid tools, and even DIY mask tutorials, head to the National Council’s COVID-19 Resources and Tools page.
  • Check out the many resources, blogs, podcasts and mental health matters practices from our partner and friend, Kevin Hines, as he shares fluidly and actively during this time.

Essential Resources to Support Staff

The Remarkable Way

Here at Remarkable Health, we have gone through a similar transition to a fully remote company within the past month. In that transition, we have learned important lessons and created innovative ways to engage our team. We want to share four initiatives that have had the most impact in order for you to integrate within your agency!

  1. Weekly Vlog: Our CEO, Peter Flick, hosts a weekly vlog (video blog) in which he communicates important updates to our team regarding COVID-19, our company, and the industry. He also takes this time to encourage us to remain positive and seek support as needed to remain healthy. It has been important for each employee to candidly hear from the CEO of the company on a regular basis during this time.
  2. Charity Miles Competition: We encourage you to check out the Charity Miles app available on Android and iOS. This app donates money to a charity of your choice for every mile you track walking, running and biking. On the app, you can create teams. This has allowed our company to participate in a competition to see who can accumulate the most miles over the next two months – promoting healthy interaction and fun competition with teammates, while engaging in activity proven to increase our mental health!
  3. Weekly Challenges: We have two challenges taking place this month in order to inject positivity and healthy habits into our team. The first is a weekly challenge to Create WOW Moments in the lives of others. Click here [upload image] to check out ideas we have come up with to Create Wow Moments. The second is a weekly challenge to engage in a new and different physical activity challenge (provided by our Health & Wellness Committee). Prizes are included for participation in both challenges!
  4. Virtual Coffee Shop Drop In & Happy Hour: Each week we have two optional companywide events to interact with one another personally. This is an opportunity to replace those hallway or breakroom interactions and ensure social interaction has found its place through a new virtual platform. 

Other Resources to Keep Your Staff Healthy

  • Forbes has put together a comprehensive survival guide to caring for staff, ranging from how to communicate about the virus and state of your company, to building team morale and addressing employment and financial needs of your team. 
  • NAMI has created a wonderful resource primarily providing resources for you and your family’s self-care and wellness. Check it out and send to your team as a reminder to take care of themselves as providers!
  • “You’re here for them, we’re here for you!” Headspace is a tool that provides guided meditations, animations, articles, and videos to improve your health and happiness. Due to COVID-19, Headspace is offering free access for healthcare professionals for the remainder of 2020.
  • Hilton & Marriott Hotels are offering special rates and deep discounts for healthcare professionals in need of a comfortable place to rest and stay. For Hilton’s offer, click here. For Marriott’s offer, email CVHelp@marriott.com.

Employee Legislative Resources 

Please reach out to anyone on our team at Remarkable Health if there are creative ways we can support you and your agency during this time. We are continuously looking for ways to remove the obstacles you face as providers – even the obstacles we can’t plan for or expect. 

Want to take it with you?  Grab our takeaway guide to share with your team!



young home office manager sitting on couch with pillows in front of laptop

Behavioral Health Agency Advantages for Managing Remote Teams During the COVID 19 Pandemic

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In an industry where the mission is driven by face to face interaction, it could be assumed that the effects of COVID-19 and social distancing would have only tremendous negative implications on Behavioral Health & I/DD Providers – where social connection and human interaction are at the crux of your everyday work and passion. In a world of daily uncertainty, crisis, and imbalance, the thought of learning new skills to manage an already intensive industry, is daunting. As you are forced to abruptly replace face-to-face interactions with telehealth and remote working, there will certainly be new challenges and for you and your co-workers. But what about the incredibly unique opportunities you as providers have to navigate this time of transition to remote working? You are a courageous group of people – a characteristic absolutely essential to working in this industry. But you also have distinctive strengths and skills that will allow you to effectively navigate this unforeseen transition to remote work.

As a way to help behavioral health and I/DD providers manage remote working environments, we’re providing a quick guide that will repurpose your proven strategies for client management to work with your team.

