The accreditation process is most valuable when staff throughout the agency are engaged, but this isn’t always easy. Harris County Protective Services for Children and Adults shares the fun, interactive methods they used to promote the culture of COA and gain staff buy-in.

The phrase “THEY ARE COMING” typically strikes fear in the hearts of agency staff and leadership preparing for a reaccreditation Site Visit. Even scarier is that a lot of the staff not directly involved in the process never know exactly who “THEY” are.   

Since the last Site Visit 4 years ago, our organization had experienced many changes to leadership. Our Quality Improvement Team had transitions in roles and was now staffed with a diverse team with a fresh set of eyes for COA.

As a team new to the process, one of the first things we did was an assessment of staff feelings and knowledge about COA.

Challenge #1: Even though our organization has been successfully reaccredited since 1978, staff still remained in panic mode. 

When it was time for our formal Site Visit COA continued to be viewed as a separate entity, a “THEY” of sorts. We wanted to be sure that the view was of our partner helping us to identify strengths and areas for improvement in ways that may not be immediately apparent. We realized that part of the issue was that historically, we had not engaged and educated ALL staff (and not just those involved in turning in evidence). We needed to reframe staff perceptions as COA being a positive experience and focus on the benefits of the visit instead of just focusing on meeting deadlines to turn in evidence.

Challenge #2: What did we do to engage staff before? What resources do we have to engage over 19 different programs with field and on site staff?

We convened a think tank of new and seasoned staff from Quality Improvement, Communications and our Training Institute. At the last Site Visit we were only able to reach staff via email blasts and a creative “Go for the Green COA Poem.” Though staff comments about COA from past surveys and focus groups was reviewed, it was hard to track who actually opened the emails and who really took-home the message of what COA is all about. 

We wanted to do something different and FUN that would appeal to our two majority generations in the agency identified from our annual staff survey: millennials and baby boomers.

Out of our think tank was born the theme for our COA Kick Off Week online Challenge, “Who Wants To Be A COA-Knowledgaire”, which included a teaser video about COA starring our own “COA Queen” which addressed and made light of staff feelings about COA. 

Teaser Video

We also found online templates for interactive Power Point Shows that were clickable to reveal correct (or incorrect, buzz!) answers that staff could complete each week to gain knowledge instead of having to read long text.

If staff passed the Grand Challenge Quiz (via Survey Monkey) with 90 or above, they were eligible to redeem limited edition swag items.  The swag items, though a small investment from the Quality Improvement department ($2,000), made for an effective incentive that got many unfamiliar faces involved and increased word of mouth.

At the end of the challenge, almost 50% of our staff had participated visiting us in person at each site to collect their unique swag, a huge participation success for a governmental agency.

The Quality Improvement Team showing off their COA swag.

We have additional engagement activities planned for the months leading up to our visit to keep the momentum going and to continue promoting our Site Visit as an opportunity to showcase our programs and to learn about the up and coming best practices for social service agencies and nonprofits. To learn more about HCPS on their website and Facebook. 

Resources

• Flip card Trivia
• How to make a power point show auto-run and clickable
• WHO WANTS TO BE A MILLIONAIRE GAME TEMPLATE sample template by Mark Damon

The views, information and opinions expressed herein are those of the author; they do not necessarily reflect those of the Council on Accreditation (COA). COA invites guest authors to contribute to the COA blog due to COA’s confidence in their knowledge on the subject matter and their expertise in their chosen field.

Emmony Pena

Emmony is a Licensed Master Social Worker from the University Of Houston Graduate College Of Social Work with a focus on program development and evaluation. She has 5 years of experience in Data Analysis and Process Improvement through her graduate research assistant experience at MD Anderson and in her current role as Quality Improvement Professional at Harris County Protective Services. Emmony’s goal is to engage staff in performance and quality improvement activities and in plan-do-study-check act cycles.

Emmony monitors the implementation of the agency’s Performance and Quality Improvement plan and provides technical assistance and leadership to programs in the areas of Council on Accreditation standards, data collection, logic model development, focus groups, case review audits and trainings.

Certifications: CANS Assessment (Child and Adolescent Needs and Strengths) Certified

Dr. Robert Block, former president of the American Academy of Pediatrics, has been widely quoted as saying, “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today.” That is a statement that many would agree holds true at this very moment, and one that cannot be ignored.  

April is child abuse prevention month, and there is no better time to raise awareness around the long-lasting effects of child abuse, neglect, and other types of childhood trauma. This article will explain Adverse Childhood Experiences, share relevant findings from the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study, and explore how to put science into practice in order to mitigate the impact of early adversity and toxic stress.  

What are Adverse Childhood Experiences?

Adverse Childhood Experiences or ACES are traumatic early life events that can lead to negative health outcomes as adults. Much of what we know about ACEs stems from the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study, conducted between 1995 and 1997, which examined 10 types of childhood trauma and their impact on long-term health and well-being. Researchers identified three categories of childhood trauma: abuse, neglect, and household dysfunction. The findings were shocking.

The study concluded that the more adversity one experiences earlier in life, the greater the risk of significant physical, emotional, and social consequences in the future. Now, you may be thinking – Why is that so shocking? A difficult upbringing being linked to hardships down the road, what is groundbreaking about that? Well, it is the prevalence at which ACEs occur, and in turn the impact that has on the population. Studies are often criticized for their self-selecting biases, however this investigation challenges that concern. The 17,000+ study participants were predominantly white, middle- and upper-middle class; most were college-educated and had stable jobs and heath care. They represent a group that we don’t typically associate with adversity, showing that trauma has no boundaries and is more common than we think.

Let’s break it down…

Everyone has an ACE score of 0 to 10, with each type of trauma counting as one regardless of the number of times it occurs.

According to the study, nearly two-thirds (64%) of adults have experienced at least one type of childhood adversity. ACEs increase the risk of: chronic disease and health issues, mental illness, engaging in risky behaviors (smoking, substance misuse, and unsafe sexual activity, for example), inadequate social skills, poor academic achievement and/or work performance, and intimate partner violence. The study also showed that ACEs cluster, meaning that if you have one there is a good chance (87%) that you have another. Almost 40% of participants reported two or more ACEs and roughly 12.5% experience 4 or more ACES. The higher your ACE score, the worse the outcomes. 

When you look at each type of trauma and look at the prevalence of specific ACEs, the most dominant ACE experienced by participants was physical abuse (28%), followed closely by having a family member with a substance use disorder (27%). However, it is important to note the type of trauma does not impact the outcome per say. To the brain stress is stress; therefore, it doesn’t matter what type of adversity you face, the health consequences will be the same. 

When a child experiences trauma, their cognitive functioning and ability to cope with tricky and icky (technical terms) emotions are compromised. Repeated exposure to traumatic events in childhood or prolonged adversity without appropriate adult/caregiver supports negatively affects the way the brain develops and functions; this is known as toxic stress. Toxic stress can be harmful on one’s physical and mental health, yielding undesirable outcomes later in adolescence and adulthood.  

