Replication and sustainability of improved access and retention within the Network for the Improvement of Addiction Treatment.
The Network for the Improvement of Addiction Treatment (NIATx) applies process improvement strategies to enhance the quality of care for the treatment of alcohol and drug disorders. A prior analysis reported significant reductions in days to treatment and significant increases in retention in care [McCarty, D., Gustafson, D. H., Wisdom, J. P., Ford, J., Choi, D., Molfenter, T., Capoccia, V., Cotter, F. 2007. The Network for the Improvement of Addiction Treatment (NIATx): enhancing access and retention. Drug Alcohol Depend. 88, 138-145]. A second cohort of outpatient (n=10) and intensive outpatient (n=4) treatment centers tested the replicability of the NIATx model. An additional 20 months of data from the original cohort (7 outpatient, 4 intensive outpatient, and 4 residential treatment centers) assessed long-term sustainability. The replication analysis found a 38% reduction in days to treatment (30.7 to 19.4 days) during an 18-month intervention. Retention in care improved 13% from the first to second session of care (from 75.4% to 85.0%), 12% between the first and third session of care (69.2-77.7%), and 18% between the first and fourth session of care (57.1-67.5%). The sustainability analysis suggested that treatment centers maintained the reductions in days to treatment and the enhanced retention in care. Replication of the NIATx improvements in a second cohort of treatment centers increases confidence in the application of process improvements to treatment for alcohol and drug disorders. The ability to sustain the gains after project awards were exhausted suggests that participating programs institutionalized the organizational changes that led to the enhanced performance.
Department of Public Health and Preventive Medicine, CB669, Oregon Health & Science University, CB669, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States.
Kim A
KA
Hoffman
James H
JH
Ford
Dongseok
D
Choi
David H
DH
Gustafson
Dennis
D
McCarty
D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation*; D000553:Ambulatory Care / Q000706:statistics & numerical data; D015331:Cohort Studies; D003196:Computer Graphics; D003631:Day Care, Medical / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006302:Health Services Research / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008134:Long-Term Care / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D014481:United States