title: Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.
abstract: OBJECTIVE
  To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment.
  
  
  METHODS
  Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS).
  
  
  METHODS
  The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance.
  
  
  METHODS
  Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007-2008.
  
  
  RESULTS
  Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient.
  
  
  CONCLUSIONS
  Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present.
authors.affiliation: School of Global Leadership & Entrepreneurship, Regent University, Virginia Beach, VA 23464, USA. dailfie@regent.edu
authors.forename: Dail
authors.initials: D
authors.lastname: Fields
authors.forename: Paul M
authors.initials: PM
authors.lastname: Roman
authors.forename: Terry C
authors.initials: TC
authors.lastname: Blum
mesh_terms: D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D019538:Health Care Surveys; D006295:Health Resources; D006801:Humans; D008962:Models, Theoretical; D010043:Outcome and Process Assessment, Health Care; D018802:Patient-Centered Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States
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