overview process improvement. history founded in 2003, niatx works with behavioral health care...
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OverviewProcess Improvement
History
• Founded in 2003, NIATx works with behavioral health care organizations across the country to improve access to and retention in treatment for the millions of Americans with substance abuse and/or mental health issues.
• NIATx was formerly the acronym for the Network for the Improvement of Addiction Treatment. Now, we're known simply as NIATx.
Overview
NIATx– History– AIMS– Principles– Promising Practices– Tools– Missouri Change Projects
NIATx Aims
• Reduce waiting time
• Reduce no-shows
• Increase admissions
• Increase continuation
Aims
Aims
NIATx Aims
NIATx Principles
Five Principles
• Understand and Involve the Customer
• Focus on the Key Problems
• Pick a Powerful Change Leader
• Get Ideas from Outside the Organization
• Do Rapid-Cycle Testing
1. Understand & Involve the Customer
• Most important of the Five Principles
• What is it like to be a customer?
• Walk-through, focus groups…
Five Principles
Why Walk-through?
• The walk-through is useful for:– Understanding the customer and organizational
processes– Providing a new perspective
• Allowing us to ‘feel’ what it’s like• Letting us see the process for what it is
– Seeking out and identifying real problems – Generating ideas for improvement– Asking why?…and why? again
Five Principles
2. Focus on Key Problems
• What keeps the CEO awake at night?
• What processes have been identified by staff and customers as barriers to excellent service?
Five Principles
Examples of Key Problems• Excessive paperwork
• Initial and ongoing client no-
shows for services
• Length of the intake process
• Creating successful handoffs
across levels of care
• Improving financial solvency
• Staff turnover
• Tailored treatment
Five Principles
3. Select a Powerful Change Leader
Who has:– Influence, respect and authority across
levels of the organization– A direct line to the CEO– Empathy for the staff– Time devoted to leading change projects
Five Principles
4. Seek Ideas Outside the Organization and the Field
• Provides a new way to look at the problem
• Real creativity in problem solving comes from looking beyond the familiar
Five Principles
5. Do Rapid Cycle Testing
Start by asking three questions:1. What are we trying to accomplish?
2. How will we know the change is an improvement?
3. What changes can we test that will result in an improvement?
Model for ImprovementReference: Langley, Nolan, Nolan, Norman, & Provost. The Improvement Guide, San Francisco, Jossey-Bass Publishers, 1996
Five Principles
Before Starting the Change
• Collect baseline data
• Determine the target population and location
• Establish a clear aim
Five Principles
Make Changes• PDSA Cycles
– Plan the change– Do the plan– Study the results– Act on the new knowledge
• Adapt• Adopt• Abandon
• Rapid-cycle changes should be doable in two weeks
Five Principles
Change Cycles
Hunches Theories
Ideas
Changes That Result in
Improvement
A P
S D
APS
D
A P
S DD S
P ADATA
Reference: Langley, Nolan, Nolan, Norman, & Provost. The Improvement Guide
Five Principles
Promising PracticesPromising Practices are changes which were tested and shown to be actual improvements by various behavioral health organizations.
Process Improvement Tools
• Nominal Group Technique– The Nominal Group Technique (NGT) is designed to promote group participation
in the decision-making process– The Nominal Group Technique can be used by small groups to reach consensus
on the identification of key problems or in the development of solutions that can be tested using rapid-change cycles.
• Flow Chart– Flowcharts force an organizational focus on process.– Flowcharting is useful for:– Providing a starting point/baseline view – Understanding the process – Identifying key problems/bottlenecks – Showing where to test ideas for most impact
• Walk Through
• PDSA
Change Leader Calls
•Facilitated by ADA staff•Calls
•One hour, each month•Participants share change projects •Ask for comments, questions, feedback after each report
•Participants working on change projects utilizing the same process and working on familiar AIMS.
Mark Shields, M.Ed, LPC
Director Access to Recovery
(573) 751-8133
http://www.niatx.net/Home/Home.aspx