Staff Alignment and Retention
Just as organizations are working to keep consumers, they, too, must focus on staff retention and satisfaction. Many healthcare
organizations suffer from a “skill supply chain” challenge, meaning there are not enough qualified employees to fill muchneeded roles. This challenge becomes even more acute when employees leave their jobs for other companies, abandoning
already hard-to-fill voids; it can take between three and five years to make a new professional fully productive, according to a
2014 report by Forbes Magazine.
Giving Meaning to Measurement
Reichwald’s main role is to train and prepare staff to do their jobs at Rosecrance, and she relies heavily on data to evaluate and
ensure her trainings are effective -- leading to happier and more invested staff.
“Staff – leadership, clinical, front line, clerical, support staff – really have to understand the mission, vision and values of our
organization and see the value in the way we work with our consumers,” explained Reichwald. She also noted staff should all
understand the organization’s clinical tools and have basic knowledge about which are most effective, and when.
Three behavioral health/addiction
treatment providers say an important
facet of high quality healthcare is
harnessing data to improve outcomes
and organizational performance
“Data drives what we do in training and employee education,” Reichwald continued. She said her team takes the information
from employee surveys to see where Rosecrance is still falling short and where it is making progress. Then, they design and/or
modify future trainings around that.
Further, there are regular employee satisfaction surveys that address the way staff feel working at Rosecrance, as well as areas
staff feel they could use additional support. The results drive the culture, and are also benchmarked against previous years’
results and those of other similar organizations to help retain staff and to make them more effective at their work.
“Data moves us forward” was the sentiment of Sarra
Reichwald, talent management coordinator for Rockford,
Il.-based Rosecrance. The private, non-profit behavioral health
and addiction treatment organization offers inpatient and
outpatient services for children, adolescents, adults and families.
It is important that staff satisfaction is measured and compared across multiple dimensions, including satisfaction with the
organizational environment, leadership, compensation and benefits, opportunities for growth and recognition, relationships
with co-workers, as well as organizational quality.
What Does the Future Hold?
“Good news or bad news, the data tells us in which direction to
go,” she said, noting that benchmarking plays a central role in
moving the organization forward.
“Really good data is the future,” said Boxley.
He said the old-fashioned way of paper and pencil just won’t cut it in 2015, and
that automated benchmarking will be key to the sustainability of any healthcare
organization, especially within this era of accountable care.
“Moving to an electronic health record and then a more automated benchmarking
process helped tremendously,” said Boxley, noting that now any director in any
department can pull a report to see how their areas are doing, what they should be
focusing on, or the probability of certain treatments on impacting outcomes.
“That is a huge change.”
“Moving to an electronic
health record and then
a more automated
benchmarking process
helped tremendously.”
– Dr. Robert Boxley, Manatee Glens
Boxley believes that the era of big data and the drive for proper data analysis and benchmarking is in its infancy, and that soon
all organizations – large or small, medical or behavioral health – will be using more data to drive decisions and prove their
effectiveness to payers and donors. He also predicts that data entry and analysis will become a part of more people’s roles, with
staff on all levels entering information that can be extracted from data to knowledge and, ultimately, to organizational wisdom.
Lastly, he said he sees a push toward greater data collection standardization in the behavioral and mental health arenas.
“You’ll have to compare apples to apples, compare between California and Florida. From states, maybe we will eventually
benchmark across countries,” said Boxley. “The possibilities are endless.”
Are you interested in benchmarking, too?
Learn more about Netsmart’s benchmarking program at
www.NTST.com/Solutions-We-Offer/benchmarking_analytics.aspx.
What is benchmarking?
In general terms, benchmarking is the act of evaluating or checking something by comparison with a standard. Benchmarking
can be used to evaluate financial viability, operational efficiency and clinical effectiveness. In the behavioral health and
addiction treatment communities, some specific examples of how benchmarking can be used include estimating length of
stay and cost, monitoring and achieving consumer program completion as well as outcomes and satisfaction; evaluating the
prevalence of co-occurring disorders, and as one component of assessing staff and organizational performance.
Benchmarking can impact all aspects of a healthcare organization – clinical financial and operational, says Reichwald, as well her
colleagues at two other leading health and human services organizations, Caron Treatment Center and Manatee Glens.
Dr. Robert Boxley, director of clinical training and supervising psychologist for Florida’s Manatee Glens, said his organization has
been benchmarking in “the broadest sense” for decades. But in recent years, as Manatee Glens has moved toward greater care
integration – in-line with the direction of the rapidly changing healthcare landscape – the agency has shifted what data it looks
at and how it examines that data. His and the other organizational representatives’ tips, tricks and other valuable advice can
help similar organizations to identify and enhance their benchmarking strategies.
