washington state niatx/ddcat pilot 2008-2010
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Washington StateNIATx/DDCAT Pilot
2008-2010
AcknowledgementsAcknowledgements
• NIATx 200 NPO- Alice Pulvermacher and NIATx 200 NPO- Alice Pulvermacher and Dr. Jay FordDr. Jay Ford
• DASA- David Dickinson & Robin Roberts DASA- David Dickinson & Robin Roberts • NFATTC- Denna Vandersloot and NFATTC- Denna Vandersloot and
Dr. Steve GallonDr. Steve Gallon• Dartmouth Medical School- Dr. Mark Dartmouth Medical School- Dr. Mark
McGovern McGovern • Project Manager: Janet BardossiProject Manager: Janet Bardossi
What’s this all about? The DDCAT-NIATx Pilot Project
Past Year Treatment* among Full-Time Employed Adults Aged 18 to 64 with Co-Occurring Serious Psychological Distress (SPD)
and a Substance Use Disorder: 2004 and 2005
The challenge in getting there
What is “there”?
The lack of a shared measure
Using the DDCAT measure
DDCAT & DDCMHT (3.2): 7 DIMENSIONS & CONTENT OF 35 ITEMS (McGovern, 2008)
Dimension Content of items
I Program Structure Program mission, structure and financing, format for delivery of mental health or addiction services.
II Program Milieu Physical, social and cultural environment for persons with psychiatric or substance use problems.
III Clinical Process: Assessment
Processes for access and entry into services, screening, assessment & diagnosis.
IV Clinical Process: Treatment
Processes for treatment including pharmacological and psychosocial evidence-based formats.
V Continuity of Care Discharge and continuity for both substance use and psychiatric services, peer recovery supports.
VI Staffing Presence, role and integration of staff with mental health and/or addiction expertise, supervision process
VII Training Proportion of staff trained and program’s training strategy for co-occurring disorder issues.
DDCAT: SELF VS. INDEPENDENT RATINGS (n=14 agencies in
Australia)
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
5.00
Hobar
t
Wod
onga
Mac
kay
Brisba
ne
Canbe
rra
Canbe
rra T
CPer
th
Man
dura
h
Darwin
Baseline DDCAT Score Self DDCAT Score
DDCAT PROGRAM CATEGORIES:BASELINE ASSESSMENTS ACROSS 9 STATES
(McGovern M., 2008)
A (n=61)
71%
29%
B (n=12)
75%25%
C (n=11)
64%27%9%
D (n=10)
100%
E (n=19)
100%
F(n=14)
79%21%
G (n=23)
83%17%
I (n=11)
82%18%
100%
H (n=4)
AOS DDC DDE
The challenge in getting thereHow to integrate services using existing resources
• NIATx and Process Improvement
Overview DDCAT-NIATX Pilot Project
• Use the DDCAT as a baseline measure
• Take the information from this review and develop a strategic plan based on DDCAT measures
• Use NIATx Process improvement as a vehicle of change
Phase I Project Activities and TimelinesAgency Recruitment
– October 2008- January 2009Initial Fidelity Review and Onsite Training
– February 2009Onsite TA
– March 2009Learning Session
– May 2009Final Review
– July 2009 and August 2009• Monthly Calls
Outcomes and Project DataOutcomes and Project Data
The Goal of The Project
• Demonstrate improvement in two measures
Washington State-DDCAT-NIATx Project 2009Number of Measures Changed
17
6
2
0
2
4
6
8
10
12
14
16
18
ABHSDaybreakPerinatal
Goal=2
Long term goalHelp agencies move towards
integration
Washington State DDCAT-NIATx ProjectInitial and Final Composite Scores
Level of IntegrationPerinatal
AOS/DDC to AOS/DDCABHS
AOS to AOS/DDCDay Break
DDC to DDC/DDE
Follow Up Results- March 2010
Aggregate Scores February/July 2009
Follow Up March 2010
3.11
1.6
3.74
2.3
4.08
2.62
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
Daybreak ABHS
Baseline
Project End
Follow-Up
Number of Measures ChangedJuly 2009 to March 2010
DDCAT- NIATx Phase II
• Phase II began with program selection in December and January 2010.
• January/February 2010 a baseline review using the DDCAT
• The final DDCAT reviews were conducted in May 2010 and demonstrated dramatic and positive results for all agencies.
• Six agencies selected- one drop out
DDCAT Phase II
DDCAT Phase II
Lessons Learned
The Value of the Walk Through
Structure and Leadershipmay help sustain change during
difficult times
Turnover impacts treatment
Value of Partnership with SSAValue of Partnership with SSA
• Created a feedback loop to State regarding financial and licensing barriers to integrated treatment
• Linked providers with key state personnel for trouble-shooting financial/resource access issues
Provider Quote of the DayProvider Quote of the Day
“Without regulations or rewards is it worth it?”
DDCAT as a baseline measure for defining integrated services is key!
Questions & Discussion
Contact Information
• Janet Bardossi bardossi@yahoo.com
• Denna Vandersloot vandersd@ohsu.edu
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