Why does this occur? Stressful or traumatic events early in life have a direct impact on a child’s brain development. The brain experiences rapid changes during the first five years, especially from birth to age three. During this informative time, the brain and its neural pathways are susceptible to external factors. While occasional stress is part of a child’s healthy development, chronic stress can negatively affect learning, growth, and behavior. This is in large part due to the overload of stress chemicals and their influence on the brain. When we feel threatened, the body activates our stress response systems and releases stress hormones (e.g., adrenaline and cortisol). Stress reactions and chemicals are meant to protect us, but too much can have the opposite effect. Enter toxic stress. Extended activation of stress response systems in early childhood can disrupt the structure of the brain and the way it communicates with the body, which can lead to major health issues in the future.   

Building resilience 

The brain is constantly changing in response to the environment; it is kind of like a chameleon in that way. This adaption is key to facilitating positive change in the face of toxic stress. Creating safe, stable, nurturing relationships and environments are critical to mitigate and prevent the consequences of childhood adversity. While ACEs have the potential to be long-lasting, they don’t have to be; we have the tools to help children thrive in the face of adversity and go on to meet their full potential. 

A strong (and continuously growing) literature base has demonstrated that building resilience can help negate stress-induced changes in the brain. Resilience is the “process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress”. Experts in the field of child trauma convey that one of the biggest determinants in being resilient is having nurturing and supportive relationships with adults in one’s family and community. Dr. Bruce D. Perry, a childhood trauma guru, considers “the more healthy relationships a child has, the more likely he will be to recover from trauma and thrive.” And it’s true, adult-child relationships play a significant role in helping children cope with challenges. If stress reactions are time-limited and buffered by protective adult relationships, a child is able to recover and learns how to adapt in difficult situations. That is why high-quality, evidence-based parent education, home visiting programs, and parenting practices are so important. These interventions emphasize the power of familial relationships, caregiver bonding, and positive social interactions. Just as critical are protective factors and their role in strengthening families and preventing trauma. Studies have shown, and continue to investigate, the ways in which different protective factors promote optimal child development. And while intervention can occur at any time – there is no magical cut-off age – there is clear evidence that shows the earlier the better. 

There is hope

It’s true that the findings from the ACE Study don’t leave you feeling warm and fuzzy. In fact, at this point, you may be wondering if there is any hope or if we are all doomed.  Fear not! This is actually the exciting part (hear me out…). 

The ACE Study findings are paving the way for innovative solutions to a public health crisis. It’s cutting across sectors and systems to bridge services and advocacy, and encouraging individuals and groups to collaborate and communicate like never before. From pediatricians to social workers, people in communities nationwide (and internationally) are using ACEs science to join forces and better the lives of children and families. Here are just a few examples: 

• The Center for Youth Wellness developed an ACEs screening questionnaire and protocol for pediatric care providers to target more effective early intervention strategies.
• In Manchester, NH, a joint-response team a – Adverse Childhood Experiences Response Team (ACERT) – is bringing together law enforcement, mental health professionals, and community providers to respond to the service needs of children who have been exposed to violence.
• Lincoln High School in Walla Walla, WA incorporates ACEs into their work with students, more specifically their approach to school discipline.
• Trauma-free NYC, a university-community partnership, aims to raise awareness of ACEs and design and promote training and learning opportunities for the larger NYC community.
• Community members and practitioners in Raleigh, NC came together to watch a film about the science of ACEs, Resilience, and have an in-depth discussion around how systems can better address children who have experienced trauma.

A call to action

In her 2014 TED talk on childhood trauma, Dr. Nadine Burke Harris closed in saying, “The single most important thing that we need today is the courage to look this problem in the face and say, this is real and this is all of us. I believe that we are the movement.” Indeed we are. We are the change makers that can combat the effects of childhood adversity. Knowing what we now know, how do we move forward? 

Continue to raise awareness

We must continue to raise awareness, not just of the long-term outcomes assocaited with childhood trauma, but also the power of early intervention. Recently, 60 Minutes did a piece on the impact of childhood trauma, highlighting the impactful work of organizations like SaintA and Nia Imani Family, Inc.. The eye-opening conversation was facilitated by Oprah Winfrey…yep, Oprah. The importance of stories like these in mainstream media cannot be understated. We know that when Oprah talks, people listen. Look at the traction that this one segment has gotten over the past month. It’s been invigorating. 

Want another example? Sesame Street collaborated with the Robert Wood Johnson Foundation to launch an initiative to help children manage traumatic life experiences. Who better to take on the task than the beloved Sesame Street Muppets? The characters are loved by children and adults alike. An array of research-driven materials have been created through the partnership and are available to children, parents, and professionals. The content is truly original and inspired – it even includes Muppets modeling coping strategies – and emphasizes the power of resilience in the face of adversity.

Now, recognizing that we all don’t have access to Oprah, Big Bird, or a national TV network (wouldn’t that be awesome though?), it is important to take to the platforms we do have at our disposal to spread our message. Post an article on your organization’s Facebook page, email your colleagues, tweet at your community partners…Connecting with diverse audiences ignites new and ongoing conversations around where we are, what we know, and what we can do. 

Become trauma-informed

Trauma-informed care is no longer the exception, but instead the expectation. It’s about reframing the conversation from “What’s wrong with you?” to “What happened to you?” There are a great deal of resources out there that provide excellent guidance on becoming trauma-informed, both in clinical practice and at the organizational level. Here are a few that you may want to check out:

• ChildTrauma Academy
• Child Welfare Information Gateway – Trauma-Informed Practice
• National Child Traumatic Stress Network (NCTSN)
• National Center for Trauma-Informed Care and Alternatives to Seclusion and Restraint (NCTIC)

Promote shared learning

Many in the field have been advocating for the implementation of programs and policies that address ACEs, calling for more data and additional research to better target prevention efforts and supports. The fact is that while the ACEs may be new to some, others have been implementing innovative trauma-informed, resilience-building practices in their everyday work to create positive change. We have presented a few examples, but there are many more being spearheaded by individuals, organizations, systems, and communities nationwide. Shared learning is crucial to creating and maintaining a movement. 

Be part of the movement

And with that…we want to hear from you. What do you think about the ACE Study and the findings? How are you addressing the needs of children and families who have experienced trauma? Are you implementing innovative trauma-informed practices at your organization? 

Share your thoughts in the comments below! 

A big thank you to Stan Capela of Heartshare Human Services of New York for this guest post!

My name is Stan Capela and I have been a COA Peer Reviewer and Team Leader since 1996. By the end of April, I will have completed 112 Site Visits. At the glorious age of 65 after devoting 40 years to the field of social services, I’m beginning to reflect back on my journey. I want to share my experiences with you in honor of Volunteer Month.

Before I share my story let me give you a snapshot of a Volunteers numerous responsibilities. First you are assigned a Site Visit. I started as a Peer Reviewer, working with a team of colleagues to review an organization. Ten years ago, I became a Team Leader and gained more responsibilities such as; making contact with the organization, setting up travel for the Peer Review team, developing the Site Visit schedule, assigning standards sections to the Peer Reviewers, and leading the entrance and exit meetings where the team interacts with the organization. The latter gives the Peer Review team a chance to introduce themselves to the organization and provide information about how the review will take place.

