Making "stone soup": improvements in clinic access and retention in addiction treatment.
BACKGROUND
The Network for Improvement of Addiction Treatment (NIATx) provides 39 treatment organizations with collaborative learning opportunities and technical support to reduce waiting time between the first request for service and the first treatment session, reduce the number of patients who do not keep an appointment (no-shows), increase the number of people admitted to treatment, and increase continuation from the first through the fourth treatment session. ACADIA'S STORY-TREATMENT ON DEMAND: Given capacity constraints, only 25% of the clients scheduled for outpatient care at Acadia Hospital (Bangor, Maine) showed up for their assessment appointments, and only 19% made it into treatment. A variety of changes were introduced, including increasing staff availability to provide clients with assessments immediately on arrival (at 7:30 A.M.), establishing a clinician pool to handle client overflow, and allowing for same-day admission to intensive outpatient or chemical dependency services. These process improvements reduced the time from first contact to the first treatment session from 4.1 to 1.3 days (68%), reduced client no-shows, and increased continuation in treatment and transfers across levels of care.


CONCLUSIONS
The successes experienced by organizations in the NIATx initiative should be useful for implementing change in other fields of service delivery.
Capoccia
Victor A
VA
Robert Wood Johnson Foundation, Princeton, New Jersey, USA.
Cotter
Frances
F
Gustafson
David H
DH
Cassidy
Elaine F
EF
Ford
James H
JH
Madden
Lynn
L
Owens
Betta H
BH
Farnum
Scott O
SO
McCarty
Dennis
D
Molfenter
Todd
T
D001071:Appointments and Schedules; D017598:Efficiency, Organizational; D006265:Health Care Coalitions; D006297:Health Services Accessibility / Q000458:organization & administration / Q000592:standards; D006778:Hospitals, Psychiatric / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008281:Maine; D010349:Patient Compliance / Q000523:psychology*; D017060:Patient Satisfaction; D010865:Pilot Projects; D017064:Process Assessment, Health Care; D016320:Substance Abuse Treatment Centers / Q000592:standards* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D017749:Total Quality Management