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How do I get staff engaged in making changes?

Posted by daveg on Friday, June 04, 2010 at 01:10 PM

What’s it like to be a direct line staff person in a substance abuse treatment agency? In a lot of places they have direct service quotas that they have to meet, but high no-show rates for appointments. They have a lot of paperwork to complete, especially on new clients, and since they have high no-show rates, they are often getting new clients set up, and they feel like all they do is fill out forms. Often they feel isolated, stressed, frustrated with the lack of progress they see in their caseload. In many places they were trained in individual therapy but most of what they do is run groups. When you think about what it is like to be a front line staff person as well as what it is like to be a client, you will probably identify some changes that work for everyone.

Involve them in the process: Doing a walk-through is not the same as mystery shopping. The walk-through process is to identify procedural problems, not to catch staff in mistakes. Let them know when you are doing a walk-through and engage them in discussion as you do the walk-through. They will help you identify things that are troublesome to them as well as uncomfortable for clients. Many agencies create change teams that include staff in deciding what needs to be improved. People are full of ideas about how to improve their work. Solicit and try their ideas.

Choose changes that improve the working environment: Almost all clinicians will say that paperwork is their biggest problem. Clinicians will appreciate changes that eliminate extra paperwork and simplify the screening/intake process to allow the clinician to spend more time engaging with the client. If the work environment is dark, cramped, and unwelcoming for clients, it also feels that way to staff who spend much more time there. Any effort to spruce up the office will be a welcome change for staff.

Do short pilots: As one program executive said: “You can tolerate almost anything for a couple weeks.” Trying out a change idea on a small scale for a short period of time and collecting information on whether or not it is working, makes a change more palatable to staff. When you say, “We are going to try this for two (or three or four) weeks, and we are going to measure the impact. If it doesn’t have a positive impact, we will stop.” then follow through on your promise, staff can begin to see change in a different light.

Measure improvement and share data: We have a myth in our field that we don’t do numbers and we don’t like data. But nobody, regardless of the industry they work in, likes collecting data that they don’t use. Using simple data collection tools and sharing the outcomes with staff will engage them in using data to make decisions. And you’ll find that it is hard to argue with the numbers. If you are trying to decrease your no show rates by getting people in quicker, it is easy to see in a few weeks whether that is happening or not. People actually love data that is relevant and tells them something they want to know.

Reject changes that don’t work: If you are true to your word and pilot test changes and only fully implement those that prove effective through your chosen data point, staff will become more engaged in helping you identify changes that will work. Failure isn’t a bad thing in this way of thinking. If the investment wasn’t huge, it is easy to reject failed trials, and staff appreciates the willingness of management to adjust. Of course, you need some successes, too, or people will think nothing works, but rejecting a failed project demonstrates management’s flexibility, which is important in engaging staff.

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