Day in the life of
Chief Clinical Officer – Justin Baksh
I’m the Chief Clinical Officer at Foundations Wellness.
My Typical Day
Variety! That’s one of the reasons the position is appealing. Daily duties involve a wide range of tasks including employee supervision, programming coordination, resolving client issues, resolving staffing issues, auditing charts, reviewing, researching, and implementing policy, program development, intern supervision, and culture development.
Employee supervision: I have been fortunate over my career to supervise licensed professionals, non-licensed professionals, administrative staff, and medical staff. There has been supervision of employees at our local facility and our out of state facilities. This included recruiting management for the out-of-state facility and ensuring they were onboarded, trained, and supported correctly. There are also the functions of buffering or delivery of the executives teams/ownership needs.
Programming coordination: Ensuring we are not only in compliance with our licensing and accrediting agencies, but the programming offerings are robust, effective, evidenced-based, and most importantly engaging. Ensuring that the clinical department and all other departments are communicating, supporting, and providing the best care for each client. This function also includes occasional review of groups offered and materials used to ensure we are always up to date and in compliance with the best practices of the industry.
Resolving client issues: This process starts with having an engaging and effective orientation process in place to allow the clients to acclimate. Client issues can range from a client wanting to leave treatment early to family calls/interventions. There is the daily support offered from the client’s clinician but also the overall conceptualization and support from the entire team. Evaluating cases on a 1:1 basis with a treating clinician to ensure the clients goals are met and the clinician has the skills to meet those goals. I have served as a grievance coordinator, venting spot, confronter on maladaptive behaviors within the group/community setting, confronter of positive urine screens requiring stepping up to a higher level of care or being administratively discharged from the program. This has also involved finances from dealing with private insurance requirements, self-pay options, and utilization review measures for maintaining payor status.
Resolving staffing issues: Just as with any business, there are call outs, vacations, and vetting for suitable fit within the organization. Review are completed with ample opportunity to allow growth and correction of any deficiencies. There is also balancing the budget and motivating the team to perform with the number of clinicians on hand. It’s finding creative ways if the bottom line does not support that additional clinician in the moment.
Auditing charts: A typical client chart upon completion ranges from anywhere between 350-600 pages. Most all of them require review and signatures indicating they are correct and in compliance. There is a tremendous amount of screen time involved in a client’s chart in this industry. There is a saying for us, “If you didn’t document it. It didn’t happen”. Also, enforcing good documentation standards with weekly audits completed by the clinical team ensures we are always audit and survey ready from our licensing and accrediting agencies.
Reviewing, researching, and implementing policy: I call this keeping your hand on the heartbeat of the facility. Forever evolving and changing, it is being aware of changes that need to be implemented. There are policies that will always remain consistent and untouched, but there are needed times when staffing, group facilitation, department communication falls, there is the tendency for humans to do what they do best and that is not enforce policies and procedures. Staying abreast of changes and new tech to help deliver the same message but in a different format is beneficial.
Program development: What’s new but more specifically what’s needed. You don’t have to be groundbreaking, but why not bring you agency into the here and now with creating new ways to reach new clients. Allowing your services to be offered in multiple formats or bridging the gap with underserved populations.
Intern supervision: It was once explained to me that supervisors are the gatekeepers of the industry, no matter the industry. This is something I let every intern know that they will grow to bother personally and professionally with their time with us. As a receptor of both bachelors and master’s level graduates, we offer 3 months to 1-year long internships. These interns eventually learn to run groups, completed assessments, master treatment plans, weekly notes, and then discharge planning. They learn the nuances of navigating psychotherapy sessions, family interventions, and calls, and confronting clients. It’s supervising the transition from book learned know to on-the-job training.
Culture development: This is what the key to it all is. When you create an atmosphere where employees thrive and feel empowered then the clients also feed off that energy. It is an atmosphere of inclusion, diversity, appreciation, but most important raw transparency and fun. Being able to blow off steam with your peers who also help hold you accountable for getting your paperwork completed on time is what a work environment should be…at least in my opinion.
Pros and cons
See above! The autonomy and freedom granted me comes from being able to demonstrate over the past 5 years that all these items above and the ones not listed are huge pros. I leave you with this…one of my mentors in this field explained it to me once…if you create a program that works, is effective, evidence-based, and engaging, then the program serves just as well as an individual session. I’ve created this above through my role as a Chief Clinical Officer.
