title: Improving quality of care in substance abuse treatment using five key process improvement principles.
abstract: Process and quality improvement techniques have been successfully applied in health care arenas, but efforts to institute these strategies in alcohol and drug treatment are underdeveloped. The Network for the Improvement of Addiction Treatment (NIATx) teaches participating substance abuse treatment agencies to use process improvement strategies to increase client access to, and retention in, treatment. NIATx recommends five principles to promote organizational change: (1) understand and involve the customer, (2) fix key problems, (3) pick a powerful change leader, (4) get ideas from outside the organization, and (5) use rapid cycle testing. Using case studies, supplemented with cross-agency analyses of interview data, this paper profiles participating NIATx treatment agencies that illustrate successful applications of each principle. Results suggest that organizations can successfully integrate and apply the five principles as they develop and test change strategies, improving access and retention in treatment, and agencies' financial status. Upcoming changes requiring increased provision of behavioral health care will result in greater demand for services. Treatment organizations, already struggling to meet demand and client needs, will need strategies that improve the quality of care they provide without significantly increasing costs. The five NIATx principles have potential for helping agencies achieve these goals.
authors.affiliation: Department of Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., CB 669, Portland, OR 97239, USA. hoffmaki@ohsu.edu
authors.forename: Kim A
authors.initials: KA
authors.lastname: Hoffman
authors.forename: Carla A
authors.initials: CA
authors.lastname: Green
authors.forename: James H
authors.initials: JH
authors.lastname: Ford
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: Wisdom
authors.forename: David H
authors.initials: DH
authors.lastname: Gustafson
authors.forename: Dennis
authors.initials: D
authors.lastname: McCarty
mesh_terms: D016739:Behavior, Addictive / Q000628:therapy; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D019982:Organizational Case Studies; D009936:Organizational Innovation; D010358:Patient Participation; D018802:Patient-Centered Care; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards*; D012424:Rural Population; D016320:Substance Abuse Treatment Centers / Q000592:standards* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000628:therapy*; D013637:Tape Recording; D014505:Urban Population