2010 SAAS National Conference and NIATx Annual Summit

1. 2010SAAS National Conference and NIATx Annual Summit Implementing the NIATx Model In A Statewide Case Management Organization Presentation TitlePresentation Title

2. 2010SAAS National Conference and NIATx Annual Summit Specifically, �How TASC implemented the NIATx model throughout the state of Illinois during an unprecedented human services budget crisis.�

3. 2010SAAS National Conference and NIATx Annual Summit Or, to be really specific, �How TASC made mistakes but persevered in implementing the NIATx model throughout the state of Illinois during an unprecedented human services budget crisis (that has no end in sight).�

4. 2010SAAS National Conference and NIATx Annual Summit TASC Who are we? (Treatment Alternatives for Safe Communities) A statewide Illinois non-profit organization Offering behavioral health recovery case management services for individuals with substance abuse and mental health disorders. At 30 locations, with 300 staff, serving 25,000 clients annually.

5. 2010SAAS National Conference and NIATx Annual Summit TASC is not a funded NIATx agency. And, we are not treatment. But our funders and CARF like NIATx very much!

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7. 2010SAAS National Conference and NIATx Annual Summit So, how did this happen? (Hint: implementing NIATx is itself a change project)

8. 2010SAAS National Conference and NIATx Annual Summit Evolution of NIATx At TASC: Before the Crisis April , 2008: Staff Attended NIATx Change Leader Academy October, 2008: Presentation of TASC Change Leader Academy (TCLA) Plan November 2008: Beginning of Local Change Pilots April, 2009: Presented NIATx Model to Administrators May 2008-June 2009: Local Offices Launch Projects May-June, 2009: Regional Work Shops Conducted

9. 2010SAAS National Conference and NIATx Annual Summit Evolution of NIATx At TASC: During & After July 2009: Agency-Wide Furlough September, 2009: State-wide PI Project Resume 2010: Launch of Operations Leadership Team (OLT) Process Improvement Project 2010: OLT PI Project Cycles: Supervisor Surveys 2010: OLT PI Project Cycles: Development and Testing of Targeted Curriculum 2010 VP C. Ross� Email Announcing New PI Plan, New Projects Due to VP Ross, Administrators Present Projects to QI Director

10. 2010SAAS National Conference and NIATx Annual Summit April, 2008: NIATx Change Leader Academy Four staff, 3 administrators and QI manager, attend the NIATx Change leader Academy in Madison. The group is certified in December 2008 following the completion of a change project in the Edwardsville office focusing on improving show rates for assessments at treatment providers.Four staff, 3 administrators and QI manager, attend the NIATx Change leader Academy in Madison. The group is certified in December 2008 following the completion of a change project in the Edwardsville office focusing on improving show rates for assessments at treatment providers.

11. 2010SAAS National Conference and NIATx Annual Summit NIATx Model & Organizational Culture Four staff, 3 administrators and QI manager, attend the NIATx Change leader Academy in Madison. The group is certified in December 2008 following the completion of a change project in the Edwardsville office focusing on improving show rates for assessments at treatment providers.Four staff, 3 administrators and QI manager, attend the NIATx Change leader Academy in Madison. The group is certified in December 2008 following the completion of a change project in the Edwardsville office focusing on improving show rates for assessments at treatment providers.

