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Posted: Jan 30, 2008 11:08


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By Jim Powell, PhD and Bill Valentine, PsyD, CC

In our last essay we discussed the current intense scrutiny under which our industry finds itself and proposed that this time of seeming adversity is really "a time of tremendous opportunity for parent-choice, private therapeutic programs." Key to seizing this opportunity, in our opinion, is careful selection, training and on-going mentoring of all staff. In addition, we feel that "implementing a thorough Risk Management Program (RMP) that is comprehensive in its scope" is a tool that can, and should, be put in place and monitored continually.

It seems like everyone these days is talking Risk Management. And certainly Risk Management is central to all reputable programs. However, a "thorough and comprehensive" quality RMP can provide much more than simply managing risk. Documentation of due diligence and good faith efforts has the potential to not only reduce risk but to also:

  • limit potential exposure

  • support regulatory compliance

  • identify trends and patterns

  • inform programmatic decisions

  • provide pro-active feedback on program effectiveness

  • inform financial and other resource allocation

  • improve student outcomes and satisfaction

  • increase parent participation and satisfaction

  • improve customer service with referring professionals

  • decrease insurance rates

  • improve staff morale

While we agree that all business has risks, our industry has some in particular that make an RMP so vital. We know the basic areas - compliance and regulatory mandates, medication management, staffing and supervision ratios, human resource and labor laws, exposure to the elements and occupational safety and hazard regulations to name a few. But, what about some of the more unique, challenging and often subtle risks? Contractual conflicts with our customers, custody and family dynamic issues, privacy and personal rights, interstate transporting of minors, use of paraprofessionals and the clinical complexities of the populations we serve also require our attention.

So where to start? First, take a look at the pieces already in place. What kind of information do you currently track? Is the information recorded in a way that is simple, clear and easy to understand? Does the tracking system allow you to easily see trends and patterns? Is there a way to compile the information so that you can review multiple indicators in one sitting? Is information recorded in real time so that it may be acted upon proactively?

Some of the basic information to track might be: accidents, incidents, physical holds, runaways, enrollments, departures, program completions. What is the average length of stay? Is it in line with your recommended program duration? What is your retention rate? What days do you have the most runaways? What activities bring the most accidents? Could you evacuate your entire program for an extended period of time and still provide quality care? Just tracking this basic data can provide you with a wealth of feedback for your school or program.

What about the more subtle information you can glean from the data? Here are other questions for consideration:

  • Is it a coincidence that referral source X's clients don't seem to complete your program? Does he/she not understand your student profile or do you not have a comprehensive enough screening criteria and process?

  • Why do divorced parents tend to have the lowest satisfaction rate? Does your parent communicator get frustrated hearing them constantly bad mouth each other and sub-consciously give them less attention and service?

  • How come most employees call out sick on Wednesdays?

  • How many movies are shown in the classroom per semester?

  • How is contraband getting on campus?

You might be surprised at the answers. Anything can be tracked. Each one is like a page in a book - providing a piece of the story and a glimpse into the subtle unspoken messages your program may be expressing. Objective evaluation of the data will allow you to make more informed decisions about your staff, your participants and your program.

We believe that implementing an RMP should be a top priority for all schools and programs. It should evolve and expand over time, being open and flexible to accommodate your school or program's growth and development. It should be as prevalent in your day to day operations as anything else you do. It should be articulated and understood with the same clarity and importance by staff at all levels of your organization.

It sounds clichéd, but the easiest way to implement your RMP initiatives is to take them one at a time and manage them consistently and relentlessly until everyone forgets there was ever another way to do things. Find the person on your team who is the critical thinker, the most detail oriented or the pit bull, and give them permission to remind you everyday (without retribution) of the initiatives and timelines to which you are committed. Like any good habit, it takes practice and a commitment. Before you know it, you will have an RMP in place that is thorough and comprehensive in its scope. And with it safety and success will follow - for you, and your clients.

About the Authors:
Dr. Jim Powell is Co-Founder of Powell & Elliott Collaborative, LLC, Lake Arrowhead, CA, 951-317-3151,

Dr. Bill Valentine is Co-Founder of Next Step For Success, a parent and family coaching service, Redmond, OR 541-504-4748,,

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