Perkins School for the Blind Transition Center

Designing Databases That Drive Continuous Improvement for Clients and Organizations

Today’s classrooms are often filled with technology, some not even imagined just a decade ago. Tablet computers loaded with educational or communication software, PC stations, iPods, Augmentative and Alternative Communication (AAC) devices, and Wi-Fi internet service are all commonplace. They serve various uses including data collection, communicating, skill acquisition, or reinforcement.

This article will focus on the technologies that help collect and analyze data across students, classes, programs and schools. These solutions offer teachers the tools to deliver individualized treatment to their student in a timely and effective manner while providing the organization with the information it needs to continuously improve on key areas of quality and effectiveness.

Individual Treatment Solutions

Delivering evidence-based teaching strategies competently and effectively often requires a tremendous amount of measurements, data-collection, calculation and analysis. Technology can assist the teaching process dramatically by providing real-time data collection, calculations of results, automation of the workflow processes, graphing and reporting, assessment data, analysis tools and automation of agency and governmental requirements. Such technology improves the speed of delivery and shifts thousands of hours of teacher time from data-entry work to working with the students.

Due to the data-intensive nature of evidence-based teaching methodologies like Applied Behavior Analysis, much of the focus of custom technology solutions revolves in some part around a database. A database is basically a central repository into which all forms of data from around the organization can be collected, organized, reported, graphed, charted, compared and otherwise analyzed. Databases can be programmed directly to include automation of workflow, reporting and more, or it may collect data from a separate “front-end” program or web application the organization has developed.

Designing a database and program that is right for your school requires both a bird’s eye view of the organization and a detailed understanding of the day-to-day tasks each member of your staff encounters. Melmark, for example, designed and programmed their proprietary academic and clinical database over seven years ago from the ground up. This program automates the academic and clinical data collection as well as all the graphing and reporting requirements. Implementing this program freed each direct staff member from approximately two hours of data and report preparation per week, equating to thousands of hours per year shifted from paperwork to working with the students. Additional databases at Melmark serving the individual include weight and BMI trackers, bowel movement and menses trackers, sleep charts and proprietary bed-checking hardware and software.

The data from all of these sources are available for real-time analysis and are prepared for formal analysis every two weeks. Some of the databases include business processes as well: if a client has no bowel movement after three days, the program detects and reports that; or if an overnight staff member misses their 15 minute bed-check, a supervisor is automatically and immediately notified by text message alarms.

Organizational Solutions

Whether it’s policies or procedures, environment variables or staff support and training, every organization has room for improvement. Strategically selected data sets – when regularly analyzed by a qualified team of clinicians and administrators – provide the information the organization needs to guide continuous improvement in outcomes for clients. The key to organizational data analysis is discovering just the right type of data to take and the best way to report on that data for analysis: too much data and important findings get lost in the static, too little and the data bears no fruit.

Melmark has several organization-wide database applications that track detailed data regarding unusual incidents, Workers’ Compensation claims, protective holds and much more. Each database has a front-end program to make data-entry a quicker and easier process than paper and pen, a workflow to ensure the electronic forms are routed to the appropriate employees for review and electronic signatures, output capability for sending the completed reports to governmental agencies, parents and other parties, and reporting capabilities for regular review by the senior clinical team.

When many people think of graphing organizational data, they think numbers like frequency of events or amount of time involved in incidents. While important, the real gold in the data is in mining actionable information that guides improvement, and that is found in the details. For example, rather than looking at how many incidents occurred in a particular residence, a well-designed database will show you that behaviors or incidents are more likely to occur in the lower bathroom than the any other room. This is actionable information; a clinician can access that particular location and make physical changes to the environment to reduce the issues and then continually assess the data for trends to ensure the changes are effective. Another example of actionable information is reporting on staff injuries across the organization; trends can be established comparing staff injuries to who they were working with, where they were working and in what activity they were engaged. These trends can be evaluated by the clinical team to identify areas for all-staff training, individual staff that could use retraining or client protocols that could be improved, just to name a few. The possibilities for powerful, actionable data are only inhibited by the amount of data and the quality of the data recorded.

Where to Start

Developing a custom database is often a long and cumbersome task, but as you can see, the benefits are well worth it. While there are innumerable considerations involved in designing a database application from scratch, a few basic guidelines can help you get started.

The first step to designing a database is writing a complete “functional specification” – a report that explains in great detail every field and feature, including automation and business processes (workflows) that you want the program to do. This is the guiding document for the development of the program, so make sure to be as complete as possible.

Once your functional specification is written, you can present it to software development vendors for quote. The ideal candidate for a programming team is one that has not only an exceptional programming resume but one that has at least some members in the education field or who are willing to learn the teaching methodologies your school utilizes. You cannot underestimate the importance of having a team that understands your organization and its procedures in detail.

Finally, an on-site project manager must be selected that has both the technical skills and the academic and clinical skills to guide the team through the project development and implementation phases.

Custom databases and applications provide an organization the tools it needs to make competent, evidence-based decisions for their clients and for the organization, and can save thousands of hours of time filling out forms and reporting on data manually. While no database or computer application will ever replace competent staff, teachers and clinicians, technology, when designed and implemented thoughtfully and pragmatically, should be embraced.


 Andrew Shlesinger, MSW, is the Director of Clinical Technology at Melmark. He has been with the organization for over ten years and has extensive experience in database /application programming and academic and clinical treatment of children on the Autism spectrum. He can be reached at

Frank Bird, MEd, BCBA is the Chief Clinical Officer at Melmark. Frank has over 30 years of experience in the field of community-based human service delivery systems. Over his career, he has developed over 50 programs in support of individuals with disabilities. Frank can be reached at

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