12. 2010SAAS National Conference and NIATx Annual Summit The TASC Change Leader Academy October 2008: The Original Plan The foundation of the model is the replication of the Change Leader Academy model within the organization. The TASC Change Leader Academy (TCLA) is comprised of staff that completed the change leader trainings conducted by NIATx in Madison WI and Chicago, 2008. The TCLA provides training in the NIATx process improvement model to local TASC staff, including TASC Directors and Administrators. The TASC CLA training curriculum replicates the training materials presented in Madison and Chicago, condensing the two-day training into one day. The training of local staff in the NIATx model is initiated at request of TASC Administrators to TASC QIC, who in turn facilitate the schedule and location of face-to-face trainings by TCLA members. The assigned TCLA trainers serve as the local change team�s ongoing sponsor and participate in a call-in to the PI change team meetings. The TASC Change Leader Academy October 2008: The Original Plan The foundation of the model is the replication of the Change Leader Academy model within the organization. The TASC Change Leader Academy (TCLA) is comprised of staff that completed the change leader trainings conducted by NIATx in Madison WI and Chicago, 2008. The TCLA provides training in the NIATx process improvement model to local TASC staff, including TASC Directors and Administrators. The TASC CLA training curriculum replicates the training materials presented in Madison and Chicago, condensing the two-day training into one day. The training of local staff in the NIATx model is initiated at request of TASC Administrators to TASC QIC, who in turn facilitate the schedule and location of face-to-face trainings by TCLA members. The assigned TCLA trainers serve as the local change team�s ongoing sponsor and participate in a call-in to the PI change team meetings. The TASC Change Leader Academy October 2008: The Original Plan The foundation of the model is the replication of the Change Leader Academy model within the organization. The TASC Change Leader Academy (TCLA) is comprised of staff that completed the change leader trainings conducted by NIATx in Madison WI and Chicago, 2008. The TCLA provides training in the NIATx process improvement model to local TASC staff, including TASC Directors and Administrators. The TASC CLA training curriculum replicates the training materials presented in Madison and Chicago, condensing the two-day training into one day. The training of local staff in the NIATx model is initiated at request of TASC Administrators to TASC QIC, who in turn facilitate the schedule and location of face-to-face trainings by TCLA members. The assigned TCLA trainers serve as the local change team�s ongoing sponsor and participate in a call-in to the PI change team meetings.

13. 2010SAAS National Conference and NIATx Annual Summit October, 2008: Presentation of TCLA Plan Pro: Plan used staff trained in by NIATx; replicated NIATx curriculum; addressed scheduling needs of local offices. Con: Condensed 2-day workshop to 1-day; left initiative at local level minus agency wide vision; underestimated logistics of strategy, including availability of certified staff.

14. 2010SAAS National Conference and NIATx Annual Summit November 2008 Local Change Pilots Begin Pro: Allowed local staff to be introduced to the NIATx model and experience results; allowed QI staff to test training strategies. Con: Created mixed results in implementation and project outcomes; It became clear that the �wow� factor should be reconsidered.

15. 2010SAAS National Conference and NIATx Annual Summit April, 2008 Presented NIATx Model to TASC Administrators

16. 2010SAAS National Conference and NIATx Annual Summit May 2008-June 2009 Local Offices Launch Projects

17. 2010SAAS National Conference and NIATx Annual Summit May-June, 2009 Regional Work Shops Conducted A modified version of the workshop was given in five regional sites in May and June of 2009. The length of time between the administrator workshop and the regional workshops created a loss of technical skills and momentum. Some Adm where not able to attend which created a further disconnect between Adm (Change Sponsor) and Supervisor (Change Leader). The supervisory responsibility shifted from the adm to QI staff creating a disconnect.A modified version of the workshop was given in five regional sites in May and June of 2009. The length of time between the administrator workshop and the regional workshops created a loss of technical skills and momentum. Some Adm where not able to attend which created a further disconnect between Adm (Change Sponsor) and Supervisor (Change Leader). The supervisory responsibility shifted from the adm to QI staff creating a disconnect.

18. 2010SAAS National Conference and NIATx Annual Summit June, 2009 Agency-Wide Furlough Two week stall furlough, effectively disrupting work for four weeks, followed by lay-offs. Treatment providers experienced similar, including closing of facilities. Upon return to work, a reduced work force had to scramble to re-refer clients who had be discharged and find alternative options for those lost resources. Very chaotic period; moral was low; NIATx took a back seat.Two week stall furlough, effectively disrupting work for four weeks, followed by lay-offs. Treatment providers experienced similar, including closing of facilities. Upon return to work, a reduced work force had to scramble to re-refer clients who had be discharged and find alternative options for those lost resources. Very chaotic period; moral was low; NIATx took a back seat.

