Strategic Client Care Improvement at Berks County Counseling Center

Delivering great care is all about responding to client needs and continually improving the quality of your services. Measuring those client needs and understanding to implement change across your organization isn’t always so simple. To stay compliant and deliver the best service, CCBHCs need purposeful, consistent data collection on client outcomes. They also need the right strategy to use that data to improve processes. So how do you get there?

Berks County Counseling Center in Pennsylvania faced all these challenges in its transition to a new care model. Berks had decided to become an Integrated Care and Wellness Center (ICWC), Pennsylvania’s continuation of the CCBHC care model. ICWCs measure and report on the same Behavioral Health-Led client outcomes as CCBHCs, so demonstrating high performance was essential for compliance and reimbursement.

To succeed as an ICWC, Berks needed to understand their outcome measures at a deep level. Simply reporting numbers wasn’t sufficient. They needed the right tools, processes, and work culture to identify and follow through with positive change. They followed six steps to achieve success in that journey.

Step 1: Build Efficient Workflows

Building efficiency in data capture is a crucial step for any new CCBHC or ICWC. Berks’ first challenge was to design workflows that could consistently capture the outcomes data they needed. To build a foundation for these workflows, Berks carefully documented every step of their existing processes. To eliminate confusion, they minimized changes to familiar processes during their evaluation.

Next, Berks used their evaluation findings to construct more efficient workflows that overcame obstacles and bottlenecks. Many of the new workflows were created with one key goal in mind. They had to be simple and efficient enough to capture data at the point of care. Berks staff studied the relevant outcome measures in detail, returning to them periodically to glean more insights and improve processes.

Step 2: Adopt Consistent Data Collection

Berks replaced free-form text fields with structured form tools like radio buttons, checkboxes, and drop-down descriptors whenever possible in their electronic data capture tools. This change made the data collected much more consistent and accurate. Consistency across all forms also made it easier to pull client information forward from one form to the next, eliminating repetitive data entry. Overall, the improved consistency made reporting on that data simpler and easier.

Technology was just one part of consistent data collection. Staff also had to understand the how and why of structured data capture. For Berks, this meant teaching their teams how to apply workflows to the complicated Behavioral Health-led measures. They brought together clinical and technical staff to ensure that everyone understood the importance of consistent data collection. They emphasized ongoing training for timely data capture, appropriate follow-ups, and plans for continual data collection improvement.

Step 3: Establish Performance Baselines

Early data documentation can save new CCBHCs or ICWCs significant time and energy down the road. They may not have to begin reporting outcomes until a year or two into the transition process, but collecting data, and learning from it, takes time. Berks knew the sooner baselines could be established, the more time they would have to implement improvements to forms and workflows.

Each outcome measure for each provider needed a starting point. With more efficient workflows and consistent data, Berks could start outlining performance baselines for future comparison. They tied each baseline measure to a specific provider. This approach helped Berks set goals for provider performance, offer constructive feedback, and identify where extra consultation or training could be helpful.

Step 4: Pivot to Address Underperforming Outcomes

With consistent data collection and proper baselines, many new CCBHCs and ICWCs see, for the first time, which outcomes are performing well, and which ones need work. Berks were no different. Not all measures were clicking, but this was expected. Once underperforming measures were identified, it was time to pivot and focus on those measures that needed more attention.

Charting data and building dashboards to monitor progress allowed Berks to compare performance to established benchmarks. Management could now work with their providers and identify what processes needed to change to ensure success. They could also update their data collection or training processes to address these gaps in care.

To support this process, Berks established a “measure champion” program. Each provider was assigned to a specific outcome measure and challenged to generate ideas for improvement. This strategy proved immensely successful and led to better performance across multiple measures.

Step 5: Communicate Success

Once Berks improved quality across their services, they looked to communicate that success to leadership, staff, and the market. They used configurable dashboards to bring together all the relevant data needed to demonstrate quality improvement over time to ICWC leadership. Providers can adopt these kinds of tools to tell a story with their data and tailor their messaging to different audiences.

Sharing consistent feedback on the measure outcomes with providers was a critical component of continuous improvement for Berks. Better communication helped bolster the provider’s confidence and buy-in needed for long-term success.

That same data could also demonstrate high performance to payers and the market. With payers, it could lead to more favorable value-based rates and sharing success with the community reflects the quality of CCBHC and ICWC services.

Step 6: Repeat the Cycle for Continuous Improvement

Client needs and outcome measures are constantly evolving. As such, quality improvement is no singular event; it’s an ongoing process. After all, change is the only way for new CCBHCs and ICWCs to push toward becoming efficient, high-performing organizations. Evaluating change for what worked and what didn’t is invaluable. You want to adopt, adapt, or abandon change and the proof is in the data. Did it improve outcomes? If not, a different process might be needed. The data will tell the tale.

Berks uses their improved data collection and process to learn about new quality measures, modify their data capture workflows, and drive improvements in care. This process of continual evaluation and growth is the heart of value-based care for successful CCBHCs and ICWCs. Download our Quality Improvement Checklist for more information.

Six Steps to Success

Berks, and other CCBHCs and ICWCs just like them, are held to a higher standard for a reason. These counseling centers are committed to dramatically improving the lives of those in need. The providers and leadership at organizations like Berks have embraced the work it takes to maintain that higher standard. They do that work, not just because it’s required of CCBHCs and ICWCs, but because it’s also the key to making a positive impact on people’s lives.