Wait! I’m getting ahead of myself. The entire review process begins with a Self-Study submitted by the organization and reviewed prior to their Site Visit. When the review team arrives on-site most of their time is spent reviewing case records, policies and conducting interviews. By the time the exit meeting occurs, the Team Leader and review team are ready to provide an overview of the organization’s strengths and challenges. If you want to learn more about the Site Visit process then I recommend reading Recipe for Conducting Quality Accreditation Site Visits which I co-authored with Joe Frisino, a member of the COA Standards Development team, in New Directions for Evaluation.

The decision to become a COA Volunteer starts with the simple question, why? And traveling through my many memories leads me to that answer.

I remember on my first Site Visit I was eating dinner and mistakenly bit into an olive and broke my tooth. The executive director of the organization we were reviewing offered to have one of her board members who was also a dentist patch me up. I declined since I felt it would be a conflict of interest. After all it was just a cracked tooth.

Another significant memory is when I interviewed two girls, one 8 years old and the other 12 years old. They both had been abused and while talking with them they expressed how much they appreciated the staff helping them get through their pain.

There was also a memorable exit meeting where I remember commenting on the risk management minutes and asking who was responsible for creating them. A woman stood up and I complimented her on her work. That moment made the executive director stand up in that same meeting and say, “it goes to show you, we are all a part of a team dedicated to helping people in their time of need.” At the conclusion of that exit meeting the employee I engaged with beamed with pride as leadership walked over to say that they didn’t realize they were in the presence of such a star.

Once I was making the rounds and asked an employee to tell me a story that would make me remember the organization. He told me about Johnny and the mailbox. Basically, it was an individual with developmental disabilities who lived in a group home. One of his goals was to get the mail and distribute it. One day he went outside to the mailbox and found a baby inside. Johnny being trained properly brought the baby inside and gave it to the site manager. Many years later there was a knock on the door. The site manager opened the door and saw a very professional looking woman who asked for Johnny. The site manager said Johnny passed away a few years ago. The woman said I was the baby and wanted to thank him.

I remember another time that I was scheduled to meet with a client during a Site Visit. The client was transgender. During the interview the client expressed appreciation for how the staff treated her while she was transitioning. It felt good to hear how well the staff supported her and addressed her needs.

I have many more stories but these are just a few. So again, why? It’s about interacting with people and observing inspiring team work. When I conduct an entrance meeting as a Team Leader, I start by saying I know this is a lot of work, but we’ll get through it together. You should look at this Site Visit as an opportunity to invite people into your home and share your world with them. I try to get the point across that we are a family of helpers who have dedicated our lives to helping people in need and going through the accreditation process provides an opportunity to affirm what we do.

It’s very easy for me to answer the question why become a COA Volunteer after all these experience in these roles. My time as a Volunteer has made me feel like the richest person on the face of this earth. Again, why? Simple, I have decided to help people in my work at HeartShare Human Services of New York and in these roles at COA. In all my roles I’m able to make sure we all strive to meet the highest standards to reaffirm that the work we do meets the needs of the people we serve.

The views, information and opinions expressed herein are those of the author; they do not necessarily reflect those of the Council on Accreditation (COA). COA invites guest authors to contribute to the COA blog due to COA’s confidence in their knowledge on the subject matter and their expertise in their chosen field.

A big thank you to Leslie Chaplin for this guest post!

Making the shift from therapist to administrator can be tough.  Being an effective leader is not the same as being a great therapist and many of us get promoted without any formal training in leadership.  

With the help of my organization, I am completing a PhD program in Organizational Leadership at The Chicago School of Professional Psychology.  Deciding on a dissertation topic was a process of considering what our field could most use in terms of children’s mental health and also in terms of leadership.  As our profession has become better at trauma-informed care we have done an excellent job at educating and preparing our staff for the phenomenon of vicarious trauma. However, I have seen a mindset develop where the risk of vicarious trauma becomes such a strong focus that it almost becomes a self-fulfilling prophecy.  Leadership responds by communicating  about self-care and work life balance.  I began asking myself, if our work is so traumatizing, then why would anyone do it?  The answer is vicarious resilience, the topic of my dissertation. 

Vicarious trauma and vicarious resilience

Vicarious trauma is a term that can be somewhat interchangeable with things like burnout or secondary traumatic stress.  It materializes as we listen to the stories of clients who have known horror, unspeakable fear or near death experiences.  As we hear these stories over and over the risk of showing the symptoms of trauma become very real.  

Vicarious trauma is deeply ingrained in our dialogue and training to mental health professionals, and staff is quick to fulfill our predictions.  We address vicarious trauma by urging staff to focus on self-care – things like taking vacation days and exercising.  This may provide temporary relief but it does little to reduce the trauma felt once returning to work. I have supervised many brand new therapists in the trauma field and they are always eager to make a difference and help the kids through the tough things that have happened in their lives.  We train them for what they will likely experience and the personal struggles that will come with the job of trauma professional.  This is important, however, it can become a primary topic of conversation with both the supervisor and the therapist becoming overly focused on the trauma.  The point of healthy awareness often becomes overwhelmed by the perseveration and anxiety about traumatic experiences.  Taking time away from the job is often where the “self-care” plans end.  If we, as leaders in the mental health field, want to reduce our staff turnover and keep our trauma therapists healthy and thriving, we need to do more than grant vacation days. 

Where we are falling short is completing the cycle of trauma work and neglecting a critical piece of the process which leads our staff to heal and makes our difficult work worthwhile: vicarious resilience. Vicarious resilience happens when the professional experiences personal growth in their own life through witnessing the growth of their clients.

The concept of Vicarious Resilience was first defined by Hernandez, Gangsei, & Engstrom (2007).  Their grounded theory study examined the experience of psychotherapists working with victims and families of political violence.  They found that witnessing their clients overcome adversity demonstrating an immense capacity to heal had a positive effect on the therapist.  The therapists’ own attitudes and emotions were changed allowing them to reassess their own problems and were better able to cope with their own adversity.  The main finding for trauma professionals is their work does have a positive effect on the therapists, and this effect can be strengthened by bringing conscious attention to it (Hernandez, Gangsei & Engstrom, 2007).  

Those of us who have been in the field for decades and still love coming to work every day do it because we experience vicarious resilience.  Resilience is succeeding against all odds; it’s overcoming adversity and having the grit within you to rise above what is trying to keep you down.   As the client taps into their resilience with the help of the professional they begin to get better and as a result the professional shares in the process of getting better.  A therapist who can fully embrace this phase of the process will find themselves becoming stronger and more resilient in their own lives leading to higher job satisfaction, less burnout and less turnover in employees.

Harnessing the power of resilience

Research shows that by simply talking about the concept of vicarious resilience and letting people know that it exists (just like we do with vicarious trauma) will raise the likelihood of people having the experience.  I have found (in research and in practice) that adding resilience to the conversation brings an immediate shift to the dialogue.  We develop insight into our own response to the trauma work and then shift to the successful moments where healing is starting to develop.  When the professional can maintain a focus on what has been accomplished instead of the struggle that remains, they create a sense of purpose, fulfillment, and motivation within themselves to stay in the profession.  This leads to successful cases of healing and resilience in the child, giving the professional more opportunity to experience vicarious resilience within themselves.  In the end, it’s really a simple concept.  Stay positive!  But in practice, it is predominantly missed and overlooked.  

