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