title: Process improvement needs in substance abuse treatment: admissions walk-through results.
abstract: Researchers have questioned whether the addiction treatment infrastructure will be able to deliver high-quality care to the large numbers of people in need. In this context, the Robert Wood Johnson Foundation and the Center for Substance Abuse Treatment created a nationwide network to improve access and retention in treatment. Applicant agencies described results of an admission process walk-through. This qualitative study used narrative text from 327 applications to the Robert Wood Johnson Foundation, focusing on admissions-related problems. We developed and applied a coding scheme and then extracted themes from code-derived text. Primary themes described problems reported during treatment admissions: poor staff engagement with clients; burdensome procedures and processes; difficulties with addressing the clients' complex lives and needs; and infrastructure problems. Subthemes elucidated specific process-related problems. Although the findings from our analyses are descriptive and exploratory, they suggest the value of walk-through exercises for program assessment and program-level factors that may affect treatment access and retention.
authors.affiliation: Center for Health Systems Research and Analysis, University of Wisconsin, Madison, WI, USA.
authors.forename: James H
authors.initials: JH
authors.lastname: Ford
authors.forename: Carla A
authors.initials: CA
authors.lastname: Green
authors.forename: Kim A
authors.initials: KA
authors.lastname: Hoffman
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: Wisdom
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Riley
authors.forename: Luke
authors.initials: L
authors.lastname: Bergmann
authors.forename: Todd
authors.initials: T
authors.lastname: Molfenter
mesh_terms: D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008603:Mental Health; D010343:Patient Admission; D036301:Qualitative Research; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000628:therapy*