My training on vicarious resilience resonated with Faith, a Northwood residential counselor, who reflected,“Our jobs are hard sometimes and we forget to focus on the success stories.  Learning about Vicarious Resilience immediately turned my mood around and I felt like a weight was lifted off my shoulders”.  

As leaders, we need to support our staff by helping them realize that self-care does not mean take time off of work only to come back to these traumatizing clients.  Self-care should focus on resilience including taking time to play, have fun and notice the positive steps.  Look for the successes, no matter how small.  Focus on the struggles that have been overcome in the past.  Identify strengths and potential.  Know that anything is possible and healing really does happen.  Use inspirational photographs or phrases that focus on resilience.  Remind yourself of the greater purpose in what you are doing.  Find encouragement in a smile, a laugh.  I’ve found incorporating these success stores into my everyday interactions with colleagues and staff is an effective way to reinforce this as a concept. At your next case record review or team meeting, in addition to focusing on the usual questions, you might try asking staff to tell you about a success from the past year.  Connecting a tangible, specific example to the concept of vicarious resilience helps reinforce the power of what could otherwise be abstract.  When I did this recently, one of my staff recalled a client recently sharing that she had taught him how to smile again. That is a powerful example to call upon and connect to the concept of vicarious resilience.  Following up on those moments of resiliency 3 months later and taking the time to check in on the successes can make all the difference.  Remember “this too shall pass” (Persian adage) and “what doesn’t kill you makes you stronger” (philosopher Friedrich Nietzsche). Make a difference in the clients’ lives and help them find their resilience because that is how you find yours.  If we are asking our clients to get out bed each morning in the face of their challenges, we realize we need to be, and are, able to do the same.  They get better, we get better.  

We stress personal resilience in our therapeutic models for our clients and it’s time to start stressing it with our staff.  Mental health professionals undoubtedly see resilience in their clients. To be a child who has experienced significant trauma and come out on the other side takes significant strength and resilience. We see the resilience in them, and it makes us better people. This is why we do the work that we do.   We absorb the strength we see in them each day and we are able to incorporate it into our own lives – in our work, with clients and with others.  The impact is exponential.  

It’s an exciting time for vicarious resilience as we begin to recognize and name it in our work.  If this concept resonates with you in your personal and professional experience, we’d love to hear about it in the comments below!   

Reference
Hernandez, P., Gangsei, D., & Engstrom, D. (2007). Vicarious Resilience: A New Concept in Work with Those Who Survive Trauma. Family Process, 46(2), 229-241 13p

The views, information and opinions expressed herein are those of the author; they do not necessarily reflect those of the Council on Accreditation (COA). COA invites guest authors to contribute to the COA blog due to COA’s confidence in their knowledge on the subject matter and their expertise in their chosen field.

Leslie Chaplin

Leslie Chaplin has over 20 years of experience in the field of children’s mental health including work as a director, child/adolescent psychotherapist, clinical supervisor, program consultant, school social worker and adjunct instructor. She holds a Masters degree in clinical social work from the University of Minnesota and is a PhD candidate at The Chicago School of Professional Psychology. Her passion is the development of new programming to better serve children with mental health needs across disciplines and leading change to better organizations. She is a proud member of the Northwood Children’s Services Executive team in Duluth MN where children and families have been served for over 130 years. Leslie is currently a Peer Reviewer with COA and actively researching the phenomenon of vicarious resilience.  When not at work she is happily working on her hobby farm and training therapy animals.

This article was reprinted with permission from the Nonprofit Risk Management Center (NRMC), publisher of the RISK eNews.  

To say that the term risk assessment has many meanings is an incontrovertible understatement. My Google search of the phrase “what is a risk assessment” yielded more than 127 million results in an astonishing .88 seconds! From time to time at NRMC we ponder what the phrase means, and why it’s relevant-to the mission of the people and community-serving organizations we serve.

Why risk assessment matters

Stewardship is significant

The leaders of nonprofits are mission stewards, responsible for guiding, supporting and sustaining the missions, values and assets of their organizations. In his book, Finance Fundamentals for Nonprofits, thought leader Woods Bowman reminds us that: “…the risks of a nonprofit are borne by the people it serves (its clients), who have neither a voice in selecting the organization’s leadership nor the ability to manage the risks.” It is thus the responsibility of nonprofit leaders to manage risks that might directly or indirectly affect our stakeholders.

Stuff happens

All nonprofit teams face obstacles and difficulties–some capably forecast and some startling–throughout their organizational journeys. Thoughtful leadership and mindful management cannot eliminate the possibility of frustrating or resource-draining “stuff” obstructing your view or impeding your progress.

Reflection builds resilience

Reflecting on the risks in your landscape is a vital step in building resilience. Former NRMC board member Felix Kloman says it best: “The proper goal of risk management is to build and maintain the confidence of stakeholders. That combined confidence and trust is often translated into much-needed support, financial and otherwise, when surprise inevitably hits. It is the essence of resilience.

How nonprofits evaluate their risks

In the NRMC team’s experience, risk assessments take various forms. For example…

Intuitive approach

Some leadership teams (boards, staff teams, volunteer teams, etc.) intuitively ponder the risks associated with any change in strategy or new program. We’ve heard from our consulting clients and Affiliate Member teams that instinctive questions like “what are the risks associated with that?” often pop up during team meetings. Often a single team member can be counted on to ask that question, while in other groups various members take a turn with the risk champion or devil’s advocate role. One of the goals we’ve heard client teams reiterate time and time again, is to evolve risk management in a way that makes risk management skills–or the function itself–baked-in rather than bolted-on. One possible motivator for a baked-in risk function is the recognition that creating a new department of risk professionals is impractical and costly. Few leaders of ambitious nonprofit organizations have extra dollars or people available to support and fully-staff a new risk management function. A dedicated risk function also won’t guarantee that all of your team members are considering risks while making decisions each day. Read our article Designing a Durable, Doable Risk Management Function & Capabilities to explore this topic further.

Checklist approach

Still, other nonprofit teams use checklists to assess risk management capabilities and identify gaps. I wrote about the potential value of checklists in the Risk eNews article Making My List and Checking It Twice, describing them as “among the simplest and least expensive tools at your disposal.” I was inspired to rethink my aversion to risk management checklists after reading The Checklist Manifesto: How to Get Things Right. In his terrific book, Atul Gawande explores how the simple device of a checklist can help translate a large data set into safer practices.

Deep dive, all-in approach

Yet another approach to risk assessment is a full-on review, facilitated by an internal or external risk champion. At NRMC we are honored every time we are selected to lead a

Risk Assessment or an Enterprise Risk Assessment for a nonprofit client. During these intensive engagements, we interview stakeholders representing diverse vantage points across the organization, we bring an outsider’s fresh perspective as we consider the nonprofit’s risk landscape, and we present detailed recommendations for action steps and strategies that will fortify the mission and key objectives of the nonprofit. These engagements often wrap up with training or risk champion coaching to equip our client teams with the resources they need to sustain lasting changes to their risk programs.

Each of these approaches offers a potentially meaningful, mission-advancing way to uncover and better understand the risks you face. Each approach can inspire action in the face of the inevitable uncertainty facing all organizations. Yet many nonprofit teams crave a self-guided option–one that is less time-consuming than an all-in assessment and more nuanced than a checklist.

