BA450 Unit 9 OBM Intervention Evaluation Paper Example

Four Homes, Four Start Dates: A BA450 Unit 9 Intervention Evaluation Paper

[Student Name]

Purdue University Global

BA450: Organizational Behavior Management

Unit 9 Intervention Evaluation Paper

[Instructor Name]

[Date]

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

From Plan to Evaluation

Our agency's performance improvement plan for medication documentation errors combined clearer instructions, a binder kept open on the medication cart, a "medications in progress" lanyard, rescheduled showers and weekly graphed feedback. The agency director wanted to know whether the plan worked before extending it to our day program. Before-and-after data at one home would not answer that question convincingly, because errors might fall for other reasons, such as a new pharmacy audit or a seasonal change in staffing.

The Design

I could set up only one home at a time, so the plan began two weeks apart at each of the four homes. That practical constraint created a multiple baseline design across settings. Cooper et al. (2020) describe this design as one in which the same intervention is introduced to different settings, people or behaviors at different times, while baseline continues in the others. If performance changes in each setting when, and only when, the intervention is introduced there, the change can be attributed to the intervention with reasonable confidence.

Baseline lasted four weeks at the first home, six at the second, eight at the third and ten at the fourth. House managers counted errors per 100 administrations each week from the medication records, and I checked their counts against the pharmacy's monthly audit.

Results

At the first home, errors averaged 8.0 per 100 in baseline and fell to 2.1 within three weeks of the plan starting, then to an average of 1.3. At the second home, baseline averaged 6.5 and stayed level while the first home improved, then fell to 1.6 after the plan started. The third home's baseline averaged 5.2, stable for eight weeks, and fell to 1.1 after its start. The fourth home showed a slight downward drift during its long baseline, from about 5.0 to 4.2, and fell to 1.4 after the plan began.

Each home's line stayed flat until the plan reached it, and then it fell.

Visual Analysis

Cooper et al. (2020) describe visual analysis of level, trend and variability within and across phases. The level changed sharply at each home after the plan began, with no overlap between baseline and intervention weeks at three homes and one overlapping week at the fourth. Baseline trends were flat at three homes. The fourth home's slight downward drift may reflect staff hearing about the plan from colleagues, a form of diffusion that multiple baseline designs can suffer when settings share staff. Even there, the drop after the plan began was much larger than the drift.

Checking the Measure

Weak data would undo the whole evaluation. House managers counted errors from the records, and they also had an interest in seeing their homes improve. To check their counts, I independently counted errors for one randomly chosen week per month at each home. My counts matched theirs within one error in most weeks. In two weeks at the second home, the house manager had counted initials written slightly outside the box as correct, which the pharmacy counted as errors. We agreed on the pharmacy's rule and recounted her earlier weeks, which raised her baseline slightly but did not change the pattern. The monthly pharmacy audits, completed by a pharmacist with no stake in the plan, showed the same decline at each home in the month after the plan began.

Decision Rules in Practice

The plan's decision rules were written in advance, and the evaluation tested them. No home needed a repeat diagnostic observation, since each fell by more than half within four weeks. The first and third homes met their goals for four consecutive weeks and moved to feedback every two weeks; their rates stayed low afterward, which gave an early sign that thinning feedback did not undo the effect.

Integrity

Integrity observations during the 8 p.m. pass showed that most components were in place most of the time. The binder was on the cart and graphs were current in every check. The lanyard was worn in about three of four checks; staff reported forgetting it when covering a shift unexpectedly. Showers were rescheduled at three homes and partly at the fourth, where one resident's evening routine could not change. Error rates were lowest at the home with the highest integrity, which supports the plan's role.

Cost and Acceptability

The plan cost little: laminated cards, lanyards and about two hours a week of house managers' time for graphs and feedback. A short staff survey at the end found that most staff rated the plan as helpful and fair. The most valued component was the lanyard, which staff said reduced interruptions from coworkers; the least valued was the thank-you notes, which some found awkward. House managers rated the weekly graph as easy to maintain.

What the Evaluation Cannot Show

Because the plan's components were introduced together, the design shows that the package worked but not which component mattered most. A component analysis would require introducing parts separately, which the director judged not worth the risk to residents while errors were high. The evaluation also covers sixteen weeks; whether the effect lasts is a separate question.

The Wider Literature

In the review by Gravina et al. (2018), many interventions in human service settings improved staff performance, often as packages combining antecedents, feedback and consequences, as ours did. They also observed that maintenance and long-term follow-up were less often reported. Langeland et al. (1998) showed the value of years of performance data in a community mental health setting, where tracking and feedback settled into everyday management. Our plan's next step follows their example: the weekly error graph will continue at every home, reviewed quarterly.

Recommendation

Based on the evaluation, I recommended extending the plan to the agency's day program, again with staggered starts if possible, and continuing weekly graphs at all homes with quarterly review. The director approved both.

Conclusion

A multiple baseline design across four homes, made possible by staggered start dates, showed that medication documentation errors fell at each home only when the plan began. Visual analysis as described by Cooper and colleagues supported a clear effect, integrity data linked the effect to the plan, and staff rated it acceptable. The maintenance plan draws on Gravina and colleagues' review and on the long-term data of Langeland and colleagues.

References

Cooper, J. O., Heron, T. E., & Heward, W. L. (2020). Applied behavior analysis (3rd ed.). Pearson.

Gravina, N., Villacorta, J., Albert, K., Clark, R., Curry, S., & Wilder, D. (2018). A literature review of organizational behavior management interventions in human service settings from 1990 to 2016. Journal of Organizational Behavior Management, 38(2-3), 191-224. https://doi.org/10.1080/01608061.2018.1454872

Langeland, K. L., Johnson, C. M., & Mawhinney, T. C. (1998). Improving staff performance in a community mental health setting: Job analysis, training, goal setting, feedback, and years of data. Journal of Organizational Behavior Management, 18(1), 21-43. https://doi.org/10.1300/J075v18n01_03