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Overview

CO HIV-STIC NIATx Kick-off Training. Overview. November 8, 2011 Colorado Springs, CO. Good Morning!. Linda Frazier RN, MCHES NIATx Coach. Why Process Improvement?. Between clients and clinicians lies a canyon of poor business processes that interfere with care

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Overview

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  1. CO HIV-STIC NIATx Kick-off Training Overview November 8, 2011 Colorado Springs, CO

  2. Good Morning! Linda Frazier RN, MCHES NIATx Coach

  3. Why Process Improvement? • Between clients and clinicians lies a canyon of poor businessprocesses that interfere with care • Customers, (clients, family, staff, payers, referrers), are served by organizational processes • 85% of customer related problems are caused by organizational processes, not people • To better serve customers, organizations must improveprocesses, not improve the staff’s use of existing processes

  4. NIATx: Growing and Making a Difference • NIATx started in 2003 with 13 substance abuse treatment provider organizations • Today, NIATx works with more than 2000 payer and provider organizations across multiple initiatives in 50 states

  5. NIATx Provider Results Reduce Waiting Times:23.6% reduction (82 change projects in 34 agencies) Reduce No-Shows: 32% reduction (51 change projects in 29 agencies) Increase Admissions: 25.3% increase (52 change projects in 25 agencies) Increase Continuation: 13.5% increase (102 change projects in 34 agencies)

  6. Conducting a Change Exercise PDSA cycles • Plan the change • Do the plan • Study the results • Act on the new knowledge Rapid cycle changes • Changes should be doable in 2-3 weeks

  7. Common Goals • Increasing the number of people served • Eliminating waiting lists • Implementing evidenced based practice • Reducing recidivism • Increasing retention NIATx Can Help!

  8. The NIATx Offer Simple and innovative solutions to: • Get people into treatment faster • get more people into treatment • keep them there longer • reduce costs • improve staff morale • increase revenue using existing resources

  9. Box for DC orders in Clerk’s Office & Spreadsheet of new client information for Arkansas DC Team • RESULTS: March & April 2010: Days from Call to Assessment decreased BUT total days from Call to Admission increased by 7 days

  10. MidCoast ARC: Snapshot of calls requesting MAT (15-20/mo); Feb. 2007, 25% of those with opiate addiction with LOC Asses retained past initial eval & all retained able to access suboxone; all who did not engage in treatment (75%) unable to access MAT.

  11. ME STAR SI Retention project NIATx aims: Reduce no shows Increase continuation rates Change Made: Agency level changes

  12. Alabama RESULTS (STUDY) • Change #1: Admission Appts. to Open Scheduling • Baseline: Average number of days between orientation and admission = 12.4 • Post Change: Average number of days between orientation and admission = 2.0 84% decrease in time

  13. Impact In addition to favorable results directly related to the change, we had an unintended positive side effect: • Increased client return rate by nine percentage points (from 76% to 85%), saving counselor time and increasing billing • Business Case: $17,000 per year

  14. Missouri Screen –Admission Days

  15. Missouri Cost Savings- Impact$48,929.00

  16. RESULTS (study) Began AIMS 3/1/11 Avg 8.5/mo Avg 3.4/mo

  17. WI CHANGE CYCLE #1 • Aim: Reduce the time for the response from Defense Attorneys indicating their interest in DTC • Change: Client Services Specialist from State Public Defender’s Office will also contact Defense Attorneys to obtain response • Result: Pre-change = 10 days ( N=28) Post-change = 1.6 days ( N=12) • Act: Adopt the change

  18. SAMSHA TCE/HIV Program • 17 Sites working on admissions, HIV testing, follow-up/continuation. • 30 to 90% increase in clients attending next four sessions after intake in LA. • 10-80% increase in clients agreeing to HIV testing in urban site. • 44-100% increase in completed intake/assessments

  19. What DC Change Teams Say • Small changes can make revenue impact • Clinicians more aware of productivity • [Data] - Analyze your data—it can tell you what the problem is—it’s continuous - look at your data -Turn to Data to Indicate Need for Change & Problem Solving • Rapid cycle testing has given us the opportunity to see that even small changes can have a large impact • Successful collaboration leads to better client outcomes • In addition to favorable results directly related to the change, we had an unintended positive side effect: ---- Increased client return rate by nine percentage points (from 76% to 85%), saving counselor time and increasing billing • Taking time to study the results and process how each member of the team felt about the results or helped to support the decision • Used “WALK THROUGH” for other processes

  20. Ball Pass PDSA • Stand in a circle • Change Leader pass ball to someone not next to them. • After all have touched ball it goes back to the change leader. • Time from beginning to end of cycle • 1 Change at a time • Document results

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