My Risk Assessment

I’m excited to announce the release a brand-new self-assessment web application for nonprofit teams: My Risk Assessment. Inspired by earlier self-assessment tools developed by NRMC and lessons and insights from many deep-dive risk assessments we have led, the new My Risk Assessment is a powerful, practical and affordable fourth option for teams seeking to understand and act on their principal risks. How does My Risk Assessment work?

Risk Ranking capability

A brand new Risk Ranking feature enables users to swiftly create a team and invite colleagues to select and rank their top risks. Whether you want to poll a team of twelve or cast of hundreds, My Risk Assessment gives a risk champion the ability to quickly and efficiently gut-check different perspectives on risk. The Risk Ranking component features 100 risks suggested by NRMC and covers 13 areas of exposure and operations. Users have the option of adding two organization-specific risks before inviting their team members to weigh in. The web app aggregates team member scores and reports the number of votes and relative rank on a top ten list of risks. We recommend that teams use the Risk Ranking feature as a starting point for a conversation about priority risks, exploring the top ten list to validate it and to determine what risks require action.

Risk advice from trusted advisors to nonprofits

My Risk Assessment features 13 topical risk assessment modules that users can complete to self-assess the risks facing their organizations. The NRMC team updated the assessment questions, the pop-up advice, and the detailed report and recommendations shared after you complete one or more of the 13 modules. All of the guidance in My Risk Assessment is written by NRMC team members, who are risk champions with experience advising hundreds of leadership teams in diverse nonprofits.

Robust reporting

You asked and we answered! Users of My Risk Assessment are able to generate an Executive Summary containing a high-level overview of assessment highlights and suggested action steps, or a full report with detailed recommendations, context, and helpful resources. Choose the report format that suits your needs in the moment, and return anytime to download or share the shorter or more substantive version of your risk assessment report.

The app is designed for any and all risk management professionals – whether you’re a long-term risk champion who is rarely surprised by risk events, or a leader who has recently accepted a risk leadership role. We invite your questions and feedback as you use My Risk Assessment to delve into the always fascinating, never lackluster world of risk in your organization! 

This article was reprinted with permission from the Nonprofit Risk Management Center, publisher of the RISK eNews.  Read past issues of this free publication. 

A big thank you to Jennifer Flowers of Accreditation Guru for this guest post!

As an organization evolves, it will inevitably face changes in leadership. While many of these transitions are anticipated, as when additional leadership roles are established or when a leader retires, other times the agency faces the dilemma of filling an unexpected opening. The key to making any leadership transition a seamless process for staff and clients alike is to develop a thoughtful succession plan that will guide decisions when the need arises. Here, we offer fundamental succession planning tips that can help your organization to Prepare for Greatness!™ 

Why participate in succession planning?

Succession planning should be proactively and thoroughly analyzed, planned for, and reviewed, in the same manner that an organization does so for budgeting, daily operations, and strategic planning, among others. While there are many motivating factors for an agency to participate in succession planning, two key elements at the forefront are to:

1. Ensure Organizational Sustainability– First and foremost, having a well-developed, formal succession plan supports organizational sustainability, while preserving the continuous coverage of duties critical to an agency’s continuing operations.
2. Increase Transition Success – Thoughtfully considering succession possibilities will lead to smoother transitions. The executive director or CEO serves as the direct line of communication between the board of directors and agency personnel; he or she is responsible for providing the leadership and guidance to help the organization meet its strategic and operational goals and fulfil its mission. He or she also provides an understanding of the intentions and policies of the board of directors by informing and guiding senior staff leadership, administrative functions, and operational staff in the daily work of the organization. It is important to ensure a continuity of this leadership in the event of unplanned and unexpected changes, as well as during planned changes due to termination, resignation, or retirement of top leadership, including the executive director or CEO.

According to The Bridgespan Group, succession planning remains the number one organizational concern expressed by nonprofit boards and executive leadership. Additionally, BoardSource recently reported that only 34 percent of nonprofits surveyed report that they have a written succession plan in place – yet, half of all CEOs intend to leave their positions within the next five years.  

Key succession planning considerations

• Always include the board of directors and all senior leaders in succession planning, its implementation, subsequent monitoring, and future reviews.
• When listing potential candidates, consider maintaining an adequate level of staff diversity, recruiting a wide range of individuals who provide the skills your agency will need in the future, and cultivating long-term employee retention.
• Develop a short list of potential leadership successors who possess the ability to lead effectively and recognize the emerging needs of the organization, matching each individual to the most appropriate position.
• Consider how vacancies may arise – while some are easily identified, as when an executive retires or is promoted to another position, others will be unexpected and provide no advance indication or notice. By properly planning for these scenarios beforehand, selecting a replacement will be less daunting and will support a smoother organizational transition.
• Consider whether the placement of an interim leader would be of greater benefit than placing someone in a position quickly just to fill a vacancy. This is especially important for the highest-level positions in the agency where it may be beneficial to seek outside candidates for consideration.
• Succession planning must include planned, unplanned, temporary, and long-term absences. Unplanned vacancies require emergency transition plans that outline the delegation of responsibilities and authority during leadership disruptions.

Communicate and keep communicating

Communication is essential. Communication means transparency. Thoughtful and timely communication before, during, and after any leadership transition will go a long way in supporting the success of a new leader and the organization – keeping the focus squarely on fulfilling its mission of serving others.

Planning tips for leadership transitions

• Secure agency-wide commitment and continued support to ensure a smooth and successful transition.
• Identify current and/or potential challenges and the corresponding leadership qualities necessary to effectively navigate these adversities.
• Adopt an Emergency Leadership Transition Plan to address the timely delegation of duties and authority whenever there is an unexpected transition or interruption in key leadership.
• Identify opportunities to cultivate the leadership skills of current staff and board members, thereby ensuring a selection of emerging leaders who are prepared as needs arise.
• Cross-train staff to minimize disruptions from unexpected personnel changes.
• Create a formal plan that adequately supports newly-placed employees that includes coaching, mentoring, and defining job-related goals and responsibilities.

Who is responsible for planning for leadership transitions?

Generally, a board of directors is responsible for initiating a succession plan for an executive director or CEO. The board must understand that succession planning is a critical component for ensuring the short and long-term sustainability of an organization and must be considered a proactive risk management strategy. Succession plans should be carefully reviewed on an annual basis. 

The human factor

Succession planning discussions often bring apprehension to many within the organization. Those in leadership roles may see this as a sign that their performance is lacking or signals that they are considering leaving the organization, while staff may misinterpret planning as an internal power struggle, among others. Regardless of the concerns that surface, it is paramount to unambiguously clarify that leadership is simply prioritizing the agency’s future sustainability and the needs of the community it serves. The ideal time to conduct such planning is while there are no transitions taking place, allowing for greater focus of planning without additional pressure.

Other questions to consider

• If an executive is suddenly unable to serve, is it clear within the agency who will fill that role until a permanent replacement is selected? Does the board of directors have the expertise required to evaluate and appropriately fill the position?
• Are the responsibilities of the leadership position reasonable and manageable? That is, can this position realistically be served by one individual?
• Is the position’s salary commensurate with those for similar positions in comparable organizations? Wage data compiled from a variety of statistics can be found by visiting the Bureau of Labor Statistics and the Nonprofit Time’s Nonprofit Organizations Salary and Benefits Report.
• For nonprofit agencies, does the executive director also serve in the chief fundraising and development role? If so, what impact does this have on overall fundraising activities and organizational revenue?
• Are there any obvious internal or external candidates for the job?