Agency Advantage 1: Client Engagement as a Model for Remote Team Engagement  

Previously, we posted two blogs surrounding client engagement and maximizing the time between sessions with clients (aka, the time when clients are remote). Simply put, there are skills needed to creatively and intentionally engage clients that you have already cultivated. In the blogs, we talk about how one session a month is simply not enough time to build the necessary trust with your clients or partner with them to successfully accomplish their goals – as clinicians, you are forced to maximize time outside of the sessions themselves to truly see progress and engagement. Whether you are a manager or team member at an agency, we want to simply remind you of the very same tactics we outlined for client engagement between sessions and translate them to help with engaging one another as (newly formed) remote teams.   

For Team Members:

  • Instill trust from a distance. You likely do not know how or what your co-workers are feeling as you begin to transition to remote working. You also may not be aware of the larger personal challenges one may be facing during this crisis. It is important to use your training, empathy, and compassion to cultivate trust with each other in order to support each other well from a distance.  
  • Meet your co-worker where they are at. Listen intuitively, observe carefully, and ask the right questions at the right time. Do your best to speak the language of your co-workers based on comfortability with the transition to remote work, listen without judgment, and be mindful of when to confront or challenge a co-worker in their way of thinking as you navigate this together. 
  • Identify barriers of remote work and create solutions. It is important to be sensitive to your teammates and the barriers that may emerge – remain curious and seek to learn as you take new challenges head-on. Always seek to create a solution as you work through what is going well and what isn’t as a remote team. 

For Managers: 

  • Employee Journaling. Could we use the same practice we use with clients to help those we lead during this uncertain time? You may decide in the transition of leading a remote team that a daily or weekly team meeting is essential. No matter what the frequency, there is still time between each meeting in which your team is navigating new challenges. Encourage them to journal their emotions, barriers, and new learnings of working remotely. Create space for team members to then share what they are learning. This will help with increased feedback and ownership in obtaining goals – similar effects we see from client journaling.  
  • Ongoing Communication. As a leader, we encourage you to creatively maximize the time between regular team meetings with various forms of communication. What is the communication preference of your team members? What creative new outlets of communication can you integrate to effectively communicate (more to come soon on tools we recommend!)? What are out of the box ways in which you can check in with those on your team and socially connect one another? Again, use some of the creative means you and your team have already come up with to utilize with clients and apply them directly to one another. 
  • Include your team in decisions. A sure way to effectively achieve buy-in during this time of change is to include the people you lead in your decisions. Ask questions, gather feedback and input, and consider every side of the story as you weigh the best routes to take and decisions to make. 
  • Establish concrete goals. Your team will likely feel discouraged if they do not have clear and concrete goals to measure progress (this feeling of discouragement from lack of clarity will likely be enhanced when remote). Remember to include your team on the development of goals and outcomes you will measure while working together from a distance.  

Agency Advantage 2: Maximize Coping Strategies to Proactively Address Mental Health Challenges that Accompany Remote Work  

As a behavioral health provider, you have the unique skill set and capability to identify mental health challenges, while knowing how to most effectively cope with and navigate them. While making this transition into becoming a remote agency, it’s important to first be aware of the many mental health challenges that can come with remote work: isolation, feelings of being ‘out of sight, out of mind’ with a leader or teammate, stress accompanying new work boundaries physically and mentally, abrupt changes in routine, and many more.

For Team Members:

Once aware of the mental health challenges you are facing, it is important to encourage both in yourself and co-workers, ways to cope with these feelings you may be experiencing during this transition:

  • Take breaks
  • Practice yoga
  • Exercise
  • Aromatherapy
  • Meditation
  • Diet
  • Focused breathing
  • Social connectivity
  • And many more!

Don’t forget to integrate those creative coping practices you have come up with for clients and use them in your day to day.

For Managers:

While of course, it’s still important to deliver high-quality services for clients during this time, it’s equally important to keep on the forefront of our minds the time of crisis and uncertainty we are all living in – a time that no one was prepared for. This is an incredible opportunity to use the grace and compassion that so often characterizes this industry for those considered to be your most important assets – the individuals that make up your team. We are reminded during this time as leaders of how to truly create WOW moments in the lives of others: “Look for a way to lift someone up. And if that’s all you do, that’s enough” – Elizabeth Lesser 

Please reach out to anyone on our team at Remarkable Health if there are creative ways we can support you and your agency during this time. We are continuously looking for ways to remove the obstacles you face as providers – even the obstacles we can’t plan for or expect. 

Want to take it with you? Grab our takeaway guide to share with a co-worker or post at your desk!