BA450 Unit 8 Performance Improvement Plan Example

Initials in the Right Box: A BA450 Unit 8 Performance Improvement Plan

[Student Name]

Purdue University Global

BA450: Organizational Behavior Management

Unit 8 Performance Improvement Plan

[Instructor Name]

[Date]

The writer, the agency, the homes, the staff and every figure are composite and illustrative; the articles cited are real.

The Problem

Direct support staff at our agency's four group homes administer residents' medications and initial a medication administration record after each dose. A monthly pharmacy audit in the fall found documentation errors, mostly missing initials and initials in the wrong time box, at a rate of 6.2 per 100 administrations across the agency, well above the pharmacy's expectation of under 2. No resident was harmed, because doses were given correctly, but missing documentation creates risk: a later staff member may not know whether a dose was given. The agency director asked me to write a performance improvement plan.

Pinpoint

Staff initial the correct time box on the medication administration record immediately after each dose, before moving to the next resident.

Measure and Baseline

The measure is documentation errors per 100 administrations, counted by the house manager each Monday from the previous week's records and checked monthly against the pharmacy audit. Baseline for four weeks showed rates of 8.1, 6.6, 5.4 and 4.7 per 100 at the four homes. Errors clustered on the 8 p.m. medication pass.

Diagnosis

I completed the Performance Diagnostic Checklist-Human Services, described by Carr et al. (2013), at each home through interviews with house managers and observation of the 8 p.m. pass. Findings were similar across homes.

Training: staff knew the procedure; all could describe it correctly. No training problem was found for current staff.

Task clarification and prompting: the procedure said to initial "after administration" but did not say "immediately"; some staff initialed all doses at the end of the pass.

Resources and processes: the record binder sat in the locked medication cabinet, so staff closed and reopened it for each resident, and the 8 p.m. pass overlapped with showers and phone calls, causing frequent interruptions.

Consequences: staff received feedback only when the pharmacy found errors months later; correct documentation was never acknowledged.

The errors came from the end of a busy evening, not from staff who did not know the rule.

Interventions Matched to Causes

Task clarification: the written procedure now reads "initial immediately after each dose, before the next resident," and a laminated card with that sentence sits on the medication cart.

Resources and processes: the record binder now rests open on the cart during the pass. Showers are rescheduled to begin after the 8 p.m. pass at each home, and the staff member passing medications wears a "medications in progress" lanyard signaling others not to interrupt.

Consequences: feedback follows Alvero et al. (2001), whose review found that feedback combined with goals and delivered frequently, with graphs, produced the most consistent effects. Each Monday, house managers post a graph of the home's error rate beside the goal line and say one sentence about it at the staff meeting. Individual staff with zero errors for the week receive a brief thank-you note.

Training: no current staff need retraining. New staff will learn the procedure through behavioral skills training, following Parsons et al. (2012), practicing an actual pass with a trainer until they complete it correctly twice in a row.

Goal

The agency-wide goal is fewer than 2 errors per 100 administrations within eight weeks, with each home's goal set by its staff at or below that level.

Staff Input

I presented the diagnosis at each home's staff meeting before finalizing the plan. Staff proposed the lanyard and the shower schedule change; both came from their experience of interruptions. They also asked that feedback not name individuals publicly, which shaped the decision to post team rates.

Review and Decision Rules

House managers send me each week's rate. If a home's rate does not fall by at least half within four weeks, I will repeat the diagnostic observation there. If a home meets its goal for four consecutive weeks, its feedback moves from weekly to every two weeks. If any home's rate rises above baseline, the plan is reviewed with the director within a week.

Risks

Three risks could undermine the plan. Staff might rush the pass to finish before showers, trading documentation errors for administration errors; the monthly pharmacy audit checks both, and any rise in administration errors stops the plan for review. A focus on error rates might lead staff to hide errors rather than report them; the plan treats self-reported errors as useful information and never counts them against a home's goal. And the shower change may not suit every resident; house managers will adjust times individually where needed.

Integrity

Monthly, I observe one 8 p.m. pass at each home and check whether the binder is on the cart, the lanyard is worn, showers are scheduled after the pass and the graph is current. The plan cannot be judged without knowing whether it is in place.

Timeline

Weeks 1 and 2: procedure revision, cart setup, lanyard and schedule changes. Week 2: first graphs posted. Weeks 2 to 8: weekly feedback and monthly integrity checks. Week 8: review with the director against the goal.

References

Alvero, A. M., Bucklin, B. R., & Austin, J. (2001). An objective review of the effectiveness and essential characteristics of performance feedback in organizational settings (1985-1998). Journal of Organizational Behavior Management, 21(1), 3-29. https://doi.org/10.1300/J075v21n01_02

Carr, J. E., Wilder, D. A., Majdalany, L., Mathisen, D., & Strain, L. A. (2013). An assessment-based solution to a human-service employee performance problem: An initial evaluation of the Performance Diagnostic Checklist-Human Services. Behavior Analysis in Practice, 6(1), 16-32. https://doi.org/10.1007/BF03391789

Parsons, M. B., Rollyson, J. H., & Reid, D. H. (2012). Evidence-based staff training: A guide for practitioners. Behavior Analysis in Practice, 5(2), 2-11. https://doi.org/10.1007/BF03391819