Aug 1 / Jamie Turner, MBA, PMP, BCBA

Employee Preferences, Incentives & Retention With OBM

I used to be confused by what makes people want to do certain things at work. Why do some people jump in to help solve problems, put in extra effort to help clients, but others put in the bare minimum to remain employed? The answer is tied to what causes each colleague to behave the way they do. These causes are unique to each colleague, much like the population of clients we serve. Research shows money usually isn’t the best reinforcer.

We first need to understand what is reinforcing to a colleague (BCBA, Technician, etc.). This article on Organizational Behavior Management (OBM) Reinforcement can help. Remember, what’s reinforcing is different to each person. Money is impersonal. Research shows salary increases don’t result in incremental increases in effort or productive behavior in the workplace. Yes, people need enough money to pay bills, but after meeting basic living expenses, money isn’t a strong motivator. Bonuses are likely more reinforcing than incremental salary increases; off cycle payrolls can be used to isolate and create a more salient provision of money as a potential reinforcer in the case of bonuses. A separate amount increases the chances someone contacts reinforcement rather than not noticing a bonus bundled in with their regular pay. 

Other incentives like gift cards are likely to be more effective. Understanding someone’s reinforcers and managing incentives and other things according to what is reinforcing to them will ultimately result in better retention.

Preference Assessments

Conducting OBM Preference Assessments for staff members helps us to determine a list of possible reinforcers. There are limited assessments available in the research, but rankings, surveys and multiple stimulus without replacement (MSWO) assessments have all been used successfully. Of these, surveys are often the least reliable since people will often report money as preferred although money has been proven time and again not to serve as the most effective reinforcer for most incentives.

Rankings

These are simple; ask staff to stack rank their most preferred rewards. The top 2-3 items for each person have the highest likelihood of being reinforcers.

Surveys

Ratings of 3 and higher on a 5-point scale have the highest likelihood of being reinforcers. Surveys are also a good way to collect additional potential reinforcers you might not have thought of yet. Provide some choices in a survey and allow people to suggest other items.

MSWO

Much like conducting a preference assessment for a client, offering up a number of rewards for people to choose from; once an item is gone, it’s not available again. The most popular items have a higher likelihood of acting as reinforcers. This is the most time consuming option.
Try a combination of different preference assessments to gather preferred items. Then try them out in incentives to see which items are reinforcers for which people.

Contacting Reinforcement

How quickly someone contacts reinforcement is also important. Annual raises don’t work well as incentives since they only happen once per year. If you are doing time based annual raises for hourly staff, it’s important to annualize the hourly increase ($3,000 per year estimated when it’s $1.50 per hour). Daily incentives are often too cumbersome to manage. Weekly incentives are the sweet spot. For anyone familiar with Aubrey Daniels’ PIC/NIC Analysis, this won’t be a surprise. The closer someone contacts reinforcement following behavior, the higher the likelihood of the behavior occurring again in the future. Stay tuned to a blog coming up about Performance Management Systems.

Designing incentives can be a fun and engaging way to drive organizational performance. At Acclaim Autism, they design regular incentives to drive performance around certain metrics. Here’s one example of a well-designed incentive to increase session note completeness, accuracy and timeliness:
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  • To opt-in to the incentive which goes for 4 weeks, each person completes a survey with their most preferred reward. This is their way of ‘opting in’, and also gives data around preferred rewards.

  • Each week, each person with the highest % of session note accuracy AND same-day session verifications wins.

  • For example: if a BCBA/RBT works two sessions in a week, completes the session notes accurately, and collects signatures the same day, they would have 100% for the week.

  • Another example: If a BCBA/RBT has four sessions in the week, completes four session notes accurately but only three sessions have same-day signatures, they would have 75% for the week.

  • Last example: If a BCBA/RBT has four sessions in the week, only three session notes completed properly, but collects all signatures to verify the same day, they would have 75% for the week.
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The weekly incentive allows people to contact reinforcement close enough to the desired behavior for the reinforcer to be effective. Even if someone doesn’t have the highest percentage, they can still contact reinforcement by seeing their name on a list of high scores, a supervisor giving feedback, or other ways. This particular incentive is a bit labor-intensive to review session notes. However this can be done by a technician accruing supervision hours, an admin staff, or even AI if it’s HIPAA-compliant. 

Another option is lotteries. I.e. ‘everyone who completes all session notes on time this week will be put in a draw to win a $100 gift card of their choice!’. Research shows people need at least a 12% chance of winning to be effective, ideally 25-50%. Of course, the bigger the potential prize, the lower the chances of winning can be. Workplace incentives aren’t a national lottery with incredibly low odds of winning. However, bigger prizes will be more of a motivator. 

When designing incentives, keep in mind the outcomes they drive. This can be outcomes for clients, the organization, or ideally both. Make sure to select objective measurable outcomes rather than subjective ones to avoid a perception of unfairness. Outcomes can be measured across different levels or metrics:
  • Did employees gain new skills? Use a checklist to make this objective.

  • Did the improved skill impact the client in a meaningful way? Client progress is data you should already have to reference. 

  • What’s the impact on the organization? Liking or enjoying the new skill is subjective and might not be related to how effective or meaningful it is. Again, refer to objective data. If you have a client who cancels 20% of the time, and someone uses their new skills to deliver feedback to the family, and cancellations drop to 5%, that’s meaningful progress for both the client and the organization.

Monitoring & Retention

Preferences change, even within a month you could see a different preference for the same person. Observe consumption/engagement and conduct a new preference assessment if needed. Doing a preference assessment during an initial meeting with a new employee, and regularly thereafter (when preferences change or reinforcement is less effective than before). Gift cards of their choice, PTO, and other fun things like a dedicated parking spot at the clinic for a month can all work well for different people.

By collecting and listening to employee preferences, we can better align incentives with potential reinforcers. Using objective data helps align the fairness and objectivity of these systems, which is a driver of employee satisfaction and retention. Most people want to be heard, and collecting preferences is just one way to give staff a voice. Engaged employees feel heard, and that’s another key driver of retention. With ABA organizations having such high turnover rates, we should do everything we can to keep staff engaged and happy.

ABA practice owners can reach out for support any time. We don’t do paid consulting, and are simply happy to have conversations with like-minded BCBAs trying to improve the field.  OBM@acclaimtraining.com

Jamie Turner

MBA, PMP, BCBA