How Brellium helped one QA manager coach 500 therapists — without burning out

Elizabeth Zammillo lights up when she talks about employee recognition.

As Quality Assurance and Training Manager at Achievement Behavior Services, Elizabeth oversees the development of more than 500 clinical staff across three states — including hundreds of early-career registered behavior technicians who are learning in real time. She knows firsthand how impactful meaningful feedback is in this field, and what it can cost when it doesn’t arrive.

"Recognition is unfortunately really rare in ABA," she told Brellium. "When it is given, people really appreciate it. They're almost surprised — like, 'wow, you noticed that?'"

Recognizing your employees can make the difference between a talented therapist staying for years or departing for another opportunity, Elizabeth said. But as ABA practices scale, praise is one of the first things to fall through the cracks.

Supervisors have less time to offer individualized feedback and management loses visibility into clinicians’ daily performance. At Achievement Behavior Services, Elizabeth knew this was happening. She just didn't have a way to fix it — until she found an unexpected solution in Brellium.

Achievement Behavior Services decided to partner with Brellium to minimize their compliance risk. Switching note review from a reactive, manual process to a proactive, automatic system instantly offered Elizabeth’s team power to reduce the practice’s audit exposure. It also gave Elizabeth something she hadn't expected: insight into every therapist’s documentation quality, week over week.

Prior to working with Brellium, Elizabeth fielded hundreds of compliance questions from RBTs about common documentation errors from individual therapists — about academic language, vague goals, or notes signed outside the required window.

"It took several hours per staff to follow up each week," she said. "And that's before you factor in looping in the BCBA who supervises them."

Her manual QA processes also caught some errors, triggering another chain of emails, but she didn’t have a process in place to systematically find patterns in clinicians’ notes, which could reveal opportunities for training.

Elizabeth wasn’t confident that she had complete insight into compliance risk, and she wanted to raise the standards for employee feedback and development across the organization.

Once Brellium began automatically checking every therapist's notes, Elizabeth suddenly had a complete, running picture of her staff’s documentation quality over time. Brellium enables Elizabeth’s team of five part-time auditors to do the work of 20 full-time employees. The software reviews every note for errors and develops feedback for staff.

“Brellium is like another admin assistant that is really, really good at their job,” Elizabeth said.

Brellium provided weekly error reports, plus outlined how clinicians were improving quality over time.

With Brellium, Elizabeth sends automated weekly feedback emails directly to each individual therapist and their supervisor. The emails show the therapist's audit pass rate, their most frequent errors, and a plain-language explanation of why the flagged language would fail a review.

The result is a feedback system that runs at a scale no small QA team could sustain manually.

If someone's notes keep appearing in the flagged list week after week, it's a signal to Elizabeth to offer more personalized training and support.

"We are able to catch those people early and really try our hardest to give them a shot — give them all the training we possibly can — where we would miss those people otherwise,” Elizabeth said.

Achievement Behavior Services also uses automated feedback reports to celebrate the workers who consistently complete exemplary notes. Writing session notes is a skill — one that takes time to learn and discipline to maintain. Brellium helps ensure Elizabeth recognizes and commends that dedication.

Achievement Behavior Services is just getting started unlocking the full potential of Brellium for staff training and development, Elizabeth said. The quality assurance team plans to use Brellium emails to create a compliance leader board and will offer rewards for therapists who consistently have the fewest errors in their notes.

The team is also adding therapist coaching to automated emails to encourage therapists to adopt best-in-class language in their notes.

“Right now, the emails tell therapists what language is wrong. I want the emails to tell therapists how they can improve,” Elizabeth explained. "That's the point of Brellium, right? Not only to catch the errors, but help prevent them."

For a QA team that spent years reacting to problems after the fact, that vision of proactive compliance is within reach — and it’s a meaningful shift in what's possible.

Brellium offers Elizabeth certainty that her organization and people are meeting compliance and clinical standards each week. She no longer has to rely on manual spot checks and hope that she’s pulled a representative sample of notes. Like most compliance professionals, she likes to dot the i’s and cross the t’s — Brellium lets her do that, every time.

“I need systems in place and I need organization. That’s why they brought me into this role,” Elizabeth said. “Brellium has just been a huge stress reliever.”