Assigning an interim leader

Changes in leadership are inevitable, including those that are unplanned and immediate, as when an executive director is no longer able to fulfil his or her responsibility and the position is vacated. Often, the board president will work closely with the agency’s executive leadership team to identify a potential temporary replacement and offer this recommendation to the full board of directors for approval. The board will meet with the candidate, determine his or her ability to fulfil the role, and swiftly act to appoint the candidate to this interim role, as appropriate.

Following the appointment of the interim leader:

• Immediately notify the entire board of directors;
• Communicate with organizational staff;
• Direct the communications team to send press releases, communications, electronic messages, etc. to critical governmental and funding partners, families and clients served by the agency, community business partners, and the public to announce the interim appointment.

Soon after, the executive committee should meet to determine:

• Anticipated length of appointment:
  • Short-term (three months or less)
  • Long-term (greater than three months)
  • Permanent
• At what point in the future the interim position should be permanently filled
• Key benchmarks and timeframes to be provided for the board

Selection process for new agency head with advanced notice

When an agency head provides proper notice of intent to resign from his or her position, an official transition team should be assigned to conduct a formal search for a new executive director or CEO. The committee should include board members, senior staff representatives, and other relevant stakeholders associated with the organization. 

The committee should consider the following when conducting its search:

• Always consider both internal and external candidates for the position; this may include conducting a national search unless there is an internal candidate who is appropriately prepared and qualified for the job.
• Determine whether the agency’s senior-level positions could and/or should be realigned to meet the agency’s current and future needs.

Do not underestimate the power of time

It is not unusual for the head of an organization to give upwards of two years notice of his or her planned departure. However, this announcement can mistakenly be met with a “we have plenty of time” response from those involved in filling the future position. Procrastinating to fill what is arguably the most critical leadership role in the agency will often lead to unnecessary confusion and disruption throughout all levels of the agency. 

While the future is not easily predicted, taking advantage of all the time an organization is given to fill key leadership roles will not only allow the search committee to make intentional, strategic choices, those who are served by the agency will benefit, as well. Through a well-executed plan, an agency ensures that the transition is a time of focused, organized, and thought-out change. After all, uninterrupted mission fulfillment is at the forefront of every public service agency. 

The views, information and opinions expressed herein are those of the author; they do not necessarily reflect those of the Council on Accreditation (COA). COA invites guest authors to contribute to the COA blog due to COA’s confidence in their knowledge on the subject matter and their expertise in their chosen field.

Jennifer Flowers

Jennifer Flowers, Founder and CEO of Accreditation Guru, is an experienced accreditation consultant and has dedicated her career to the areas of accreditation and nonprofit management. Her 20+ years of accreditation experience includes serving as Director of Volunteer Services and Accreditation Commission at COA, as well as working with a variety of nonprofits in the education, health care, religious and social service sectors. Her background gives her an intimate knowledge of what Peer Reviewers look for during an onsite survey and what Commissioners need to make an informed accreditation decision. 

Prior to founding Accreditation Guru, Inc. in 2009, Jennifer has held key management positions in both for-profit and nonprofit organizations. She earned her B.A. in Sociology from the University of California, Berkeley and holds an MBA in International Management from Thunderbird School of Global Management. Jennifer is also certified in Nonprofit Board Education by BoardSource.

This year COA turns 40. To honor the occasion, here’s a timeline of key milestones that have helped define COA and its role in the human services field. 

One of the most frequently asked questions we get from organizations, is what the differences are between these three entities: accrediting bodies, licensing authorities, and certification organizations. Commonly there is overlap, but sometimes there are distinct differences. Before we explore those differences, there are a few points to highlight:

• Accreditation, licensing, and certification may vary by location and by the entity providing the credential. While we hope this article is helpful in providing a basic understanding, always be sure to check with your local jurisdiction to determine what is required.
• There is often an interdependence between these three categories. We discuss this correlation later in the post.
• Accreditation, licensing, and certification are not interchangeable terms. They each have a unique meaning and implication.

Now let’s walk through the definitions and examples of each category, and then take a look at some examples of how they can overlap.  There’s an infographic at the end of the post that gives an overview of this discussion. 

Accreditation

• Accreditation is both a process and a credential
• The accreditation process is voluntary
• Only organizations, agencies, or programs can be accredited

If an organization is accredited this means they conducted a thorough self-assessment and compared themselves to recognized standards of best practice. Accreditation means that the organization, agency, or program was able to demonstrate evidence of implementation to all of the relevant standards. It is a rigorous process conducted by a third party organization.

The process is voluntary; however regulating bodies often require accreditation in order to be licensed or certified. The accreditation process typically repeats every 2-4 years, depending on the accrediting body. Normally, individuals or private practices are not able to become accredited; however, some exceptions may exist.

Example:

The Council on Accreditation (COA) develops standards and guidelines for the accreditation of services delivered by behavioral health and social service agencies. The accreditation process is designed to assist agencies in implementing organizational structures (i.e. financial management), and processes of care (i.e. case-management) that will help them achieve better results in all areas, and ultimately improve the well-being of their clients. Organizations use their accredited status to demonstrate accountability to clients, funders and donors.

Accreditors of human and social services

The most common accreditors of human and social services are as follows:

Council on Accreditation (COA)
CARF
Joint Commission

Here’s a comparison between the above accrediting bodies.

Licensing

• Licensing exists primarily for public safety and the well-being of consumers
• Typically, licensing is involuntary
• Individuals, facilities, programs, organizations or agencies can be licensed

Individuals are often licensed by their respective state to practice counseling, social work, or nursing. Organizations may need to be licensed in order to provide a specific service such as services for substance use disorders or residential treatment. Practitioners and programs are required to be licensed or face penalties, including suspension or closing of agency.

Examples:

Under New York State law, no organization may operate an adult group home without a license.

In most states, including New York, individual social workers must have a clinical license in order to provide psychotherapy without supervision.

Certification

• Certification demonstrates the capability to provide a specialized service or particular program
• Typically, certification is voluntary, but sometimes regulatory bodies require certification in order to provide a specific service
• Individuals, facilities, programs, organizations or agencies can obtain certification

Certifications at the organizational level can definitely vary, including the terminology. Some structured evidence-based models require certification. In these cases, the certification can be called “authorized provider” or “approved site.”

Example:

We also often see certifications for individuals. Many schools of social work have certificate programs. For example, Tulane University in New Orleans, Louisiana offers a certificate in Family Practice. This is an opportunity for students to get a specialized education and accrue experience in this specialized area which they can include on their resumes. 

Understanding the correlation between accreditation, licensing and certification

More and more, regulating bodies are requiring that organizations become accredited or certified in order to be a licensed provider in their respective state.

Examples:

Effective January 1, 2017 in California foster care providers must be accredited or in the process of being accredited to qualify as a licensed provider. We call this a recognition, the state is recognizing the value of accreditation and using it to identify credible and accountable organizations who have implemented best practices. 