Continued >>
Clinical Outcomes
From a clinical perspective, benchmarking can assist healthcare organizations in achieving an important aim: better clinical
outcomes at a lower cost. This is especially true when considering the rising number of individuals with co-morbidities and/
or co-occurring disorders – specifically mental illness and substance use disorders. Research is beginning to prove the value of
integrated care for people with these challenges. Having access to meaningful clinical data can help organizations tackle the
challenge of writing effective treatment plans for this high-risk population.
Assessment data is critical to determining the probability of success for an individual. At Caron, a leading non-profit provider of
addiction and behavioral healthcare treatment for adolescents, young adults, adults and seniors, Dr. Stephen Shechtman, lead
psychologist, said that during intake prospective consumers are asked a series of questions. Depending on their responses, they
are either admitted to Caron or another treatment option is recommended.
“We want to make sure that [the] individual is in an appropriate state for our level of care,” Shechtman explained, noting Caron
is able to analyze consumer success rates against intake assessment responses to help make that decision. This process permits
them to provide client-centered treatment, while also lowering the cost of treatment.
Caron further monitors consumers through regular re-assessment at days “Our completions are relatively high –
five, 14 and 25. Every treatment plan is personalized to an individual’s
consistently 90 percent or higher.”
addiction and/or co-occurring disorders, and includes consumer
benchmarks at the time of each assessment. A living and breathing
– Rosemarie Sullivan, Caron
document, the treatment plan evolves via daily multidisciplinary team
meetings and again at each of these assessment stages, ensuring the consumer is on a path toward recovery.
“Our completions are relatively high – consistently 90 percent or higher,” said Rosemarie Sullivan, Pennsylvania director of
quality at Caron. She explained that program completion is one of the key areas the organization benchmarks against similar
organizations.
“We are really proud of our completion rates,” she said.
Completion rates are indicative of client quality of life and reduces readmission after discharge.
Manatee Glens likewise uses clinical benchmarks to improve outcomes and drive down costs. Integrating mental health,
addiction and physical health treatments, the organization focuses on use of evidence-based practices. Boxley said Manatee
Glens looks outside its organization to determine which practices to use, but also within – tracking and benchmarking the
effectiveness of variant treatment plans and protocols, and then using that data to impact future treatment plans.
Additionally, Manatee Glens tracks co-occurring disorders to determine which are most common. That data helps the agency
better understand when to monitor a consumer for a co-occurring disorder and ensure effective treatment of the whole person.
For example, said Boxley, there is a very high percentage of substance use disorder for individuals with schizophrenia.
Knowing these statistics can help an organization identify expected outcomes at the forefront, said Rosecrance’s Reichwald.
Because Rosecrance serves such a diverse population, outcomes measures look different for different service lines. Like Manatee
Glens, Rosecrance tracks successful completion of its substance use treatment track. The inpatient co-occurring disorders
program has been holding at a steady rate of around 83 percent.
In their mental health treatment track, Rosecrance collects social services data on its consumers, which can impact progress
and potentially skew benchmarks if not looked at in the correct context. For example, homelessness or incarceration can impact
treatment time and length to recovery.
Therefore, tracking consumers as they step-down in
care, taking into account the consumer’s history, and
continuing to monitor progress is critical to obtaining a
complete picture and ensuring consumer well-being.
Consumer Satisfaction
Another shift in the evolving healthcare landscape is the
push for increased consumer engagement and consumer
expectations of their providers. Gone is the era of the allknowing clinician and the passive consumer. It has been
replaced by a “me age” in a consumer-driven economy,
forcing healthcare organizations to focus not only on
health outcomes, but consumer satisfaction with the
services they receive.
“Tracking [our consumers’] happiness with us is
something we have undertaken in the last several years
in a systematic way,” said Boxley. “As consumers get
more sophisticated with healthcare choices, healthcare
organizations have to be aware … that people will
choose the places that treat them well.”
Boxley said high client satisfaction has become “kind of
our mission” and that Manatee Glens regularly looks at
those benchmarks to see, “in what areas we fall short and
in what areas we excel. We can then figure out how we
can use where we excel to help us excel more in areas
where the numbers aren’t where we want them to be.”
At Rosecrance, a culture of recovery is very important
to the agency’s work. Hence, Rosecrance focuses on
whether or not consumers feel the environment is
reflective of that mission. All employees are trained on
recovery-based treatment methodologies, best practices
and use of recovery-based language. Rosecrance surveys
staff and consumers regularly to confirm alignment and/
or determine if additional training is needed.
Consumer satisfaction is not limited to overall
satisfaction with treatment. Benchmarking metrics
related to satisfaction must be appropriate to the
population and program as well as capture the full
range of consumer experience, from being treated with
respect and dignity to active participation in treatment
planning and goal setting and more.