The effects of performance feedback on the safety of client lifting and transfer.

Individual written and verbal performance feedback was examined to determine its influence on the safety with which physically disabled clients were transferred. Two client-transfer techniques were task analyzed and six direct service providers' on-the-job performance was measured weekly. A multiple baseline across settings and subjects was used to evaluate effects of the feedback. Consumer satisfaction and the costs of the procedures were also assessed. Results showed that feedback was consistently followed by improvements in safe performance. These improvements tended to maintain as feedback was faded. Participants favorably rated the feedback procedure and consistently recommended its use with other staff

Improving Safe Consumer Transfers in a Day Treatment Setting Using Training and Feedback

An intervention package that included employee training, supervisory feedback, and graphic feedback was developed to increase employees' safe patient-transfers at a day treatment center for adults with disabilities. The intervention was developed based on the center's results from a Performance Diagnostic Checklist (PDC), which focused on antecedents, equipment and processes, knowledge and skills, and consequences related to patient-transfers. A multiple baseline (MBL) across two lifts (pivot and trunk), with one lift (side) remaining in baseline was used to evaluate the effects of the treatment package on three lifts commonly used by three health-care workers. The results indicated a substantial increase in the overall safe performance of the three lifts. The mean increase for group safety performance following intervention was 34% and 29% over baseline measures for the two target transfers, and 28% over baseline measures for the nontargeted transfer. The implications of these findings suggest that in settings where patient transfers are frequent and injuries are likely to occur (e.g., hospitals, day treatment centers), safe lifting and transferring behaviors can improve with an efficient and cost-effective intervention

Evaluating the Relative Effects of Feedback and Contingent Money for Staff Training of Stimulus Preference Assessments

Performance feedback has facilitated the acquisition and maintenance of a wide range of behaviors (e.g., health-care routines, seat-belt use). Most researchers have attributed the effectiveness of performance feedback to (a) its discriminative functions, (b) its reinforcing functions, or (c) the combination of the two. In this study, we attempted to evaluate the relative contributions of the discriminative and reinforcing functions of performance feedback by comparing a condition in which the discriminative functions were maximized and the reinforcing functions were minimized (i.e., performance-specific instructions without contingent money) with one in which the reinforcing functions were maximized and the discriminative functions were minimized (i.e., contingent money with no performance-specific instructions). We compared the effects of these two conditions on the acquisition of skills involved in conducting two commonly used preference assessments. Results showed that acquisition of these skills occurred primarily in the condition with performance-specific instruction without contingent money, suggesting that the delivery of performance-specific instructions was critical to skill acquisition, whereas the delivery of contingent money had little effect