Timothy Zercher 0:00

Well, Nick, thank you so much for joining us. We really appreciate you taking time. Certainly. Absolutely. So let's jump right in. First question I want to ask is what led you to start Great Day ABA?

Nicholas Klinkefus 0:11

Yeah. So I finally decided to start my own company because I love home-based care and I've done it for the vast majority of my career. I think there's just such a valuable opportunity to support clients and families, like in that most natural environment. And at least here in Des Moines, they're with so much effort in the clinic space and there's so many clinic providers. There was just that lack of service for families who might need a different kind of service modality. So it was just seemed like a natural opportunity to provide something that I feel like I'm good at and can meet a lot of needs for people in this community. So that's kind of one of the main reasons why we started a great day. But I think that was really all so centered on just how I became very obsessed with burnout and the turnover problem that we have in this field. And I think those two things just pushed me to finally decide just to go for it and commit to the work. So here we are.

Timothy Zercher 1:05

That's awesome. I think related to burnout, you've been pretty outspoken about compensation culture and like ethical practices in ABA. Where do you think the biggest tension exists today between business growth and clinical quality?

Nicholas Klinkefus 1:19

Yeah. I think it centers around the RBT position. I think anyone who's done this work for a while can say that like this work depends on RBTs. And yet the industry at large is kind of in this cycle in this pattern of providing the bare minimum to RBTs and then bemoaning the state of the turnover issue. I mean, data shows that average providers are having annual turnover rates of 70 plus percent, with some data suggesting that that turnover rate is over 100% annually. And when providers are continually having to replace their workforce because they are providing the bare minimum training and there's bare minimum support, and RBTs like on the brunt of camp client cancellations and they don't have pay predictability. And we're just designing this position to be unsustainable that filters down and has really detrimental effects not only on the clinical quality of care, it affects BCBA burnout, it affects families' commitment to services when they're continually dealing with the revolving door of RBTs. So I think that divide is something that's becoming much more apparent and much more important for us to be thinking about as providers who say that we're committed to providing quality of services and yet still keep doing the same things that contribute to an ongoing problem.

Timothy Zercher 2:46

Absolutely. But it's that doing the same thing and expecting a different result is the definition of insanity, right?

Nicholas Klinkefus 2:51

I'm different. I can make it happen. And then it's like, no, we know that this isn't working.

Timothy Zercher 2:56

Yeah, that makes complete sense. And so a lot of your work focuses on OBM and kind of staff performance. What have you learned about building systems that actually support clinicians instead of creating that constant burnout cycle?

Nicholas Klinkefus 3:10

I think that's what I really like about OBM, that organizational behavior management. It's we spend much more time thinking about that employee experience and their motivations and how can we support them in completing the work that we want them to do. I think there's something much more effective for clinicians when you're not just setting up hoops for them to jump through, but you're designing these systems. So that way all these things flow more naturally. There's a lot of requirements in this industry, obviously, with this everything happening in the macro environment. And the more time that you can spend designing a system that decreases the response effort for these boring, tedious, unfortunately, incredibly vital tasks. And then rather than filling in that time with more things that burn providers out, you give them, spend their time on the things that they actually enjoy and the things that gives them purpose and excitement about this work. And I think that's where proper use of AI can be really helpful and kind of helping mitigate some of that. But I think it really just comes down to where these systems are getting place and how they're being designed to actually improve not just operational outcomes, but like in the employee experience. And that goes a long way, I think.

Timothy Zercher 4:26

Absolutely. Yeah, the experience is better than the burnout, will be reduced almost always. So you've grown your organization quite a bit. What have you found is the hardest part of growing?

