Leveraging Organizational Behavior Management to Enhance Your Practice: Observation, Measurement, and Indicators to Success

By: Nick Green, Ph.D., BCBA
Business people having casual discussion during meeting

Organizations prosper when employee performance and results create meaningful change. We strive to empower individuals, families, and communities with technology to realize any desired clinical outcome. Rethink tools are a conduit that connects clinical opportunity with clinical success. Regardless of your definition of success – a child transitioning to a less restrictive environment, an improvement in overall assessment scores, or growth within an industry – organizations can benefit from a precise and scientific approach to organizational change.  

Enter OBM. 

What is Organizational Behavior Management? 

Organizational Behavior Management (OBM) is the science of human behavior applied to the workplace. That’s right! An applied science that can benefit employees, processes, and organizations no matter the industry or company size. OBM’s success relies on being clear about what individual behaviors are desired in the workplace. Afterall, without human performance in the workplace, you would not have a business to begin with!  

By taking a behavior-based approach to solving any organizational challenge – late arrivals, slow report turnaround time, training difficulties with new hires – you are better equipped to search for variables in the work environment that will garner success.  

An OBM-approach focuses on two key questions: 

Question 1: What is the expected employee behavior? 

OBM requires that we clearly define an employee’s behaviors as observable and measurable.  

Observable

Observable means that you can either see a performance in vivo (e.g., typing at the computer, walking into a school) or as a permanent product – a result of some activity (e.g., completed attendance report, an organized teaching room). Even though you did not physically see the employee write the report or cleanup a room, you know that they engaged in the desired performance.  

(As an aside, permanent products may be more common now as remote and telehealth work environments increased during the pandemic. Supervisors now have fewer opportunities to observe live performance and deliver performance feedback when in-person interactions are limited.)  

Measurable

Measurable means that you can quantify the performance of interest. Common measures include the quantity, quality, cost, and timeliness.  If you find it difficult to measure a performance, you may need to revisit the definition of the behavior itself. “Does a good job on paperwork” can easily be transformed to “Wrote 250 words minimum of patient’s assessment history and progress” or even, “Clinical reports are due by 5:30pm on Fridays.” 

Why is measurement important? Because clinical and business decisions are made daily, we need to best understand how they produce some outcome. Without measurement, it will be difficult to understand if any intervention that we deliver had an effect. Did performance improve? To what degree? How many reports were completed? How many were delivered on time? Is the room cleaned everyday or only Mondays and Fridays? With precise measurement, we can enhance the quality of performance feedback. 

With a focus on observation and measurement, we provide clarity for all staff. There is no more guesswork on employee expectations. Further, with clear definitions in place, more than one employee can agree when the desired performance occurs: another hallmark of a behavior-based approach to problem-solving. It is not fun when an employee and supervisor disagree on a job well done at the end of the day. 

After clarifying an employee’s desired performance, we can now turn towards results. 

Question 2: How can we best manage the results of employee performance? 

The challenge with analyzing results of our performance is that most feedback is often delayed. Our clinical documentation and efforts must navigate complex healthcare processes, pass internal and external quality assurance (QA) tests, and convince another professional of its merit. 

Take the life of a typical authorization report. Your report was signed, sealed, and delivered, but you often go through this checklist: 

  • Is it a well composed and complete document? Check.  
  • Correct length? Check.  
  • Delivered on time? Check.  

These tasks are important to track and monitor as they are immediate results of our performance. A manager or system can design feedback processes so that the employee knows immediately if their performance was acceptable. Further, these results are also called leading indicators as they indicate to us how well are tracking towards a desired result. Simply put, you can expect a higher acceptance or authorization rate for behavior intervention plans when they check 90% of your QA boxes.  

Your teammates will thrive in a system of positive feedback delivered on such leading indicators. 

But not everything is immediate, the true test of our performance come with delayed results. It may take 7 days or even a month to learn about an approval or denial. Regardless of the time frame, results of this sort are known as lagging indicators. They lag so far behind our initial performance (e.g., submitting the report on time) that connecting the results to the behavior that produce it is paramount. Aligning leading indicators with lagging indications is a challenge that all organizations face. Those that are purposeful in their design, measurement, and alignment will thrive more so than those who do not.  

Leveraging OBM For Your Business 

In review, businesses are successful because employees behave in particular ways. Observing and measuring performance provides a vehicle to deliver meaningful feedback to your team. This feedback will help drive the performance that you want to see in your practice today, and for years to come. We can say this with confidence because of the 75+ years off applied behavioral research. When leading and lagging indicators are aligned with your overall clinical strategy, staff performance, processes, and the organization will thrive. 

OBM is a powerful method to unleashing clinical excellence in your organization. If we know what works, why not use it?

About the Author

Headshot of Nick Green

Product Owner – Data Analytics at RethinkBH

Dr. Nick Green oversees the development of analytics tools for behavioral health customers. He leads and creates innovative solutions for clinical data-based decision-making.

Dr. Green began working in the field of applied behavior analysis (ABA) in 2009 and later earned an MS in Organizational Behavior Management (OBM) and a PhD in Behavior Analysis from the University of Florida. His expertise and research focused on reducing sedentary behavior (sitting) in the workplace. Dr. Green is a peer-reviewed author and featured presenter at annual ABA conferences. Nick’s passion lies in workplace wellness and data analysis – he wants to create the best tools for clinicians to have a better workday.

Outside of everyday analytics work, Dr. Green helps others get healthier and fit. As a PhD student, he founded his own behavior analytic consulting firm, BehaviorFit. Here, he provides expert coaching and other educational resources to help others achieve their health and fitness goals. He loves functional fitness, taking midday walks with his blue-tick heeler/cattle dog (Pete) and wrestling with his son Ogden.

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