Back to Journal

SM Addiction Research and Therapy

Performance Measurement in Behavioral Healthcare Centers

[ ISSN : 3068-0883 ]

Abstract Citation Performance Measurement in Behavioral Healthcare Centers References
Details

Received: 16-Apr-2018

Accepted: 02-May-2018

Published: 03-May-2018

Susan Steffan1 and Keith Klostermann2*

1Business Management and Leadership department, Medaille College, USA

2Counseling and Psychology Department, Medaille College, USA

Corresponding Author:

Keith Klostermann, Counseling and Psychology Department, Medaille College, 18 Agassiz Circle, Buffalo, NY 14214, USA

Abstract

Behavioral Healthcare Centers often find themselves frustrated by their lack of success in defining and meeting their key organizational objectives. This frustration is not the result of lack of skill or passion, but rather lack of clear organizational goals and concrete measurements. Leaders in these organizations often confuse “doing good” with being effective. This commentary will illustrate how behavioral healthcare managers can learn from their for-profit counterparts and translate their organization’s mission into clear performance measures across the company. T he first thing any organization needs to do when it comes to goal-setting and measurement is to understand their “big picture”. Executives must answer the question as to why their organization exists in the first place. What is the mission that will drive all other decisions in the organization? This mission should not be so generic that it could fit every other organization in your industry. Rather, it should help everyone in the agency understand what makes it unique.

Citation

Steffan S and Klostermann K. Performance Measurement in Behavioral Healthcare Centers. SM Addict Res Ther. 2018; 2(1): 1003.

Performance Measurement in Behavioral Healthcare Centers

Behavioral Healthcare Centers often find themselves frustrated by their lack of success in defining and meeting their key organizational objectives. This frustration is not the result of lack of skill or passion, but rather lack of clear organizational goals and concrete measurements. Leaders in these organizations often confuse “doing good” with being effective. This commentary will illustrate how behavioral healthcare managers can learn from their for-profit counterparts and translate their organization’s mission into clear performance measures across the company.

The first thing any organization needs to do when it comes to goal-setting and measurement is to understand their “big picture”. Executives must answer the question as to why their organization exists in the first place. What is the mission that will drive all other decisions in the organization? This mission should not be so generic that it could fit every other organization in your industry. Rather, it should help everyone in the agency understand what makes it unique.

Once the mission is defined, quantifiable goals that, if accomplished, will allow the mission to be realized, must be articulated. This is where behavioral healthcare organizations tend to struggle. A goal should not be confused with an activity. For example, while you may wish to “provide more counseling services for school-aged children”, that is not a measurable goal. How is “more” defined? How will you know if you are on-track to meet your goal? A quantifiable goal could be “Increase the number of high school mental health presentation to 24 during the 2018-19 academic year”. By using a measurable and specific goal, results can be tracked throughout the year, the organization can determine if the project is on target to achieve the goal, and they can define the required resources. Simply stated, every goal that is defined, should be measurable. Measurability, however, is necessary, but not sufficient. In the scenario above, my organization may conduct 24 presentations in the year, and conclude that its goal was met. However, the bigger question is whether meeting that goal got us closer to achieving our mission. How do we know that the presentations had an impact on the mental health of teens? We need goal measurements as well as outcome measurements. As an example, let’s say you work at a company that wants to improve sales of a key product. The marketing department is charged with increasing the market exposure through advertising, social media, etc. They are given the resources required in terms of the marketing budget. They measure key metrics of clicks on their advertisements, viewers for their ads, recognition of the product in surveys, etc. and conclude that they met all their objectives. They did everything they were asked to do in marketing the product. However, the true test of the company’s success is not in whether people liked the ads, it is whether they bought the product. The final measurement has to be sales of the product.

Robert Kaplan of Harvard Business School conducted research into how companies can translate their strategy into actionable performance measurements, which resulted in an approach known as The Balanced Scorecard. Kaplan discussed how an organization can translate their overall vision into key performance measures in four areas that apply to any organization - for profit and nonprofit alike. These four areas are: Financial, Customer, Internal Business Processes, and Learning and Growth. For nonprofit managers, the fact that nonfinancial measures receive just as much attention as financial usually helps achieve willingness to consider the approach, as so many other “business” methodologies seem to focus more on financial measures only. While Kaplan’s approach is one of many, the basic philosophy of measuring the important indicators that help the organization achieve its mission applies.

