Transcript Using the Quick-Start Road Map to Plan for Change March 2009 Follow-up Calls (Call #4) Based on the fall 2008 CATES Training Series Contra.

Using the Quick-Start Road Map to
Plan for Change
March 2009 Follow-up Calls (Call #4)
Based on the fall 2008 CATES Training Series
Contra Costa County, San Bernardino County, & Sutter County
October 24, November 7, and November 14, 2008
Call Facilitators:
Beth Rutkowski, MPH, and Sherry Larkins, Ph.D.
UCLA Integrated Substance Abuse Programs/
Pacific Southwest Addiction Technology Transfer Center
Agenda
1. This months topic: Using the Quick
Start Road Map
2. Q-A period
3. Sharing of experience with planning a
change
4. Open questions and comments about
process improvement
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Quick Start Road Map
• A graphic series of steps to make it
easier to plan and implement a change
• Steps divided into management and
change team responsibilities
• Assures that critical steps in the
process will not be skipped
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First, let’s review
management’s responsibilities
Quick Start Road Map
Page 1
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Process
Improvement
Planning
Process
Improvement Planning
Guide Guide
Identify problem important to management
Target Objective
measurable - specific
wait-time - engagement - no-shows - retention
Who will be on the Change Team?
How will you measure the change?
simple - quick - accessible
Instructions for the Change Team:
Improvement Planning
GuideGuide
ProcessProcess
Improvement
Planning
Identify problem important to management
Clients referred by the Community Assessment
Service Centers frequently miss their intake
appointments. Over the past three months 37% of
those scheduled for intake have not shown up for their
first interview, costing us both time and lost revenue.
We need to figure out how to reduce the number of noshows.
Target Objective
Reduce no-shows
to 30% or lower
measurable - specific
wait-time - engagement - no-shows - retention
Who will be on the Change Team?
Clinical supervisor, counselor, receptionist and
case manager
How will you measure change?
Reception will keep a log of CASC
referrals and record attendance at the
first interview.
simple - quick - accessible
Instructions for the Change Team:
Currently we are experiencing a high no-show rate (37%) for intakes referred by the CASCs, resulting
in unused clinical time and missed admissions. We would like your help in figuring out a way to reduce
that no-show rate. Paula will lead a small group to identify and experiment with methods that will help
us get down to a 30% or lower no-show rate. I know you will be successful and look forward to hearing
about your progress.
Now, the responsibility for change
moves to the change team
Quick Start Road Map
Page 2
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ChangeTeam
Team
Deliberations
Change
Deliberations
What situations or processes contribute to the
problem?
What possible changes might help
achieve the objective?
1
2
3
4
Outline the implementation process you will use
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What will be done?
(Plan)
Who will
do it?
(Do)
Resources
Needed
1
2
Prioritize the changes most likely
to succeed and select one
What data will be gathered? (Study)
What?
3
Who?
How often?
4
5
How will progress be monitored to determine success and to assess need for further change?
How?
Who will do it?
How often?
What is the next step? (Action):
Change
TeamDeliberations
Deliberations
Change Team
What contributes to the problem?
1. Usually the CASC calls to set the appointment. We
don’t talk with the client.
2. Referrals forget they have an appointment.
3. They may not know how to find our office.
4. They don’t have much commitment to showing up.
5. They are afraid of what will happen at the appointment.
6. They think treatment will be too expensive and take too
much time, so they avoid coming in.
Outline the implementation process you will use
What will be done?
(Plan)
Who will
do it?
(Do)
1. Take each CASC a
supply of brochures and
Case Mgr
appointment cards.
2. Ask CASC to call us at
Case Mgr
end of screening while client
is still there.
3. Ask CASC to give client
a brochure and business card
before they leave CASC office
Resources
Needed
What possible changes might help
achieve the objective?
1. Make sure referrals know how to find us.
2. Call the referral before the appointment to
answer any questions and confirm their
attendance.
3. Talk to the referral before they leave the
CASC to set up the appointment.
4. Visit the CASC and provide them brochures
with a map to the clinic and appointment cards.
5. Ask the CASC to call us and let us talk with
the client at the conclusion of the CASC
screening.
Prioritize the changes most likely to
succeed: 3-4-5
100 brochures
and cards for
each CASC
What data will be gathered? (Study)
What?
Appt. log
Who?
Reception
How often?
Every CASC
referral
How will progress be studied to determine success and to assess need for further change?
How?
Who will do it?
How often?
1. Report of CASC visits
2. Summary of appointment log
Case Manager
Change Leader
After each visit
Weekly
What is the next step? (Action): Revise plan, if necessary, based on visits and no-show rate over the next 30
days.
So, the change process
includes…
• