Transcript – Episode 413: An Interview with Maureen Werrbach on the Accountability Equation Part 1 of 2

 

Evan Dumas

You’re listening to Group Practice Tech, a podcast by Person Centered Tech, where we help mental health group practice owners ethically and effectively leverage tech to improve their practices. I’m your co host Evan Dumas.

 

Liath Dalton 

And I’m Liath Dalton and we are Person Centered Tech.

 

Liath Dalton 

This episode is brought to you by Therapy Notes. Therapy Notes is a robust online practice management and electronic health record system to support you in growing your thriving practice. Therapy Notes is a complete practice management system with all the functionality you need to manage client records. Meet with clients remotely, create rich documentation, schedule appointments, and bill insurance all right at your fingertips. To get two free months of Therapy Notes as a new Therapy Notes user, go to therapynotes.com and use promo code PCT.

 

Evan Dumas 

Hello, and welcome to Episode 413: An Interview with Maureen Werbach on the Accountability Equation, part 1 of 2.

 

Liath Dalton 

I am so excited today to welcome our friend Maureen Werbach from The Group Practice Exchange to join us and share some of her awesome experience and insights. So welcome, Maureen.

 

Maureen Werrbach 

Thanks for having me.

 

Liath Dalton 

We have enjoyed kind of collaborating and cross pollinating for many years now. And actually, some of our first interactions were what precipitated PCT creating dedicated group practice resources and support. So all of you get to have that little peek into our like origin story there. And one of the things that Maureen has been working on recently and launching in into the world to all group practice leaders benefit is the Accountability Equation. So that’s what some of the questions that are going to start us off are focused on, but really want to encourage all of you who are here to chime in and ask your specific questions and make use of of having the resource that Maureen is at your at your disposal here. So without any further ado, let’s get started. Yeah.

 

Evan Dumas 

All right. Question one. What are the areas of need and friction in group practice management that the accountability equation provides a systematized process of solution to?

 

Maureen Werrbach 

Yeah, great, great, like big question to start with. So one of the things that I noticed, not only with my own group practice, because I still have a practice group practice myself. But also in just talking to other group practice owners, which I’m sure Liath, you’ve also had this experience with just hearing the pain points

 

Liath Dalton 

Mhmm.

 

Maureen Werrbach 

for group practices, a big one came around like staff management and expectations, and holding accountability, and being able to coach our clinical and administrative teams to like being successful in their roles. And so that’s like the crux of the accountability equation is that it walks practice owners and leaders through a journey that helps them ultimately have accountabilities that people are a part of creating and agree to, so that they’re more likely to actually hold those accountabilities. That’s like the easy fast answer to it. My longer winded, I guess, one is that it goes through a cycle that I call the five A’s of accountability. And each of those A’s has a purpose to sort of helping a practice owners and leaders get to a point where they feel like their practice is running really smoothly and everyone knows what their role is and what they’re accountable for accountable for, and have like a short shared vision and moving the business in the direction that it needs to go.

 

Liath Dalton 

I love that so much. And in kind of connecting with all of the great information that you’ve put together around what the accountability equation consists of. One of the things that resonated most for me was your focus on it being an ongoing process of engagement, and that the key to making it successful is taking it from just being kind of aspirational goals and vision, but actually the action and implementation component of it. And that’s where I think, you know, when there’s so many different frameworks and solutions coming up, folks, it can be really easy to just get caught up in the first part of things and not translate that, not have the bandwidth or the toolbox necessarily, to be able to implement that in practice. So I’d love if you could share a little with us about how your process is so focused on the actual implementation and action. Yeah,

 

Maureen Werrbach 

so you bring up a good point. That is one of the reasons that I created this was there are accountability systems out there that are great. At the thing that I there, there are a bunch of things that I felt like were just missing from the equation. So one of those being once you figure out what people are accountable for there, there isn’t much information on how to ensure that that like, what are the consequences to not being accountable? What do you do, when a leader or a clinician or someone in administration, they know what they’re supposed to do and what they’re accountable for, but it’s, it’s just not happening? And months go by with conversations and frustration might happen, either with the business owner or even with the employee feeling like they’re just not getting to the place that the that the group practice owner wants them to be at.

 

Maureen Werrbach 

And so one of the big components of it is, of the accountability equation, outside of just helping you come up with what things people need to be accountable for, is like a coaching process that helps you as a leader, but also, you know, if you have people on your leadership team learn how to be effective coaches. You know, one of the things I see a lot that happens is, you know, these check ins of like, “Hey, just letting you know, I noticed you’re short on hours, or your caseload isn’t where it should be.” And it’s just like these little conversations with not a lot of movement, and there’s not a consistent kind of conversation happening. And then there’s like a certain point where the practice owner gets resentful, and then they might go quick to putting a Performance Improvement Plan in place, almost as like a security measure for them, because they’re already done and just want to terminate.

 

Liath Dalton 

Mmm.

 

Maureen Werrbach 

And the accountability equation kind of comes up with this really big middle place of coaching. Because I really believe that it’s on us to set our employees up for success. And that we should be looking inward if our teams aren’t being successful or able to do what they’re accountable for, like, have we done what we needed to do to like, coach them into success? To be side by side, and like a guide, someone who provides support and tools to help them be successful. Before we get to this point of just, you know, writing a disciplinary document like a PIP and saying,” This is what you’ve done wrong. This is where this is where it needs to be. And this is what’s gonna happen if you don’t,” That’s what I feel like, it’s like the last step that we should be going in, for most instances.

 

Liath Dalton 

Mhmm. Right? It’s like, how do you equip them and support them in being successful, above and beyond just specifying what the need that it’s their responsibility is to fill. How, how are they equipped to do that?

 

Liath Dalton 

And because I can’t help myself, you know, coming from our lens, there are so many parallels to what our keys for success with the HIPAA compliance and risk management process as well, from the you know, it’s a process, not a product. Like it requires active ongoing engagement, and that the leadership has to be continually communicating with the team in order to assess their needs and what they need to be equipped with. So I just love the sort of synchronicity of how those two pieces can fit together in a practices journey.

 

Maureen Werrbach 

Yeah.

 

Liath Dalton 

 Just towards holistic optimization, right?

 

Maureen Werrbach 

Yeah.

 

Maureen Werrbach 

One of the other things that we have, like a big chunk of information on, is like making sure that the right people are in the right seats. Because a lot of times and I’ve done this before as well, is when I first you know elevated someone into a leadership position, I did back when my practice was still under a year old. So this is like 12 years ago. I had three employees at the time, myself, the person who I would elevate to a Clinical Director role at this point, and one other therapist, that’s all there was. And obviously, she wasn’t clinical directoring me. And she wasn’t, you know, leading herself. So she really was in this role for this one other person that we had, I obviously knew we were going to grow.

 

Maureen Werrbach 

But I started very early, which is not, I guess, typical to put someone in leadership that quickly, but I just knew I needed that type of support. But the mistake I made, which is oftentimes the mistake a lot of practice owners make, is that they fill a clinician, they put a clinician into a leadership role, because they were great at being a clinician, and they assume that that’s going to translate over into leadership of clinicians. And that’s not necessarily the case.

 

Maureen Werrbach 

And so the other thing that I have in the accountability equation is a couple of assessments, leadership assessments that I made. One for you, as the leader, to be able to screen if your business is providing you, business owner, with the type of leadership support that you’re needing. And then the second one being a self assessment for leaders, because I find that one of the most important aspects of accountability is self reflection. And so there’s a self reflective leadership assessment that any existing leader or if you’re in the process of interviewing someone for leadership that could be given to them, so that they are almost self screening, their ability to lead versus like, be a middle manager, which I see so often is like, people being put into leadership to help support you as the business owner, but they’re really the middle manager who looks to you to be like, what should they do next, or this is my issue with this employee, should I PIP them, and they’re going to you, versus really stepping into owning the results of their role and pivoting if they need to.

 

Maureen Werrbach 

And I love this part of it. One of the things that I’ve seen with some of the people who’ve gone through the program and done this part was it’s like such a simple tool. But it gave them a lot of clarity around maybe the frustration they were feeling of being like, I just don’t know what the leaders are doing. Like I don’t know if they’re helping, I don’t know, like, why their teams are still not, you know, seeing the caseload, they’re supposed to, or have a lot of late notes, even though I have someone in leadership. And this really helps them understand if it’s an issue with how they’ve coached and trained their leadership, or if they have people like the, you know, in the wrong seats, the wrong people just in the wrong seats.

 

Liath Dalton 

And that kind of segues to the first A in the Accountability Equation, right, of Assemble.

 

Maureen Werrbach 

Yeah.

 

Liath Dalton 

So maybe you can share what those five A’s are.

 

Maureen Werrbach 

Yeah.

 

Maureen Werrbach 

I can also send you like the little graphic of the five A’s. It’s a simple little graphic that you can share with them too after, sometimes I know I do a better job visually than just listening. So I’ll share that with you too, for for your people later. So the five A’s are Assemble, Assess, Assign, Audit, and Action Plan.

 

Maureen Werrbach 

Assembling is essentially creating, or assembling, your business’s roles and functions. And so I think we all know about organizational charts and job titles. This essentially scraps that idea because a job title doesn’t really say much, especially these days. I don’t know, you know, for anyone listening, if they’re practice owners, I know I’ve experienced this, especially in Facebook groups is seeing someone kind of list out like my practice manager is doing this. And then they’ll say like, you know, what, what kind of things is your practice manager do? And then everyone’s response for what their practice manager does, is so different, like what one person calls a practice manager, another person calls an administrative assistant or kind of an admin. And it really makes it hard then for people to truly understand what is my role in this place, not just what’s my job title, and what are the core responsibilities, or I call them functions, of my role.

 

Maureen Werrbach 

So we do away, in Assemble, we do away with just in the regular organizational chart where there’s names inside of everything with titles, and we outline what are the core roles that a group practice has? So I say visionary and integrator. Visionary being the person who has the vision, the ideas. Typically, it’s the business owner, right? Because we’ve created a vision for our practice and brought it to life. The integrator, oftentimes in smaller practices is going to be the business owner too. They’re the ones that are lead all the departments, they know everything that’s happening across the departments, and they’re making sure that the departments are working together well. So like the admin, and the clinical department, and the HR department, that they all understand where where each other is at and can kind of support each other. So that’s essentially Assemble.

 

Maureen Werrbach 

We then go to Assess, which is literally those assessments I was telling you about. It’s knowing if the right people on your leadership team are in the right seats. So assessing who’s currently on your leadership team and making sure that they still make sense. I forget who the quote is from, it’s an older quote. But essentially, and I love this quote, it really helped me out in a time where I was discouraged about where my leadership team was at at one point. Because I’m, I think I have like, 60 Something employees now, and it’s evolved over the years. And I remember feeling disappointed in like, our, my leadership team’s ability to lead my business when we were at, like, 40 or so employees. And there was this quote, again, by someone I can’t remember. But he said, like, the people who helped you get here aren’t always the people who can help get you there. So like, everyone plays a role and might have a purpose in supporting and helping your business get to where it is now. And it’s not always necessarily the case, that they have the skills necessary to be able to support the business at the size that that maybe at 20 people or 30 people or whatever. And that sometimes it means bringing in fresh people who have the skills needed for a larger organization. So that’s what Assess is, really just making sure did you put the right people in the right seats? Or, you know, did it happen, like how I did a little bit in the beginning, which is putting people who I felt were great at their clinical job into a leadership position thinking that would translate over?

 

Liath Dalton 

And how, how do you when you identify that you have put folks into a position that is not right for them and need to adjust to like course course correct?

 

Maureen Werrbach 

Yeah.

 

Liath Dalton 

What how do you manage that piece of things successfully, and in a way that’s in keeping with the, that’s aligned with the values and like culture of respect, that is so integral?

 

Maureen Werrbach 

Yeah, I feel like this is probably the most difficult thing for practice for anyone who owns a business, essentially. But this is the hang up the most group practice owners get to when I talk about this part, is wrong people in the wrong seats. And immediately, they either have someone that they feel like that sounds like my issue, and then have like this fear of, but I don’t, I’m scared to rectify it. Because it means having a difficult conversation. It might mean shifting them into another role, or telling them that they’re not a good fit for that leadership position, or whatever. And that’s scary.