In Nebraska, organizations must be certified in Functional Family Therapy (FFT LLC) to be a licensed provider. In this example, the state is relying on a certification to ensure that specific models are implemented and relying on FFT LLC to track the fidelity of the program model.

Final takeaways

• Always pay attention when you see the words “license,” “certification,” and “accreditation.” Whether you are applying for a grant or soliciting funds from a donor, be sure to use the appropriate terms and understand what the entity is requesting.
• Don’t be afraid to ask about what the terms mean. With so many different regulating bodies out there, you want to be sure that you are all on the same page.
• Never make false claims about your credentials; you will always need documentation to support your status. Not that organizations would intentionally make a false claim, but accidentally using the wrong terminology can lead to problems.
• Stay on top of the changes and requirements of your regulating or accrediting bodies. This can be a challenge in our ever-evolving field. When there’s transition, licensing, certifying, and accrediting bodies must adjust as well. A great way to bolster your risk prevention activities is to have an internal process that regularly reviews changes in requirements. Subscribe to COA’s newsletter for standards updates.

We hope you now have a better understanding of these terms, or at least with recognizing when you need to ask more questions to ensure that your organization remains in good standing with all entities that have a stake.

Here’s an infographic summarizing what we went over in this post, feel free to share it! 

Community demographics are continuing to evolve nationwide, making the need for culturally competent organizations more prevalent than ever. In this article, we will discuss what this means for you as a provider of social services, and how your organization can progress in this realm by exploring the what, why and how of cultural competence.

The what

First, let’s define cultural competence. It can loosely be defined as the ability to respect, engage, and understand individuals who have different cultural or belief systems, where the elements of culture include, but are not limited to: age, ethnicity, gender identity, gender expression, geographic location, language, political status, race, sexual orientation, socioeconomic status, tribal affiliation, and religion.

The why

The term competency in regards to culturally responsive practice has been debated. Can one ever truly be culturally competent? There might not be a consensus, but as a provider of social services promoting cultural competence will enable you to better meet the needs of the individuals, children, and families you serve. Understanding your community and those you serve facilitates stronger partnerships, resulting in higher quality programs and service delivery. Research shows that organizational culture impacts its effectiveness. An organization that commits to cultural competence is not only better equipped to successfully address community service gaps and needs, but also creates an internal culture that fosters responsive and respectful interactions.

Here are just a few of the many benefits, it:

• fosters stakeholder engagement and empowerment
• ensures strategic initiatives, goals, and objectives to be culturally appropriate and inclusive of community needs
• supports the recruitment and retention of a diverse and inclusive governing body and workforce
• creates a safe and supportive environment that accepts and respects diversity

The how

Seek stakeholder feedback

Connect with your community! The best way to do that is to offer formal and informal ways for clients and community members to provide feedback about the work that you do. That’s why COA highlights the importance of stakeholder involvement in performance and quality improvement systems in its standards. As an organization, you get a sense of what’s working and what’s missing the mark. You can then tailor your services and outreach efforts to ensure that they are culturally appropriate. Most importantly, when you incorporate client and community feedback it makes those you serve active in organizational decision-making processes and promotes engagement and empowerment.

Conduct a community needs assessment

Conducting a community needs assessment is an effective way to identify strengths and resources in your community. It also highlights current gaps and service needs. Collaborating with community partners can enhance this assessment. You can also review other external needs assessments conducted by organizations with a community-wide focus. KIDS COUNT data center, a project of the Annie E. Casey Foundation, allows you to access local, state, and national level data and statistics on demographics and child and family well-being that can be incorporated into your assessment process.

Incorporate community demographics into your strategic planning process

Strategic initiatives should be responsive to changing community demographics and service needs. COA recommends that organization leadership review a demographic profile of their defined service population at least once every long-term planning cycle. However, it’s not enough to collect and review demographic data; it must inform an organization’s planning and operations. Promote cultural competence by establishing goals and objectives that are culturally appropriate for those you serve. Want to go a step further? Incorporate a cultural competency plan into your strategic planning process.

Foster a culturally responsive workforce

Promote cultural competence by having a diverse and inclusive workforce. A first step is ensuring that your human resources practices are culturally appropriate. Organizations should strategically recruit and employ personnel that reflect cultural characteristics of the service population. Is this a challenge for your organization? Create a plan that establishes goals for recruiting and employing individuals that represent your service population and community.

Another way you can commit to promoting cultural competence is by providing relevant education and training opportunities to personnel at all levels. Opportunities should not only focus on work with clients, but also address the internal workplace and interactions amongst other staff. Education and training should be tailored to the needs of your organization, but may include: language classes, interpreter training, mentoring programs, and diversity workshops. You can also conduct workforce assessments to inform ongoing personnel development opportunities to ensure that all staff is trained on culturally responsive policies, procedures, and practices. Once personnel have the necessary education and training, it’s time to integrate culturally responsive practices into everyday work with clients. As a provider, your goal should be to provide respectful, effective, and equitable care. This stems from adopting a service philosophy that is culturally responsive to those you serve, and culturally appropriate program-level policies and procedures.

Arguably one of the most important things that you can do as an organization is create safe and supportive environment where personnel can explore and gain an understanding of different cultures. You can do so by creating a cultural advisory committee to address workforce diversity issues or holding “cultural conversations” where staff can discuss diversity issues and learn from one another. Offering these types of forums reinforces a culture that is accepting and responsive to diversity.

Establish and maintain a diverse and inclusive board

One major responsibility of a nonprofit board is establishing and adopting organizational policy. Policies and procedures that support culturally responsive practice provide the framework for being a culturally competent organization. That is why having a board that reflects the demographics of the community it serves is so crucial. It’s no secret that board recruitment can be a challenge. If your organization is struggling to establish a board that is diverse and inclusive, establish a stakeholder advisory group that is representative of the community you serve and create a board recruitment plan that outlines strategies for getting everyone at the table. Need a little guidance? BoardSource is an excellent resource on board diversity, equity, and inclusion.

Are you feeling overwhelmed?

Don’t be. One of the most important things for organizations to keep in mind is that cultural competence is an evolving, active process; it’s not something that is attainable overnight. In fact, some researchers say there is a cultural competency continuum. The takeaway here is that every step you make towards becoming a culturally competent organization is a step in the right direction.

Want to learn more?

There are plenty of resources floating around the Internet that address cultural competence. Here are a few that you may find helpful:

National CLAS Standards

The National CLAS Standards are a set of guidelines that aim to reduce health care disparities and advance health equity. COA developed a crosswalk to demonstrate how COA standards align with the National CLAS Standards and support the provision of culturally and linguistically responsive services.

National Center for Cultural Competency (NCCC)

The National Center for Cultural Competency (NCCC) aims to promote health and mental health equity through the promotion of culturally and linguistically competent service delivery systems and offers a variety of resources and publications geared towards the promotion of cultural competence.

Standards and Indicators for Cultural Competence in Social Work Practice

Are you a social worker? The National Association of Social Workers (NASW) developed standards and indicators for cultural competence in social work practice.