Once goals and their performance measures are well-defined, the next step is assigning accountability. This is one area where nonprofit organizations need improvement. When so many people within the organization are sacrificing so much to do good in the world, it can seem crude to hold them accountable to measures and numbers; after all, they are doing admirable work. However, accountability can focus that goodwill and passion, and help these same employees be more able to achieve their personal goals as well as the organization’s mission thereby increasing job satisfaction, improving efficacy, and enhancing service delivery to patients. The accountability for performance measurement must be singular. While it is true that typically no one person controls the ability to execute a goal, one person must be charged with making sure that it is executed. Putting a team in charge of anything means that individual members do not feel the same accountability. Nothing focuses effort better than having your name on the report requiring an update to the supervisor on the status of key initiatives.

After the mission is defined, clear and measurable goals are developed and individuals are named accountable, the organization is in good shape to make progress. However, the most important part of the process is still forthcoming. The feedback loop is critical. If the organization met its goals, has it brought them closer to achieving the mission? If not, do goals need to be re-defined? Did achieving one goal result in another being missed (e.g. spending too much to achieve an outcome which results in financial health issues). Were there unintended consequences that must be addressed? The mission and goals must be constantly re-evaluated as the field evolves, regulations change, and available treatments improve. An organization cannot rest on past success; goal-setting is a continuous loop with new information used to inform decision-making on an ongoing basis.

While the process outlined above may seem daunting to many behavioral healthcare centers, it is important to remember that the process may be more important than the outcome. Having employees discuss the vision of the organization, work together to set and achieve goals, report out on outcomes, and evaluate results means that the whole organization is working together to improve. Even if they come up short, they will be far ahead of their counterparts who blindly try to “do good.” Moreover, given limited (and shrinking) resources within many of these organizations with people being tasked with doing more with less, it is critical that clear outcomes are developed and measured and results used to inform resource allocation. Simply stated, do not value what you measure, but measure what you value.

References

1. Chow D. Reigniting clinical supervision. 2018.

2. Kaplan RS, Norton DP. The Balanced Scorecard: Translating Strategy into Action. Boston: Harvard Business School Press. 1996.

Other Articles

Article Image 1

Should Pharmacological Treatment for Adolescents with Opioid Dependence Differ from that for Adults?

T he 17-year-old female patient presented herself for the first planned inward treatment. She reported having smoked Cannabis since the age of 13 years. At the age of 15 she smoked Heroin for the first time, and she did so (2 to 3 g daily) until the beginning of her substitution treatment five months ago with 80 mg L-Polamidon which she received from a general practitioner. In contact cautious, visibly excited and a sad basic mood she wished a detoxification treatment and subsequent psychotherapy. She was born in Iran. The father was a professional bodybuilder and was murdered in 2002 there. The 45-year-old mother had a fitness club in Iran. The patient immigrated to Turkey at the age of ten together with her mom and 18-year-old sister. Her mother and her sister still lived in Turkey. She reported in good English about the separation from her mother after beginning to work with 13 years. At the age of 15, her uncle from Iran met her and lured her into an apartment. Against her will he married her with his son, her cousin. He mistreated her and after month she had succeeded in escaping, come to Germany via Greece. Living in a girls’ home for five months she was attending school, showing good achievements and liked to be an ergotherapist, because she love to work with her hands, paint and do yoga.

Florian Ganzer*


Article Image 1

Ketamine Cystitis: A Case Report

Ketamine misuse is the most common illicit drug used in Singapore, Hong Kong and areas of China and Taiwan. A Chinese American male presented to our inpatient rehabilitation unit with genital urinary complaints, of hematuria, dysuria and frequency. He had been misusing ketamine for many years and had similar complaints in the past. Healthcare providers should be aware that ketamine user disorder may present primarily with genital urinary complaints. Cessation of ketamine use is of upmost importance since chronic irreversible fibrosis of the genital urinary tract may occur with continued misuse.

Salsitz A Edwin*, Spriggs Sharron and Friedman Trevor


Article Image 1

Waterpipe Smoking: Gateway to or Escape from Cigarette Use among Current Waterpipe Users in Riyadh, Saudi Arabia

Introduction: The purpose of this study is to determine whether waterpipe use may contribute to the onset of cigarette use or if it may help current cigarette smokers reduce or quit cigarette smoking.

Method: This is a cross-sectional study of 622 current waterpipe smokers selected randomly from within 15 different randomly selected waterpipe lounges in Riyadh, Saudi Arabia. Using an iPad volunteers completed a self-administered survey regarding their smoking history, tobacco withdrawal symptoms, and demographics. Those who initially started smoking with waterpipe and those who initially started smoking with cigarettes were analyzed separately.