 

Liath Dalton 

Mhmm.

 

Maureen Werrbach 

Um, I will say that the assessment, the self assessment that leaders take, is a great tool that almost helps them sometimes self select out, because they realize as they’re answering it, like, ooh, like, I don’t, I don’t feel confident in a lot of these things. But also the role and function matrix, which is essentially that the spreadsheet that we make that shows everyone’s roles, in the first category, in Assemble, it very easily shows like, this is the we’re not talking about people anymore. It’s like the only time that I say take the human element out. Because I’m, you know, I never like taking the human element out. But in this instance, if we think about the people we have, we often try to like squeeze them into these, the roles that they might not be best aligned with, because we’re afraid to say like, oh, wait, what you’ve been doing for me isn’t that relevant and this is what I need. And it may be doesn’t align with what their skills are.

 

Maureen Werrbach 

So the roles and functions matrix, that little graph that we build out that says like, this is the important role that we have visionary and integrator, we need someone in charge of sales and marketing, someone in charge of clinical operations, HR operations, admin operations, someone who’s in charge of DEI, someone who’s in charge to the finance department, right? When we get to that, we then list out like, what are the core responsibilities for each of these roles? Like what are the most important things that the person who’s in charge of the administrative back end and front end of your business, like what are their biggest responsibilities? And as you line that out, that, along with the self assessment makes it very hard for existing leaders to who aren’t a good fit to like, convince you that they are. So I like it, because it’s a good tool that sometimes helps open up the conversation in a more kind and curious way, than you noticing it, them not coming, you know, not coming to you to talk about it because maybe they notice it or maybe they don’t because they don’t understand what their role really is. This clarifies it in a way that it makes it really hard for someone who’s not a good fit to just like, dig their heels in and not want to move from, if that makes sense.

 

Liath Dalton 

Absolutely. Yeah. And I went to I imagine that would be the the most kind of difficult component of things in in practice, especially for this group and type of business owner, right. But having something that’s a tool that can be utilized to help make that less, less challenging is a really wonderful resource. You touched on on one thing that I would love to hear more about, which is the anti-oppression and equity and inclusion component of this, because that’s so vital. And like you said, in other accountability systems is so often left out and just missing.

 

Maureen Werrbach 

Yeah. So I want to start by saying that I am not, that my expertise isn’t in coaching on anti oppression. But I myself, my one of my biggest values, or biggest things that’s important to me personally, and in my business, and is one of our core tenants of my business is being a collective liberation, anti-oppressive practice. And so I have my own anti-racism coach, our practice and our leaders have them, that I pay for. And so it’s a big part of everything we do, which is why when I wrote this book, a lot of the leadership and accountability books that are out there are written, you know, for the white man, and don’t have any real acknowledgement of how, like marginalized folks, whether it’s people of different neurotypes, race, gender, ability, etc. Like how accountability can oftentimes be steeped in oppression. And what we think is accountability is really a bias, or setting up unrealistic standards for people outside of, you know, the marginalized communities.

 

Maureen Werrbach 

So when I wrote this, I talk a lot, I weave into a lot of the conversation of like, how when we are thinking about interviewing for leadership, like how are we making sure that we’re not screening from a place of, you know, oppression, where we’re looking for people who are similar to us, whether it’s front of mind or back of mind, making sure that like questions that we’re asking, that we’re incorporating accommodations, like for an example, for people of different neurotypes, a lot of what’s expected of leadership can really, in the traditional sense, go against the natural inclination of someone who is is neurodiverse. And as myself, I’m autistic and ADHD. So I, as a leader, understand that like what might typically be, you know, traditionally viewed as, like a great leader oftentimes isn’t going to be in alignment with someone who’s neurodivergent, etc. And so I just talked about how can we look at, when we’re screening for leadership, that we’re doing it in a way that acknowledges any systemic oppression that just our industry has, that the US workforce has? Looking at when we’re trying to hold someone accountable are we ensuring that we’re creating psychological safety for all the communities within our organization? Are we providing the option for accommodation so that they can be successful? When we’re thinking of Performance Improvement Plans, this is a big area where you can see a lot of oppressive kind of structures in place, like how are we training our leaders to screen for accountability in a way that takes takes oppression or anti-oppression into consideration? I write a lot about this and also acknowledge like that is the literal work that I’m doing myself as a white woman.

