In the field of behavioral healthcare, where patient well-being is paramount, staff performance and clinical outcomes go hand-in-hand. As Director of Outcomes across a number of organizations, I’ve always believed it critical to implement strategies that monitor, evaluate, and improve the performance of our staff. For this reason, we’ve decided to roll out formalized scorecards for our staff, set to roll out in the coming months. In this article, I’ll take a deep dive into why scorecards are such a crucial element and which components we’ve chosen to evaluate at Teamwork.

What Are Staff Scorecards?

BCBA scorecard template for ABA companies

Scorecards can take many forms, but at our organization they will consist of data that I pull from our data collection tool, then aggregate, and analyze on a monthly cadence. These are metrics that Teamwork already evaluates and are hard measures like what percentage of our client programs are being overrun past criterion, or what the distribution of programming looks like across domains. This data is then filtered by employee so that I can evaluate performance on an individual BCBA level. A summary of this data is then provided for Clinical Directors to review with their BCBAs.

The Benefits of Using Scorecards

A paper with benefits written on it in sharpie.

Embracing staff scorecards has myriad benefits, transforming the way we perceive and manage performance in the behavioral healthcare sector. Below we’ll dive into what we believe to be the most important benefits for our organization.

Transparent and Objective Performance Evaluation

Staff scorecards provide a structured and transparent approach to evaluating the performance of staff. We already have the data, so why not develop clinical goals around it? By establishing clear metrics and expectations, scorecards help set benchmarks for success and allow for objective measurement of performance that is predictable quarter over quarter. Objective performance evaluation also promotes transparency and fairness while minimizing bias or favoritism, ensuring that all staff are held to the same standards. Staff members can then work collaboratively with their supervisors to address any performance gaps and enhance their skills.

Continuous Professional Development

One of the primary advantages of staff scorecards is their ability to identify areas in need of additional professional development. By tracking individual performance metrics, scorecards provide valuable insights into areas where staff members excel and areas where improvement may be needed. These insights can be used to design targeted training programs and professional development initiatives. By addressing specific skill gaps and enhancing staff members’ knowledge and expertise, organizations can improve the quality of care provided to patients.

Enhanced Accountability

Scorecards can foster a culture of accountability within our organization. By clearly communicating performance expectations and metrics, scorecards enable staff members to understand how their individual performance contributes to the overall success of the organization. This shared responsibility creates a sense of ownership and motivation among the staff. Regular performance reviews and feedback sessions based on the scorecard data provide an opportunity for open communication, collaborative problem-solving, and knowledge sharing among team members. Celebrating achievements and recognizing high performers also contribute to a positive work environment. When staff members are aware of their performance and understand the impact they have on patient outcomes, they become more engaged, motivated, and committed to delivering exceptional care.

What Should Scorecards Include?

Each organization will have their own priorities when it comes to scorecards, but a few important components we choose to include are described below.

% of Overrun Programs or Delayed Treatment Changes

The devil is in the details here. A few days of extra trials may not make much of an impact, but the longer a program is taught once it has reached mastery levels, the more time is wasted for a client. Tracking the percentage of a BCBA’s programs that are overrun will provide us with insight into how often graphs are checked or how closely programs are monitored.

Distribution of Programs by Domain

Ideally, a client should have a relatively even mix of programs across domains. Teamwork filters programming into five primary domains so we can evaluate the percentage of programs that fall within each category. If we notice that one domain percentage increases beyond what is expected for that client, we will flag this in our scorecard.

% of Clearly Labeled Graphs

Example of a well labeled behavior graph in ABA

Being able to view the development of a treatment over time is critical to understanding how it should progress. Without adequate graph maintenance, this insight would be impossible to gather. During book checks, our Clinical Directors ensure that graphs include clearly labeled probe, baseline, and treatment phases (or numbers representing these items, as shown below). Our goal for maintenance is to have all necessary components perfectly labeled on 80% or more of our client graphs.

Complete List Components We Track

In addition to what is listed above, here is a complete list of components we will track for a BCBA scorecard:

% of Overrun Programs
Distribution of programs by domain
% of clearly labeled graphs
% of clients on Flag List (clients flagged for stagnant progress) for past month
% of programs began within first 30 days of service
Average # of mastered targets per mont
Behavior reduction at 80% by 6 months (y/n)?
Effective communication with families? (parent survey)
Effective communication with BT? (BT survey)

Whatever metrics your organization decides to track, you should make sure the metrics are: 1) clearly defined, 2) achievable based on historical data, and 3) regularly reviewed in order to provide feedback.

Conclusion

By investing in staff performance through scorecards, behavioral healthcare organizations can create a culture of continuous improvement that directly benefits their clients. Ultimately, improved staff performance directly translates to improved clinical outcomes, as engaged and skilled staff members are better equipped to provide high-quality care and positively impact the lives of the individuals they serve.

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