Substance Abuse and Mental Health Services Administration (SAMHSA)

The Substance Abuse and Mental Health Services Administration (SAMHSA) provides a host of information around cultural competency in the field of behavioral health. Check out this manual which focuses on helping providers and administrators understand the role of culture in the delivery of mental health and substance use services.

Okay, your turn!

What are some challenges your organization faced in this area and how have you attempted to overcome them? Can you share any tips, tools or resources that lead to your success? Please leave a comment below and help others learn from your experiences.

When beginning the accreditation process – specifically the completion of the Self-Study – one of the most intimidating challenges can be trying to figure out how to organize the work and delegate it to your staff. You don’t need a certificate in project management to accomplish this task (although having one won’t hurt!). What you do need is prep time, focus, and a solid understanding of what’s expected.

This post will discuss how to form effective workgroups that can assist your organization with completing the necessary work in order to achieve accreditation – and hopefully improve your organization’s operations as well. Now let’s get started.

When talking with organizations in COA’s network, we see a variety of types of workgroups. Some small organizations do not form new workgroups; they simply utilize a currently existing structure to fill the role. On the other hand, large organizations may develop multiple workgroups that focus on different aspects of the Self-Study.  Only the organization can determine what the best model is going to be, but we can certainly explore some basic characteristics.

According to Kozlowski, S. W. J., & Bell, B. S. (2013), workgroups have the following qualities:

• They consist of two or more people
• Their participants are part of the same organization
• They have a common goal
• Their tasks are completed together and individually
• They involve social interaction
• They retain boundaries established by the organization
• They are part of the culture of the organization

One is the loneliest number

If your workgroup only consists of you thenyou should probably revisit your plan to achieve accreditation. Even for small organizations, all levels of staff should be involved in some way. There are multiple benefits to involving many people. First off, staff will have a better understanding of the importance of accreditation if they are embedded in the process. If the process is presented to them in a positive way then they can take ownership. A common question is “how can you present accreditation to staff in a positive way?” While it’s difficult to imagine how anyone can view accreditation in a negative light, talk with your staff – particularly those that you want to engage in workgroups – and bring the focus to achieving client outcomes. The purpose of accreditation is to improve outcomes for those that receive your services. Every action that takes place in accreditation should be tied to the end user: the consumer.

Another way that staff can buy-in to participating in a workgroup is to view it as a professional development opportunity. In fact, you would be remiss if you didn’t. Think about your shining case managers, clinicians, administrative assistants, residential managers, and foster care workers who have impeccable paperwork, organized with to-do lists, and always volunteer for new projects. Working on COA-related activities can improve their administrative and leadership skills, expand their knowledge of social service management, and program development.

“Every action that takes place in accreditation should be tied to the end user: the consumer.”

A chance for collaboration!

Another commonality in workgroups is that they are all part of the same organization. Note that it’s within the organization, but not necessarily within the same department, division, or satellite office. Workgroups foster cross-departmental collaboration. For example, let’s say that you are going to create a workgroup that focuses solely on drafting and reviewing procedures for the organization.  For medium-large organizations, having this type of committee helps ensure that there is consistency across the organization, standards are still being met, and duplications are avoided. Including staff from different departments and different levels can provide different perspectives. Perhaps a member of management reviews a procedure and thinks “wow, this is great and will really help improve the reliability of our data.” Then a member of the direct service staff, who is also part of this committee, reviews the same procedure. She may have a comment such as “the intent of this procedure is spot-on, but the ability to put this in practice is unrealistic.” What’s better than a well written procedure? – A procedure that is actually practical. Having a diverse group of individuals within your organization as part of the accreditation workgroup is essential to change that is effective.

Find common ground

Common goals are an essential characteristic of workgroups. Having common goals relates to proper planning. If you establishing one committee or 3 committees to complete the work, there needs to be a goal that is achievable. You may think, “The goal is to get accredited.” Good point, that is the goal, but that’s the goal of the entire organization; not of the workgroup. The workgroup’s goal may be to establish a working PQI system, assess current practices to COA standards, or assemble the Self-Study.  The goal of each workgroup will clearly delineate its role in completing the larger mission: achieving accreditation – and as we discussed earlier ­- to improve outcomes for consumers.

To further break down the goal, we need to identify specific tasks that support the actual completion of the workgroup’s goal. Planning, again, comes into play. Recognizing that planning is not everyone’s strong suit, there are some resources out there to assist. While COA doesn’t endorse any specific resource, we do find these helpful. Meister Task is an efficient task management application that can be used to organize individual tasks as well as collaborative tasks. Consistent with our definition of workgroups, there are both individual tasks and tasks that people must work on together. This web application can help support and provide structure to both. Another great application is Wunderlist.  It provides some of the same functionality with a different style. If you are not quite ready for that level of organization and need some foundational support, try reading Getting Things Done: The Art of Stress-Free Productivity by David Allen. It’s an easy read that will help you organize your life, as well as your accreditation work. Remember, if you do utilize any of these resources, it’s recommended to take a full day to sit back and focus on implementing these systems for your work.  

Assigning the work

However you handle the workload, a workgroup has tasks that are completed individually and some that are completed by more than one person or a subgroup of the committee. When tasks of the workgroup are being assigned to its members you will want to consider the strengths and weaknesses of each member. Initially, it may be your gut reaction to assign tasks that are good matches to individuals’ strengths; however, also consider matching someone’s weakness to a task to help them further develop. Perhaps pairing that person with someone who does have more experience can be a great learning opportunity. Make the most out of your accreditation experience and use it to support a positive learning environment.  Maybe you can even develop mentorships within your staff, with the accreditation work as the central theme.  

Involve social interaction, have you ever tried to hold a committee without social interaction? Typically that’s an email with directives to everyone involved with no discussion. Sometimes effective; most of the time not. At the beginning of the process of forming your workgroups, you will be concurrently developing the buy-in of the workgroup members. Meeting in-person, with sugary treats, that typically helps (personal favorite: Insomnia Cookies). If you can’t have fresh cookies delivered, consider holding the meeting outside of your organization, at least for the first time.  Use this common goal, develop strong collegial bonds that last past COA Accreditation. And finally, manage your meeting efficiently. Here are some tips from Mindtools.com.

Introducing accreditation to your culture

Maintaining boundaries that are consistent within the organization may be a little bit more challenging for an accreditation workgroup. The group may be perceived by others in the organization as closed-off or working on something has nothing to do with the rest of the staff. One remedy for this perception is to provide communication about the status of the workgroup throughout the process to the rest of the organization. The workgroup is not charged with setting completely new and rigid policy, determining who at the organization is underperforming, or planning a coup d’état. Transparency is key, solicit feedback from staff who may not be directly involved. Always ask for volunteers, although don’t expect a waitlist. The accreditation workgroup is not a clique; it is a model for how people work as a team to achieve a seemingly insurmountable task.

Lastly, it is important to maintain key components of the organization’s culture. You can expect shifts, bumps and slides during the process, but the core of your organization will grow stronger. Your culture is the cornerstone of stability for your staff, who spend 40 hours of their lives there each week. It is a safe place for consumers whose lives you change. It is part of the connective tissue that holds your community together. Change may be inevitable but the culture of your organization is the reason for your continued success.

Share your tips!

What tips do you have for developing a strong workgroup or sustaining it once it is in place?  Please leave a comment below and help others learn from your experiences.