Enhancing staff performance measures in an acquired brain injury setting: combating the habituation to organizational behavioral interventions

Abstract

The current study examines the utility of a range of behavioral strategies involving group and individual performance feedback for direct care staff in an in-patient acquired brain injury setting. We first assessed the level of staff completion of behavioral programs for persons with brain injury who resided in one of two residential houses. A weekly percentage score for the entire house was obtained that reflected the completion of behavior programs in each residence. In a multiple baseline fashion across houses we varied the types of feedback intervention introduced to staff, which included in-service training on the importance of completing behavior programs, a weekly public posting of overall program completion by house, and a weekly public posting of completion of programs by specific staff members.

Feedback for improving staff training and performance in behavioral treatment programs

“…Feedback has been used with process information only (e.g., Guercio et al, 2005;Hutchison, Jarman, & Bailey, 1980;Montegar, Reid, Madsen, & Ewell, 1977;Parsonson, Baer, & Baer, 1974;Welsch, Ludwig, Radiker, & Krapfl, 1973;Wilson, Reid, & Korabek-Pinkowski, 1991), outcome only (e.g., Lattimore, Stephens, Favell, & Risley, 1984;Quilitch, 1975), or both (e.g., Arco, 1997;Greene, Willis, Levy, & Bailey, 1978;Huberman & O'Brien, 1999;Korabek, Reid, & Ivancic, 1981;Mozzoni & Bailey, 1996;Parsons, Cash, & Reid, 1989;Prue, Krapfl, Noah, Cannon, & Maley, 1980;Schepis & Reid, 1994). However, if the purpose of staff training is to produce specific client outcomes such as increased independent self-care or less problem behavior, then it makes sense to combine process and outcome feedback, particularly in the initial stages of training during which the functional interactions between staff and client behavior need to be seen and experienced (see Earley, Northcraft, Lee, &Lituchy, 1990, andKim, 1984, who showed beneficial effects of combining process with outcome feedback in nonclinical settings).…”

Effects of Public Posting and Goal Setting on Team Performance in a Residential Setting

“…Despite these limitations, the current study suggests that posting of group performance may be more effective than pervious literature suggest (e.g., Guercio et al, ). Furthermore, the intervention is an efficient way to provide feedback to staff, especially those whose shifts may infrequently overlap with the supervisor's presence (e.g., overnight staff).…”

“…Although public posting usually consists of posting individual performance data, this may result in poor acceptability of the intervention among both employees and management. To address this possible limitation, several studies have examined the effectiveness of posting group performance data (Guercio et al, ; Guercio et al, ). One advantage of posting group performance is that it may mitigate the aversiveness of having low or poor performance posted publicly as the specific individuals who are underperforming are not identified.…”

The Observer Effect and Its Impact on Staff Behavior in an Acquired Brain Injury Neurobehavioral Treatment Setting

“…They are also instrumental in the physical and cognitive rehabilitation of the resident (Guercio et al, 2005). In this context, it is important that staff make the residential environment pleasant so that residents are more actively involved in functional activities and productive free time (Guercio & Dixon, 2010).…”

“…Functional work performance of direct care staff in acquired brain injury (ABI) rehabilitation settings is a crucial factor in facilitating the successful recovery of the individual receiving services (Guercio et al, 2002;Guercio et al, 2005). When an individual sustains an ABI, time is of the essence and rehabilitation should allow the patient to experience quality care from direct…”