Greetings Nick Szubiak, MSW, LCSW Integrated Health Consultant National Council for Behavioral Health nicks@thenationalcouncil.org LinkedIn Twitter: @nszubiak 202.621.1625

SBIRT Supervisor Retreat Agenda SBIRT Supervisor Retreat   I Introduction: Safe Space II If you could take one skill, tool, intervention, etc.?? – and bring it back to your department ….What would it be? III Build our Agenda How can we improve outcomes? What is the data teaching us? What tools do you need to motivate your staff? Brainstorm: Why are we seeing this data? IV Supervisory skills to be effective (SBIRT) V Action Plan (Plan Do Study Act)

Supervisors Retreat

II What do you want? Need? If you could take one skill, tool, intervention, etc.?? – and bring it back to your department ….What would it be?

III Build our Agenda How can we improve outcomes? What is the data teaching us? What tools do you need to motivate your staff? Why are we seeing this data?

Organizational Change SBIRT pilot interventions proven successful Practice culture ready to SBIRT to scale SBIRT adoption as a routine part of care across all of the appropriate clinical areas Organizational infrastructure and capacity built to sustain SBIRT practice

What We Know About Practice Adoption and Sustainability Culture ready and willing Leadership supportive Workflow drives practice integration Training and re-training essential Data driven monitoring critical early and ongoing Clinical decision support and reminder systems through EHR key facilitator Guidelines or Protocols documenting procedures for all aspects of practice mandatory

What are Practice Guidelines and Operating Protocols? Based on scientific evidence about SBIRT intervention – TIP, other research studies Systematically developed into organizational policy that guides clinical decision making Allows for measurement of the impact of care through written definition of intervention Reduces variation in practice through effort to define standardization of interventions

What are Practice Guidelines and Operating Protocols? Operating Policies and Procedures: Provide standardization for essential operational activities within the clinical practice Provide clarity on how to execute activities that are important to practice and necessary for regulatory, reimbursement or other accountability factors Define roles and responsibilities of team members Help assure execution of key activities when daily practice burden may hinder implementation Transcends transitions in leadership and staff – written and approved regardless of changes Nd

Key Areas for Guideline and Protocol Development Clinical guideline on SBIRT implementation Referral to treatment Quality improvement EHR Implementation On boarding of new staff Competency-based evaluation

Group Discussion Do you currently have written protocols for SBIRT Implementation? How are you communicating those protocols or guidelines for staff? Are there things you would like change about your current protocol?

IV Supervisory skills to be effective (SBIRT)

Culture Change

SUPERVISORS CONTENT UNDERSTANDING COMMUNICATION OF WORKFLOWS TEACHING NEW SKILLS LEADING YOUR TEAM

What Matters Most? Pay or Benefits Commitment to the mission Relationship between employees and direct supervisors What does a good relationship between employees and direct supervisors like? – Nick asks, Jake scribes

What Workforce Wants: Fabulous Rock Star Bosses Reasonable compensation Ability to do excellent work Professional and personal balance Healthy relationships Chance to grow Sense of meaning Fabulous Rock Star Bosses

You are the Catalyst “Walk the Walk” as a way to “Teach the Talk” Power of Influence Visibility Teaching Opportunity

It’s a Process NOT a Program Slow/Ongoing – Build Structure Change is all about managing the changes 1. If you read my email 2. As I said in the staff meeting When we discussed the pt If you saw the memo in your box I posted this on the bulletin board Presented in the training When we discussed this in our huddle In supervision Really???? 8 Times?? Really???? Behaviors and Practices are Teaching Moments

Clear & High Expectations Expect quality Define it Talk about it Recognize and praise it Encourage it Build it from strengths Assume people want to grow, even if they don’t exactly know how. Expect lots of mistakes and learn from them. What gets in the way of clear and high expectations? JAKE BEEF UP NICK: 99% of people want to do a good job. Fall into negativity trap. CHECK YOUR NARRATIVE/FUNDAMENTAL ATTRIBUTION ERROR: Be aware of judgments of what we think employees’ motivations are. Don’t let you interpretations get out of control. Gracious with clients, not so much with colleagues. Caveat: DOESN’T MEAN YOU DON’T HOLD PEOPLE ACCOUNTABLE Most people want to be successful and valued at work and they want opportunities at work to grow and develop. In fact, research shows that the most successful organizations embrace a high quality culture and actively encourage people to stretch, learn, grow, and develop on an ongoing basis. The best organizations don’t expect perfection; in fact, they accept massive mistakes if those efforts were in the spirit of ever increasing quality and improvement. Yet they encourage, reward, and celebrate excellence.

Plan Do Study Act http://www.integration.samhsa.gov/pbhci-learning-community/PDSA_Worksheet.pdf 11/29/2018

Take One Thing and Do It!

Thank YOU! Nick Szubiak, MSW, LCSW Integrated Health Consultant National Council for Behavioral Health nicks@thenationalcouncil.org LinkedIn Twitter: @nszubiak 202.621.1625