Q. Our managers know that we have our consultation meeting every Wednesday but frequently schedule people to do shifts so they can’t attend. What can we do?
- Validate how hard it is for managers to balance all the goals of the organisation.
- Remind the management of the cost of the DBT training that they have invested in.
- Make your requests for cover in writing highlighting that DBT patients are risky and consult is part of assuring safe practice.
- Speak to managers before the rotas come out for the next period asking for DBT to be prioritised. Do this on every occasion that the current rotas are problematic.
- Record patient improvements in DBT and present this to managers linking improvements to therapists’ attendance at consult for supervision.
Q. People are often late or cancel at the last minute in favour of doing other things. What can we do?
- This is a therapy-interfering behaviour. The function of the behaviour may be different in each case so it is important to do a chain analysis. The function of the chain is not to punish, but to problem-solve.
- Put non-attendance onto the target hierarchy for the therapists for whom this is a problem. Check out how the solution-implementation is going
- New teams are often quite good at addressing non-attendance but then relax over time, so that people stop doing chains and problem solving. Have regular reviews to monitor slippage.
- Review what people are getting out of consult. The best way to get people there is to make it a very valuable experience. People prioritise things they want to do. Is your consult relevant and helpful?
Q. One of our therapists is very busy and has asked if she can attend fortnightly. Is this ok?
- The evidence-base is for weekly consult meetings.
- Beware of unintended consequences to agreeing to this request. With consult meetings being perceived as staff-intensive and costly, commissioners are often looking for ways to cut corners. Once one person is attending fortnightly, why would they pay for everyone else to come weekly? If you already have protected time then use it or lose it.
Q. How do we stop our meetings being overtaken by business discussions?
- One suggestion is to have a separate business meeting, say once a month.
- Keep business items to the last part of the meeting.
- Conduct business discussion via e-mail, circulation sheet or notice board.