 

Liath Dalton 

Right.

 

Maureen Werrbach 

But an important piece.

 

Liath Dalton 

Absolutely. I want to pause for a sec and check in on questions from our live attendees to make sure that questions as they’re arriving can can be asked and and addressed. So those of you who are on if you if the conversation so far has prompted  any questions, please let us know and we will focus on those. Otherwise Maureen and I will just keep geeking out until it prompts the prompts a particular question. Let’s actually go ahead then with the remaining A’s in it, and kind of what each consists of, because maybe that will help spark something in particular.

 

Maureen Werrbach 

Sure. So I mentioned Assemble, which is really just assembling what are the core roles in your business? What are their main responsibilities? And then we go into Assess, which is just assessing that the existing people on your teams, are the right people in there in the right seats, then also prepares you for when you bring on new leaders, that you’re more proactive.

 

Maureen Werrbach 

The third A is Assign. And this is what I call like the meat and potatoes of the Accountability Equation, which is you’re assigning clear accountabilities and coaching your team to success. So we essentially help create like a tracker, in a spreadsheet or whatnot, where you’re taking every person’s role and what their responsibilities are, from the first day and creating what their accountabilities are. And we have some core ones that every group practice will pretty much have. And then there’s going to be additional ones based off of some of the uniqueness that every one of our group practices has. But like as an example, the administrative lead, the person in charge of the administrative department, who’s accountable for the administrative department will likely have some kind of accountability related to inquiry conversions, right? How many inquiries come into the practice? What percentage is being converted to clients? That’s an accountability that needs a measurable goal so that your practice isn’t like bleeding out a ton of potential clients that are never getting scheduled.

 

Maureen Werrbach 

Another example for like a clinical like the clinical operations person, the one who, you know, has that full accountability for the clinical department. In my practice, it’s the Clinical Director. A couple of the accountabilities are going to be related to the note timeliness and quality of the clinicians. Might be around the session count, right. Most of us have like an expectation if we have, let’s say, part time or full time clients. In my practice, I’m salaried. So we do it by the year, but our clinicians need to see 1200 clients, hourly clients, in the year. She’s accountable, our Clinical Director, to ensuring that each of the clinicians on the team are meeting that. So that’s an accountability for the clinical. I have a onboarding and recruiting person, Fariha, she’s the clinician who’s in charge of recruiting new clinicians. I know you know her because she sends you the email notifications whenever a new therapist in my practice needs to take one of your –

 

Liath Dalton 

Right.

 

Maureen Werrbach 

the HIPAA and teletherapy training out there online trainings.

 

Maureen Werrbach 

Yeah, so I get a little notification that we we’ve done another one of those I know, you know, Fariha sends that to you. But um, one of her accountabilities is, in that specific role, is around growth, especially when we have open office spaces. So like for last year in 2023, one of her accountabilities, now mind you, for those listening, I am a larger practice, so the numbers might seem bigger, but that she was, her accountability was to hire 12 additional clinicians above what we had at the beginning of the year. So not just 12 clinicians, because what if 13 people leave in the year, you’ve actually lost a clinician and not grown at all. And so if we had 30 clinicians at the beginning of 2023, and we lost five, let’s say, that would mean that she needed to hire 17 people, not just 12, to actually increase by 12. So that’s an accountability she might have.

 

Maureen Werrbach 

So Assign is really bringing your leadership team together, or those that are in charge of some of these departments together to work collaboratively. And this is what I love. It also goes with anti oppression idea of sharing power, is having all the leaders sort of together helping each other come up with each other’s accountabilities, like, Oh, who’s accountable for this thing and working through it together. But you’re essentially building a spreadsheet, where each person has accountabilities with very, I say, this SMART acronym like that they have really clear goals that are measurable, that are time bound goals, that they have to reach so that at the end of the year, they can look at the tracker and be like, we’ve all helped move the business where it needs to go.

