When developing the TMACT, we omitted DACTS’ items that addressed features of the team that were not necessarily defining of ACT program fidelity, albeit likely influential on overall program fidelity. These included two DACTS items: Continuity of Staffing (H5) and Staff Capacity (H6). Despite our excluding these two items, we came to incorporate into the protocol rating rules intended to avoid penalizing teams for periodic, unavoidable staff turnover.
Applied solely to the Specialist Team (ST) subscale, if the specialist position (i.e., ST1, ST4, ST7) was newly filled or recently vacated, we included an option to not rate them on the subsequent performance items (i.e., ST2 and ST3; ST5 and ST6; ST8). The following is a rating guideline example from ST1 (p.68, Part II):
“NOTE: If there is no COD specialist on the team, rate this item as a “1,” but do not rate ST2 and ST3 if COD specialist vacancy has been less than 6 months. Also, rate COD specialists hired within past two months on this item, which will likely be a low rating as they likely are not yet operating fully within their specialty role, but do not rate on ST2 and ST3. If hired more than two months before review, rate new specialist on ST2 and ST3.”
We have observed that the conditions, as listed, are exceedingly forgiving of teams that experience excessive staff turnover, which was not our intention and compromises the scale’s validity. As such, we are enacting the following update, which observes the intention of the DACTS while also continuing to observe our aim to not penalize teams for natural, periodic staff turnover:
“NOTE: There is an option to skip the subsequent ratings for the “In Treatment” and “Within Team” performance items if this position is vacant for a short period, or if recently filled with a new employee. To qualify for this option, the following conditions must be met:
- The position of interest has been vacant fewer than 4 months, or
- The position of interest has been newly filled for fewer than 2 months, AND
- The team has not experienced excessive staff turnover, as indicated by the team rating a 4 or 5 on the DACTS’ H5 Staff Turnover Item, which reflects an annual staff turnover rate of 39% or less.
To calculate an average annual staff turnover rate:
- Refer to the Team Survey #2. The team reports the # of staff who have left the team within the past 2 years (or update if shorter time frame of team operation).
- Determine the total # of positions on the team. Add up the positions listed in the Staffing Table (Item #1), and add in vacant positions. A single part-time position = one position. Two part-time positions = two positions.
- Calculate an Annual Staff Turnover Rate using the below formula (multiply by 100 to get a percentage).
photo by Michal Parzuchowski