Program Improvement from a Provider Perspective

Bob Mirel, MSWSenior Associate

Peter Gaumond, MASenior Associate

Strategic Planning for Providers to Improve Business Practices

Sponsored by the Center for Substance Abuse Treatment , Division of State and Community Assistance - Arlington, Virginia, October 22, 2009

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A Life in the Community for Everyone

Recovery

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Session Objectives

▲You will be able to:

– Identify recovery outcomes

– Describe the process of using data to improve those outcomes

– Define terms associated with the collection and analysis of data

– Use recovery outcomes to make decisions about practice

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RECOVERY

Definitions:

▲ Recovery refers to the ways in which a person with a mental illness and/or addiction experiences manages his or her disorder in the process of reclaiming his or her life in the community.

▲ Recovery from Alcohol and Drug Problems is a process of change through which an individual achieves abstinence and improved health, wellness and quality of life.

▲ An emerging definition goes beyond abstinence alone to include a full re-engagement—based on resilience, health, and hope—with one’s family, friends, and community.

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Recovery

▲Person Centered

▲Client Choice

▲Build / Rebuild life in community

▲Holistic

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ROSC

▲Recovery Oriented Systems of Care shift the question from “How do we get the client into treatment” to “How do we support the process of Recovery within the person’s environment.”

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Recovery Oriented System of Care

Include:

▲A comprehensive menu of services and supports that can be combined and readily adjusted to meet the individual’s needs and chosen pathway to recovery

▲An ongoing process of systems-improvement that incorporates the experiences of those in recovery and their family members.

▲The coordination of multiple systems, providing responsive, outcomes-driven approaches to care.

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ATR Program

▲Client choice

▲Voucher-based purchase of services

▲Sophisticated information systems

▲Faith and community-based provider engagement

▲Recovery Oriented System of Care (ROSC)

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Terms

▲Data – discrete facts that can be captured and stored

▲Outcome – client’s personal mission statement

▲Goal – specific components of the personal mission statement

▲Objectives – observable and measurable steps in achieving the goal

▲Indicator – specific data item that is collected to inform attainment of the goal or objective

▲Measure – level of an indicator (frequency, duration)

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Process

▲Outcomes

▲Goals

▲Objectives

▲Data collection

▲Data review/analysis

▲Evaluation of current recovery plan based on data review

▲Modification of recovery plan as needed

Using Data to Improve Recovery Outcomes

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Using Data to Improve Recovery Outcomes

▲What are recovery outcomes?

▲Can they be distinguished from treatment outcomes?

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Recovery Outcomes

▲Emphasize client goals and quality of life

▲Do not view an episode of treatment or recovery support services in isolation, but rather as a component of a larger whole

▲Are best achieved by cross-agency, cross-systems collaboration

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Indicators, Measures & Benchmarks

▲Indicators must be

– Quantifiable

– Possible to track over time and across clients

– Reflect aspects of systems and services that can be modified

▲Measures quantify indicators

▲Benchmarks establish targets, thresholds, or ranges for measures of specific indicators

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Sample Recovery Outcomes

▲I would like to have an apartment and job and would like to regain custody of my children.

▲I would like to complete parole and find a job that will allow me to give back to other persons with drug/alcohol problems who have problems with the law.

▲I would like to complete high school and go to college to study music.

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Sample Recovery Indicators

▲Days of services received

▲Use of recovery support services

▲Substance use

▲Family/social functioning

▲Education/Employment

▲Housing

▲Criminal Justice System Involvement

▲Establishment and/or Attainment of Personal Goals

▲Satisfaction with services/outcomes/role in service planning/relationship with and role of staff

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Sources of Data

▲Screening, Triage, Referral, Assessment/Intake

▲Treatment and/or recovery plans

▲Service notes

▲Referral Logs

▲Client Satisfaction Data

▲Treatment Episode Data Set (TEDS)

▲Billing

▲Other service providers

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Evaluating & Selecting Data

▲Is the data collected in a consistent manner?

▲Can it be measured?

▲Is it collected at more than one point in time?

▲Is it in a form that can be analyzed?

▲Is there data you do not collect that might be of value as an indicator or outcome?

▲Is there potentially useful external data to which you could gain access?

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Sample Data Inventory Table

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Systematizing the Use of Data – Practitioner Level

▲Develop a mechanism for consistently collecting information on client goals, satisfaction with services.

▲Develop reports using existing data to track indicators and outcomes as feasible.

▲Set personal benchmarks that are measurable and achievable and track progress

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Systematizing the Use of Data – Program Level

▲Develop a data plan and strategy for systematically collecting and analyzing data and for using it to improve quality, performance, and outcomes.

▲Implement rapid cycle process improvement approaches to systematically improve systems and services.

▲Consider cross-agency, cross-systems data sharing, planning, and coordination.

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Data-driven Systems & Services Improvement

Case Studies

Using Data to Improve Recovery Outcomes