Nicholas Klinkefus 4:37

I think it's that culture. I mean, as we're a culture-led organization, that's like one of our strengths, and it's what I worry about the most. I've worked for organizations that have small company culture feel, and then as they go through their growth stages, the culture gets neglected and then it gets forgotten about. And then I make the joke that your values just end up becoming a poster on the wall and they don't really matter. So I think as we're going through our growth, I mean, we're still a young practice, we have a lot of the long road ahead of us, but it's something that I'm trying to be very mindful about always, because that employee experience in that culture is what we're based on. So it's something that we need to hold on to. And so it's trusting others to be representative of your culture. And it doesn't always have to be me doing those things. And that's hard for me personally as we're going past the oh, this isn't just my baby, this is actually a thing that other people are contributing to.

Timothy Zercher 5:34

Yeah, it's always hard as a founder to start letting go of pieces and saying, Cool, this is your problem now, this is your territory, and I'm gonna stay out of it. It's not easy.

Nicholas Klinkefus 5:44

Absolutely. And to vote being the bottleneck because you want this to grow, you want this to be all the things that you want it to be. So it's a we're in that fun limbo period right now, and I'm having the best time with it.

Timothy Zercher 5:56

That's awesome. That's awesome. As long as you realize that's a problem, that's the first step in getting past it, you know? Every day. Yep, absolutely. As long as you realize you're the problem. So because we're a marketing agency that specializes in this space, we always have to ask some marketing questions. The first one is what works best for you right now, especially outside of word of mouth when it comes to client acquisition.

Nicholas Klinkefus 6:15

Yeah. We've been really focused on that referral relationship development and really getting out there in the community. I think we take our role in this community really seriously. Anyone can spend thousands of dollars on Google ads and they do get the job done, don't get me wrong, but no one remembers a Google ad. So we've been really focusing on partnering with other providers, showing up for like other nonprofit organizations that support this community and showing up for them and seeing how we can help them in their mission and support them. And that's been really instrumental for us getting our brand awareness out there and getting our name out there as a new provider. And it ends up hopefully in the long term, developing more of that long-term referral relationship where that can lead to the client acquisition that we will need to continue growing as a practice. Recently, we did a sensory-friendly screening of the Mario movie and hosted that for families. And we were intentional in not making it a big marketing thing. We didn't shove brochures in everyone's hands and subject them to a three-minute infomercial about Great Day before the movie started. We wanted to create that experience and create that memory for families. I mean, we heard from so many of them that it was their first time being able to have that experience in a movie theater with their child. And that's a memory that they now have. And if that means that when they think about ABA in the future, they might remember us and think, hey, that was cool. Something that they did, maybe I'll give them a call. So that's what we have found so far, has been working for us. So far, so good.

Timothy Zercher 7:50

Yeah. No, that makes complete sense. The grassroots effort, like the connection by connection piece, I think is something that people often miss when they talk about marketing. Good marketing, including Google ads and digital ads and websites and all that, needs to be built on like a strong grassroot foundation. And almost always. That makes a lot of sense. What is one marketing tactic that you're either just watching really carefully in the marketplace right now or that you're actually considering for your team?

Nicholas Klinkefus 8:17

Yeah, I think short form video is something that I've been thinking a lot about. I mean, the shorts on TikTok, Instagram reels. I think there's something there about being able to show prospective families or even prospective employees like who we are and what we're trying to do, and have more of that natural opportunity to kind of connect over a video as opposed to picture ads or text posts on Facebook. But I think what gives us pause, aside from being on camera, which is always a hit and miss opportunity, is just there's so much content out there that I think can very much cross a line as it relates to client dignity and how we're talking about this work and the clients that we serve. So I think until we figure out what that balance is and what that line is very clearly interested in and wanting to explore further.

Timothy Zercher 9:07

Yeah, it makes sense. It's a good thing to be cautious about. I think some people dive in too fast and end up hurting clients and hurting their own reputation.

Nicholas Klinkefus 9:15

Yeah. No one wants to do it.

Timothy Zercher 9:17

No, I don't think so. That makes sense. Well, thank you so much, Nick. We really appreciate you taking time out of your day and good luck because you guys keep growing and scaling.