5 Ways You Have Been Wasting Your Agency’s Money

Agency Reputation

5 Ways You Have Been Wasting Your Agency’s Money

“I just came from the budget meeting, and it was so discouraging. We have been losing so much money and can hardly understand why.” Dan the COO of the HOPE Center articulated these words to Rodis, the consultant, who then responded, “It all starts with looking at what we are doing or not doing. Let us take a closer look.”

1. Your clinicians are burnt-out:

In a series of articles on Preventing Burnout, I explained that the ramifications of burnout could be devastating for our patients and clients, for our clinicians and advocates, for our agencies, and for the system, as a whole.  I added that one of the consequences of clinician burnout is an increase in patient and client no-show rate, with resulting multiple ramifications that include and are not limited to loss in revenue for the agency, increase in liabilities, and reduction in positive clinical outcomes.  I also described decreased productivity as another effect of burnout and explained that decreased productivity is related to an increase in no-show rate, but there is much more to it.  When clinicians work at their optimal level, they are more likely to be innovative, efficient, dedicated to the work and therefore more focused.  These factors are necessary for productivity, which is dampened by burnout. And this explains one of the ways for wasting your agency’s money, if it goes unaddressed.

2. Your clinicians have limited time for training and supervision:

“I don’t know what to do anymore. Two weeks ago I called 911 for 4 clients, just the space of 2 days.  There was not even enough guidance available for me to know if I was doing the right thing.” Eileen, Matthew’s therapist uttered these words; I narrated this story in a previous article entitled, De-escalation Skills: 6 Reasons Why.  I also described how limited clinical judgments, limited communication skills, and limited documentation were some of the contributing factors to an increase in liabilities, also a cause of increased expenses and waste for our agencies.  Protective time for training and supervision can be seen, at first, as an expense that you and your agency cannot afford.  However, if better viewed as an investment and given the required time, you will start seeing the return; you will realize how much you had been losing and eventually wonder why you took so long to provide protected training and supervision time for your clinicians.

3. Your clinician turnover is high:

“When I first came to the HOPE Care Center, part of my strategic plan was centered around staff recruitment.  In order to make any sustainable change, we would need to have a sustainable staffing matrix. However, soon enough, I realized that more than a recruitment issue, we had a staff turnover crisis, and that needed to be fixed immediately.”  Elena, the Chief Medical Officer uttered these words, almost with resignation.  Staff turnover has several ramifications, including and not limited to expenses associated with consistent staff onboarding and transitioning, decreased productivity, compromise of care, and overall waste.  Staff turnover has a direct impact on the revenue and profitability of your agency, and if you do not stop and seriously address it, you will continue to waste your agency’s money.

4. You adopt a reactive instead of a proactive culture:

In a previous article entitled, Recruiting Successfully: 5 Additional Key Strategies, I described, “Help Keep the End in Mind,” as a key step to successful recruitment.  I explained that once “in the trenches,” it might become easy to lose focus, to forget the big picture, and to lose purpose.  Helping our clinicians and staff to keep the end in mind can help prevent all of this.  Many employees still apply or accept work at an agency because of its vision or mission, and it is our responsibility as leaders to always help keep the end—vision and mission—alive for them.  Unfortunately, all this is easier said than done.  In addition to the front-line staff, the leadership team also tends to adopt a reactive stance instead of a proactive one.  A lack of strategic planning, or root cause or longitudinal analysis, or even an incomplete decision tree are all contributors.  Have you ever stopped and think how much you might be costing your agency by having a reactive instead of a proactive culture?

5. You are damaging your agency reputation:

In a series of articles on restoring, establishing, and maintaining a great reputation for your agency, I offered ten key strategies, many of which, if not appropriately implemented could lead to a waste of your agency’s money.  For example, you may be failing to treat your clinicians, as you would like them to treat your patients and clients.  I often recite that it’s a parallel process.  “We end up treating our clients based on how we feel about ourselves and are treated at our agencies.  We can do our best to manage ourselves, but there comes a time when we experience burn out and all bets are off,” explained Sara, a social worker.  Treating clinicians in the way we would like them to treat our patients and clients is a principle endorsed and encouraged in business.

As explained in the article entitled, Turn Your Organization Around, your front-liners spend the most time with our patients and clients, and providing the best care possible often means keeping front-liners happy.  Treating our clinicians well will trickle down to the care of our patients and clients.  It helps prevent further damage for agency reputation and failure to do so will be financially costly for the agency.

In the article series on agency reputation, I mentioned Carol, the director of the grant department, who met with Rodis, a consultant and stated, “We have been losing grants to other agencies lately. I don’t know what has been going on, but our reputation seems to be slipping away.”

Like Warren Buffet once said, “It takes 20 years to build a reputation and five minutes to ruin it. If you think about that, you’ll do things differently.”  If you think about how you may be damaging the reputation of your agency and how you may have been wasting your agency’s financial resources, you will, indeed, do things differently.

Start by:

  1. addressing burnout for your clinicians,

  2. providing protected time to your clinicians for training and supervision,

  3. addressing your clinician turnover rate,

  4. adopting a proactive instead of a reactive stance, and

  5. paying attention to the overall reputation of your agency.

When would you like to start addressing at least one of these five ways you have been wasting your agency’s money?

Contact us and let us know how we can help.


  1. Berwick, Donald M., and Andrew D. Hackbarth, “Eliminating Waste in US Health Care,” JAMA 307, no. 14 (April 11, 2012): 1513-6.

  2. Bond C, Raehl C, Franke T. Medication Errors in United States Hospitals. Pharmacotherapy. 2001;21:1023–36.

  3. Cohen JT, Neumann PJ, Weinstein MC. Does Preventive Care Save Money? Health Economics and the Presidential Candidates. New England Journal of Medicine. 2008;358:661–63.

  4. Schwab RL, Jackson SE, Schuler RS. Educator burnout: Sources and consequences. Educational Research Quarterly. 1986;10:15–30.

  5. Schulz R, Greenley JR, Brown R. Organization, management, and client effects on staff burnout. Journal of Health & Social Behavior. 1995;36(4):333–345.

  6. Taris TW. Is there a relationship between burnout and objective performance? A critical review of 16 studies. Work & Stress. 2006;20(4):316 – 334.

  7. Curran V, Rourke J. The role of medical education in the recruitment and retention of rural physicians. Med Teach. 2004;26:265-272.

  8. Pilny A, Mennicken R. (2014.) Does hospital reputation influence the choice of hospital? Ruhr Economic Papers #516. November 2014.

  9. Burger J., Giger A. Want to increase hospital revenues? Engage your physicians. Gallup Business Journal. June 5, 2014.