Results: Logistic regression showed that both the years of waterpipe use and withdrawal symptoms significantly predicted being a current cigarette smoker (waterpipe starters: years of waterpipe use: OR=1.18, C.I.=[1.07-1.30] withdrawal symptoms: OR=1.11, C.I.=[1.01-1.22] and cigarette starters: years of waterpipe use: OR=1.08, C.I.=[1.00-1.17] withdrawal symptoms: OR=1.15, C.I.=[1.03-1.27]. However, the likelihood of being a current cigarette smoker decreased as age and frequency of waterpipe use increased. Additionally, there was evidence that waterpipe withdrawal symptoms were predicted by frequency of waterpipe use.

Conclusions: Waterpipe use may be a potential gateway to cigarette use. However, among those who initially started smoking with cigarettes, older age and greater frequency of waterpipe may protect against cigarette use.

Implications: The study findings add additional evidence that smoking waterpipe may lead to initiate another smoking behavior, in a particular cigarette use, especially among young individuals. However, long history and greater use of waterpipe could be associated with less likelihood of being a current cigarette user. Health promotion and intervention programs must consider the mutual association between waterpipe and cigarette use among youth and young adults in order to develop effective health promotion programs.

Naif H Alanazi1* and Jerry W Lee2


Article Image 1

Beverage-Specific Alcohol Sales and Gender Difference in Life Expectancy in Russia

Background: The difference in life expectancy at birth between males and females in Russia is unprecedently high compared with developed countries.

Objective: The aim of the current study was to examine the aggregate-level relationship between the consumption of different alcoholic beverages and gender difference in life expectancy in Russia between 1970 and 2015.

Method: To estimate the relation between these variables across the study period a time series analysis was performed using the statistical package “Statistica 12. Stat Soft”.

Results: The results of ARIMA analysis indicate that vodka sales are closely linked with gender difference in life expectancy in Russia: an additional liter of vodka sales per capita was estimated to increase in the difference between male and female life expectancy by 4.1%. The results of the analysis also suggest that 18.5% of the difference in life expectancy between males and females in Russia could be attributed to consumption of vodka.

Conclusions: This piece of evidence provides support for the hypothesis that high level of vodka consumption in conjunction with binge drinking pattern may be a major reason for the high gender difference in life expectancy and its dramatic fluctuations in Russia during the last few decades

Razvodovsky YE*


Article Image 1

Addressing the High Prevalence of Smokeless Tobacco Use in Pastoralist Communities of Ethiopia

The use of smokeless tobacco, which includes snuff and chewing tobacco, is low in majority of the countries when examined for both women and men. In general, the use of smokeless tobacco among men is more common in South and Southeast Asia than in any other region. Yet large portions of the Borena’s adult pastoral communities are smokeless tobacco users. It is needed a call to action for policymakers and health professionals to improve the health and well being of pastoral communities of Ethiopia’s adults by increasing their access to anti notice information on smokeless tobacco use.

Edao Sinba 1,2* and Mamusha Aman Hussen3


Article Image 1

Drug Abuse among Street Children

In The Gambia like all nations, drug abuse is seen as a social and health problem that has many serious implications for the physical, social, psychological and intellectual development of the victims more especially, the children. Therefore, it continues to be a concern to families, community leaders, educators, social workers, health care professionals, academics, government and its development partners. Though there some studies on drug abuse, there is none on children and drug abuse focusing on the street children the most vulnerable category. Street children are hypothesized to be more at risk of any epidemic including drug abuse. This study sought to determine the risk and prevalence of drug abuse among street children focusing on those in Praveen, the car parks. The research was focused on six critical areas: level of knowledge of drug abuse, perception towards it, level of knowledge of the causes of it in the community and among street children, level of knowledge of negative impacts of it, level of knowledge of the preventive methods; and level of knowledge of the support services and treatments needed by victims. A structured questionnaire was used to collect the data from thirty five participants (i.e. one driver and six casual apprentices from each of the five car parks) were interviewed. The data was presented and analyzed using tables and percentage. The findings revealed among other things, that there is high level of awareness of drug abuse but the feelings towards it is mixed. Like other children, street children are abusing drugs mainly due to peer influence with the ultimate objective of getting high to relief stress, group recognition, trusted by peers, etc. Similarly, participants are highly aware of the negative impacts encompassing f ighting, stealing, mental illness, etc. To finance the behaviour, victims are engaged in all types of dangerous antisocial behaviour including romantic ones exposing them to a range of diseases including STIs and HIV/AIDS. Marijuana is the most commonly abused drug. Though in the minority, some have started experimenting cocaine/ coke, hashish; and heroin. While participants have good knowledge of the critical methods to fight drug abuse, the support services needed by victims, victims are mostly reluctant to seek the services not only because they are hard to find but fear societal stigmatization, exclusion and discrimination and professionals’ maltreatments.

Yahya Muhammed Bah*