Improving the record-keeping performance of direct service personnel

Record review procedures and contingent performance feedback were used to monitor and improve the record-keeping performance of human service staff in a behavioral residential treatment setting. A multiple baseline design was employed across three groups of B.A.-level human service personnel. The study consisted of five conditions: (1) Baseline 1; (2) Written Instructions (memoranda); (3) Written Performance Feedback; (4) Verbal Performance Feedback; and (5) Baseline 2 (return to the Baseline 1 condition). Dependent measures included highly reliable ratings by independent observers of the (1) essential documents present in case records, (2) documents approximately located/organized in case records, and (3) an overall rating of documents present, correctly organized, signed and dated, and not duplicated in the records. Results indicated that the procedures most frequently used to provide feedback to human services personnel--meetings, policy and procedure manuals, and/or written memoranda--were not as effective as verbal feedback sessions in prompting staff participation in case record maintenance. Findings were interpreted to suggest that, with adequate training, supervision, and performance appraisal, direct service personnel in residential treatment settings can effectively manage clients' case records and become more involved in, and committed to, accountability and quality control.