(WITHDRAWN) Factors Impacting Caseload of Frontline Workers: Can a Measure of Caseload Acuity be Used to Predict Retention?

Background and Purpose: The purpose of this study is to better understand what challenges caseworkers face in their roles and how certain kinds of cases translate into higher distress and turnover. The agency’s current caseload calculations are not well-understood by frontline workers, creating confusion and resentment for staff. Our aim was to mirror acuity research in nursing fields to explore possibilities of reducing sources of stress. During phase I of this study, we conducted listening sessions with front line staff to identify domains of acuity and administered surveys for participants to rate the importance of each domain on assessments of different kinds of child welfare allegations.

During phase II, the study has focused on the impact of caseload acuity on family case manager(FCM) turnover. Using the factors found during phase I, we aimed to investigate whether caseload acuity predicted turnover.

Although the purpose of our study was to address an openly held agency goal, partners holding relevant data often were unwilling to share access to nor helpful knowledge and context of that data. The democratization of leadership and problem-solving in our world requires the democratization of information. We explore insights not only from our research but the process of conducting it.

Methods: Caseworkers in 2 listening sessions identified 8 key domains. Those 2 listening sessions and 6 additional listening sessions rated assessments of different kinds of maltreatment allegations on each of these domains. After Z scores were calculated from the FCM ratings of these different factors based on allegation type, these factors were applied to actual assessment data from the case management system to create scores of acuity on the caseworker level. This allowed us to identify factors associated with higher likelihood of turnover. This study was conducted using data collected from the Indiana Department of Child Services (INDCS) electronic case file system and data from the INSPD database of INDCS employees.

Results: During the listening sessions, caseworkers identified the following 8 domains as impacting the stress of conducting an assessment: incomplete or inaccurate information, expectation of documentation and meeting deadlines, concerns for their own physical safety, the presence of substance use, compliance of participants, and collaboration with partners both internal and external to the Child Welfare agency. We found that caseload acuity was much better explained by a variety of case factors than a simple count of cases. Moreover, there are several important factors to consider beyond workload when explaining the complexity of turnover in child welfare.

Conclusions: There are many barriers to accessing information to properly evaluate the child welfare system. If we want to improve the system, we need access to vital information to properly study exceptional issues in the system, such as turnover. Most studies focused on turnover in child welfare use intent rather than turnover. This study was able to gain access and combine worker level turnover data and data about the casework preceding turnover. We discuss how continuous quality improvement creates accountability for the availability – and democratization- of data in pursuit of goals.