Recipient of the Outstanding Applied OBM Intervention Award - Implementing a Performance Scorecard

Sep 20, 2026

The document describes an OBM initiative by Kaleidoscope Interventions to improve outpatient session note writing using Applied Behavior Analysis principles. The Executive Team targeted two measures: timely completion and session note quality, because delays reduced revenue and affected billing accuracy and insurance documentation. Baseline completion averaged 68.8%, and notes written more than 24 hours after sessions were less accurate. A performance scorecard added contingent incentives and feedback, linked to bi-weekly bonuses, with structured weekly data review by directors and BCBA feedback to RBT staff, producing immediate increases and sustained outcomes.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages3

Reading Time8 min

AccessFree to download

Objective behavior(s) and/or result(s) pinpointed for improvement

Performance analysis

OBM solution

Performance scorecard process

Results

Sustained results

Recipient of the Outstanding Applied OBM Intervention Award Implementing a Performance Scorecard Pamela Furr-Holz, Chana Gehrman, Craig Devincenzo, Shannon Biagi; Kaleidoscope Interventions Describe OBM business opportunity: Kaleidoscope Interventions oﬀers outpatient clinical services using the principles of Applied Behavior Analysis to children that exhibit s kill deﬁcits and behavioral challenges. Our employees consist mainly of Clinical Aides, Registered Behavior Technicians, and Board-Certiﬁed Behavior Analysts. As with many medical service companies, session note writing (or charting) is a fundamental aspect of the job of the service provider. Session note writing is vital as it is directly associated with payment for services and overall revenue for the company. It is also important to highlight that session note writing is time-consuming, occurs after the (often diﬃcult) session, and salary is rarely directly related to its completion. For these reasons, it is not surprising that session note writing is often either not completed, not completed within an appropriate amount of time since the services were rendered, or not completed with high quality. As Kaleidoscope Interventions began taking on more clients and staﬀ, timely session note completion became an issue of concern. This would directly aﬀect company revenue as sessions without session notes, quality session notes, or timely session notes were not billed for. Kaleidoscope’s goal was to have all session notes written with high-quality. Session notes are used for insurance billing purposes as well as a means for parents to stay updated with their child’s programming and behavior during session. Parents have access to their child’s session note via an online portal. Objective behavior(s) and/or result(s) pinpointed for improvement: The Executive Team ﬁ rst pinpointed session note completion, followed by session note quality. It was rather easy to pinpoint this issue as the data on session note completion is easily pulled through an online database visible to all Kaleidoscope employees. Session note data completion rates from the previous week were pulled by the Clinical Director every following Monday. Prior to the implementation of our OBM solution, session note completion rates were 68.8% on average. Completion of timely session notes aligned with the overall business goals because it directly impacted revenue as well as accurateness of the session note. If a session note is written more than 24 hours after the rendering of the session, it is likely that what is described in the session note is not as accurate. Performance analysis: Kaleidoscope Intervention’s OBM Specialist conducted a Performance Diagnostic Checklist-Human Services (Carr, Wilder, Majdalany, Mathisen, and Strain, 2013) to better understand the possible function of the behaviors associated with not completing session notes. The PDC-HS consistently indicated a lack of consequences as a possible function/opportunity for intervention. Contingent incentives and feedback were the most commonly suggested solutions across all PDC-HS assessments. The team recruited the assistance of another OBM professional, Shannon Biagi from Chief Motivating Oﬃcers, to assist our team with the development of the performance scorecard. OBM solution: The team worked together to create a performance scorecard to provide incentives and feedback to the staﬀ. The performance scorecard was directly tied to Recipient of the Outstanding Applied OBM Intervention Award bi-weekly bonuses up to $100 . The performance scorecard consisted of three behavioral measures including timely session note completion. The performance scorecard process included the following: ● The facility Director pulled a session note report every Monday (or ﬁ rst day of the week) for data on session note completion for the prior week ● Session note data were analyzed and supervisors ( BCBA’s) were notiﬁed if incomplete session notes

FAQs

What business problem did Kaleidoscope Interventions address with the OBM intervention?

The intervention targeted incomplete, late, or low-quality session notes, which directly affected insurance billing revenue and the accuracy of documented services.

How was performance measured before and after the scorecard implementation?

Baseline session note completion averaged 68.8%. The scorecard tracked timely completion (with notes completed by 8am the next day) and later added a session note quality requirement to ensure quality, not just speed.

How did the performance scorecard provide incentives and feedback to staff?

Weekly session note reports were reviewed by the facility director, supervisors received and gave feedback regarding incomplete notes, and staff earned bi-weekly bonuses up to $100 when performance goals were met.

Sep 20, 2026

Uploaded by Olivia Brown