Transcript Document

Process Improvement
Overview
History
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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.
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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
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Reduce waiting time
Reduce no-shows
Increase admissions
Increase continuation
Aims
NIATx Aims
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 noshows 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 Improvement
Reference: 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
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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
A P
S D
Hunches
Theories
Ideas
Changes That
Result in
Improvement
A P
S D
Reference: Langley, Nolan, Nolan, Norman, &
Provost. The Improvement Guide
Five Principles
Promising Practices
Promising Practices are changes which
were tested and shown to be actual
improvements by various behavioral health
organizations.
Process Improvement Tools
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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.
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Flow Chart
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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
[email protected]
http://www.niatx.net/Home/Home.aspx