19. 2010SAAS National Conference and NIATx Annual Summit September, 2009 State-wide PI Projects Resume

20. 2010SAAS National Conference and NIATx Annual Summit 2010 Launching the �Wow� Factor: The Diffusion of Innovation PI continued to limp along and was in serious jeopardy of falling off the agency radar. OLT project injected energy, new strategies, and visibility. Prior to this, PI was essential a QI Department function. This moved the process to a larger arena. Having C. Ross as Ops VP placed a person with familiarity and enthusiasm for PI at the head of Ops, Change Project: Changing the Perception of Process Improvement at TASC Problem: Most staff view NIATx as something extra to do, not as the agency�s process improvement strategy. Goal: 75% of TASC Areas will have active PI projects by 7/1/10 Metric: % of Supervisors leading PI teams Baseline Data: 30% (11 Active Projects / 35 Supervisors) Exec Sponsor: Carolyn Ross Team Leader: Alicia Kusiak Staff: Steve McCabe Team: Selected Administrators, Supervisors, and Case Management staff. � Change team will meet bi-monthly and report PDSA cycles results and progress to the Executive Sponsor monthly. Executive Sponsor will report to OLT. PI continued to limp along and was in serious jeopardy of falling off the agency radar. OLT project injected energy, new strategies, and visibility. Prior to this, PI was essential a QI Department function. This moved the process to a larger arena. Having C. Ross as Ops VP placed a person with familiarity and enthusiasm for PI at the head of Ops, Change Project: Changing the Perception of Process Improvement at TASC Problem: Most staff view NIATx as something extra to do, not as the agency�s process improvement strategy. Goal: 75% of TASC Areas will have active PI projects by 7/1/10 Metric: % of Supervisors leading PI teams Baseline Data: 30% (11 Active Projects / 35 Supervisors) Exec Sponsor: Carolyn Ross Team Leader: Alicia Kusiak Staff: Steve McCabe Team: Selected Administrators, Supervisors, and Case Management staff. � Change team will meet bi-monthly and report PDSA cycles results and progress to the Executive Sponsor monthly. Executive Sponsor will report to OLT.

21. 2010SAAS National Conference and NIATx Annual Summit 2010 Launch of OLT Process Improvement Project

22. 2010SAAS National Conference and NIATx Annual Summit 2010 OLT PI Project Cycles: Supervisor Surveys Pro: Provided the OLT Change team a means to conduct a walkthrough of supervisor attitudes toward PI and the barriers to implementation.

24. 2010SAAS National Conference and NIATx Annual Summit Supervisor Survey Results

25. 2010SAAS National Conference and NIATx Annual Summit 2010 OLT PI Project Cycles: Development and Testing PDSA of Targeted Curriculum The Change Project Primer provides the basics of the NIATx process improvement model with a concentration on the Plan, Do, Study, Act (PDSA) rapid-cycle activities. The TASC Change Project Primer and the TASC Change Project Form Primer is a common reference guide for both administrators and change leaders to use when planning change projects.

26. 2010SAAS National Conference and NIATx Annual Summit 2010 VP C. Ross�s Email Announcing New PI Plan New Projects Due to VP Ross Administrators Present Projects to QI Director

27. 2010SAAS National Conference and NIATx Annual Summit SUSTAIN PLAN

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31. 2010SAAS National Conference and NIATx Annual Summit Thank You! Any questions?

32. 2010SAAS National Conference and NIATx Annual Summit Contact Information Alicia Kusiak, Director of Cook County Services 312-573-8371 akusiak@tasc-il.org Steve McCabe 312-573-2958 smccabe@tasc-il.org Sustain Plan Outline �Sustain Plan Outline �