 

Liath Dalton 

Yeah.

 

Maureen Werrbach 

So I would say it’s like the most difficult in terms o,f not from a fear based place, which I think in Assess, it’s fear based, like what if I have the wrong person in the wrong seat, that’s gonna be a hard conversation. This is, I hear there’s some difficulties only because it’s hard to think of what things should I be accountable for? What things should the Clinical Director be accountable for? How do I make sure I don’t forget about an accountability? And here’s where I say it’s a living document, it can always be, you know, played with and edited. It’s not something you build once and then just sit there and can’t ever be fixed.

 

Liath Dalton 

Right, absolutely. And I know the the kind of primary intended audience, for lack of a better term for the Accountability Equation is going to be an established group practice. But I know that there are a lot of ways that newly launched or even those in the inception phase who haven’t fully launched yet could incorporate these principles. And this this framework from from the ground up so that it’s scaffolding for them. And we’d love if you could speak a little bit about what it’s like.

 

Maureen Werrbach 

So where I, I know that’s like, in, when I run the this program, I say that being established, or having, you know, at least a handful of clinicians on staff, or one person, at least in leadership, is just going to be the biggest bang for the buck, because we’re literally going to make, have you implementing it.

 

Maureen Werrbach 

But in terms of like learning it, I think, like I, I wish I would have engaged in it. Remember, when I started, within the first year, I only had three people, and I already had one person in a very small leadership role, right? She did one hour a week of supervising the other therapists we had at the time. But all of this, is these things are happening, even if it’s just you, in a group practice, right? Even if it’s just you getting ready to hire your first therapist. Like creating the roles and functions in your business, whether you’re a small practice, who’s a year old, or an established practice that’s 15 years old, or a really large practice. Every group practice has someone who is a visionary has someone who and that’s obviously likely going to be you as a business owner, has someone who is needing to make sure that everyone that works in the business, the clinicians, are doing what needs to be done, might be you, that’s fine. There’s going to be someone in charge of sales and marketing, even if it’s not, even if you’re not thinking about it, it is still you. Like know when I was haphazardly, like putting Instagram posts up, or like walking to local I mean, 13 years ago, when I started, Facebook groups and stuff didn’t exist. And I would literally like walk – now don’t, this isn’t something that’s helpful these days0 – but like walk to local doctors offices and talk to the front desk staff and things. Like, like, I didn’t have, particularly any goals for myself, I would just be like, I should market, let me go call this. But they’re still whether you have a dedicated person in a marketing position or sales, right, which is bringing in new callers, that’s what we consider sales in our industry, is that we get more inquiries. Admin, even if you have someone who’s doing billing, or someone who’s answering the phones, or even if it’s you, there’s still a position, whether it’s being filled by someone or you.

 

Maureen Werrbach 

So I feel like this concept works, whether it is a like one practice owner, no leadership team and to clinicians on staff. All those roles I mentioned still exist. Someone is doing the hiring, it might be you. You’re HR then for the moment, right? You’re the recruiting and onboarding person. All of that. So to your point, yes, I think every practice owner, when they decide to hire their first therapist, it’s already a good time to at least get to know about accountability. Because what I find is, you’ll be in a better position than most of the people that I work with who are well established, there’s no accountabilities, and now we’re setting it up. And as we all know, change is hard for people. So those practice owners, although they have these people in the in the places, they’re now having to have the difficult conversations of, you know, shifting seats or saying, well, this is actually not what I really want you to be accountable for, things like that.

 

Maureen Werrbach 

And if you start from kind of square one as a smaller or newer practice, it just means you have it laid out, all of the main functions, and you can literally show it to every new hire you get and say this is all the for transparency reasons. That’s also why I like this roles and functions list is it shows people in your practice, like what it takes to run the business. Because there’s a lot that goes unseen.

 

Liath Dalton 

Mhmm.

 

Maureen Werrbach 

But it also gives them an opportunity to see like, okay, as your business grows, like I know those positions, you, business owner that are doing all of these, like there’s gonna be a time where maybe you want to let go of one. And if it’s within a skill that an existing therapist or person in your practice has, they’re gonna remember that that’s on your roles and functions list and be able to advocate and say, whenever you are ready, whenever you have the funds, or whatever, like, I have skills in this one arena, which is what Fariha did as our onboarding, onboarding and recruiting lead, she was the one that said, when you’re ready, like, I would love to do that position. And so I had that in my head, for the moment that I had the ability to do it.

 

Liath Dalton 

I love that. And I think that part of the challenge that leads to burnout, and that sort of sense of overwhelm, and isolation in a group practice context for the owner, can be that you’re wearing all of these hats, and being able to relinquish control of some of those roles and functions comes as a challenge. But if you aren’t, just don’t have them kind of mixed together in an unidentifiable conglomeration, but have them clearly identified and labeled, then being able to discern what does and doesn’t give you joy or feel nourishing or like it’s the best utilization of your particular skills, then it makes it a lot easier to effectively delegate those pieces.

 

Maureen Werrbach 

Exactly, exactly. And it helps those that are in leadership remember to not stay in their lane, but like, really stay focused. Because it’s easy to find, like little minute tasks that someone is not doing, and then like, start picking it up, and then realize you all of a sudden, as the Clinical Director, have a lot of random administrative tasks that you just picked up along the way because no one else was doing it. When you set up this roles and functions sheet, every task, once you’re aware that that task isn’t being done, very easily, can you it’s very easy to see who does it most make sense to, so that you’re not just taking random things on, which just takes you away from what your main responsibilities are.

 

Liath Dalton 

I love that.

 

Maureen Werrbach 

Yeah.

 

Liath Dalton 

Should we tackle the last two A’s, and then hopefully have some questions?

 

Maureen Werrbach 

Yeah, the fourth A is Audit. And essentially that is auditing your team’s accountability. So like, one of the things that I noticed is that some people might have what, I always thought I had accountabilities. Everything, most things that are on my tracker, my accountability tracker, I would say most things, are not new. Like since I started my practice, I had expectations on how many sessions should be had, based off of what I was paying. Expectations around what note quality looked like, and the timeliness of submitting notes and all that. Like none of that was ever new. But I definitely struggled with people actually doing it consistently. And one of the issues that I found was that I had communicated them during, you know, their job description and onboarding timeframe. But it wasn’t, that communication wasn’t being nurtured. And so building a spreadsheet that says all the accountabilities is great, but it only is helpful, if like, there’s a review of it consistently. And so the last two A’s are around that.

 

Maureen Werrbach 

The first one is audit, or I should say the fourth A is audit. And that is around building out Key Performance Indicators or KPIs that are going to help you be able to see, is everything working. Right? Because if you have an expectation of converting for admin, converting 70% of inquiries to clients, you need some Key Performance Indicator that, a dashboard of some sort, that shows you what percentage of people are being converted, right? And so that’s what this section is, is building out dashboards that really help you, at a at a moment’s glance, be able to see the health of your business, and be able to see are the accountabilities actually being met. So KPI building.

 

Maureen Werrbach 

And then lastly is Action Planning, which essentially is creating a leadership team meeting that focuses on results. And I think this was the biggest impact for me and my business, was my, our leadership team, I in that my book I write, I laugh because I today was recording the audio version of my book because it’s coming out next month. And I got to this section and I kind of giggled because I just the way I wrote it just was funny, but I said like, what my version for my group practice’s version for 10 years or 9 years out of the 13, I was like our team meetings, like the purpose of our business and our goals, like our leadership team meetings, that’s where they went to die. Because nothing ever happened.

 

Maureen Werrbach 

We went to team meetings every week or every two weeks, we do bi weekly, but for a while it was weekly. And all it was was bringing up the same issues, circular conversations about, you know, specific clinicians or issues that just never got resolved. And we would talk about them ad nauseam, there’d be no, like, goal of how to fix it. And it just I like hated leadership meetings, because I was like, I nothing is happening. It’s a waste of my time, it’s a waste of their time. And so in Action Plan, I built like a very, it feels very different from typical leadership meetings in that it can feel like, not very personal. We do give five minutes in the beginning for people to say what’s going on in their lives. But then that’s it, use, like, as soon as the meeting is over, get it out, you know, get out of your chair and go talk to that leader about your day and your life. I’m not saying don’t do that. But the leadership meeting itself, for the respect of everyone on your leadership teams’ time, is all geared towards looking at the tracker, literally, going through the tracker, all the accountabilities, and that person being like saying on track off track, they don’t get to say why. Which is really hard to do, initially. You just, someone is reading and saying, you know, clinical director, you know, accountability, and they go on track. Next one off track. Next one. That’s five minutes long. And that’s it, and you can’t have an hour long conversation about why it is off track, you just are saying it.

 

Maureen Werrbach 

And it’s really part of the accountability building piece, because people don’t, people want to naturally explain themselves why. And they know they can’t, which is a little bit of extrinsic motivation to actually get the thing done. But the last hour of that meeting, every issue that a person on leadership has, someone’s writing them down. So if someone’s like, I’d like to talk about this, I’d like to talk about that, there might be 20 things which can never get done in an hour, typically. But that’s why we would historically be very circular, because people just, you know, yadda yadda, on about the same things.

 

Liath Dalton 

Right.

 

Maureen Werrbach 

What happens is when we get to that section, the team, as a whole, has to agree to the top three most important things that are on that list. And that’s only what gets covered.

 

Liath Dalton 

Wow.

 

Maureen Werrbach 

So number one, they agree as a whole, what’s the most important of all the things we’ve all just like just mentioned, is important to discuss? What’s number one, and that’s where we start. And so we know that we’re very focused on that first issue that’s coming up. At the end of that issue, there has to be an action that needs that is going to be done by the next leadership meeting.

 

Maureen Werrbach 

So it could be that they’re going to, I’ll give one example. But like my team last year, was noticing, and you that are listening in right now my experience is too, that there’s a big decrease in the amount of applicants coming in for clinicians. And I have my onboarding Fariha has an accountability to bring in a lot of new people. And if she’s not reaching it, she’s thinking about, that might be an issue she’s listing. And so last year, one of these times, that was the number one issue to be discussed. And she said, I have done everything I can think of. And she mentioned bringing provisionally licensed folks in, which my practice has never historically done. And and so her action item to move the needle forward was, by the following bi-weekly meeting, she will have come up with a pros and cons list of implementing a provisionally licensed program in our practice. So we would have a big view, we’re not making any real decisions on it, but like a small micro goal. And, you know, to sort of fast track it, by at this point now in a year’s worth time, we have a provisionally licensed program, it is very detailed, like 100 page, like training manual, we have like seven supervisors now for provisional folks, it’s like a really robust program, but it was through real action planning. That’s essentially it.

 

Liath Dalton 

I love that so much. And the idea as well, or the kind of not idea but core component of microgoals, as well, because I think that’s something that I see end up being a barrier so many times is, you know, when there is a really impactful challenge that you want to solve, you want to go all the way to the solution instead of chunking it out into pieces that are actually manageable. And then when you haven’t hit that big goal, by the initially, you know, desired timeframe, it can just kind of all all fall apart a little bit and be discouraging.

 

Maureen Werrbach 

Mhmm.

 

Liath Dalton 

So having microgoals. I mean that’s the same way that we like to approach the compliance and risk management process too, is chunk at a time, start with highest priority needs, but break even the highest priority needs into incremental tasks that are that are measurable.

 

Maureen Werrbach 

Yeah, we find the most success when we, or we find that most people meet accountabilities when they get a lot of like smaller successes, and so, might as well break it down.

 

Evan Dumas 

That was an interview with Maureen Werbach on the Accountability Equation, the first part of a two part series. Stay tuned for next week’s episode where we finish up the interview. Take care.

 

Liath Dalton 

This has been Group Practice Tech, you can find us at PersonCenteredTech.com. For more podcast episodes, you can go to personcenteredtech.com/podcast or click podcast on the menu bar.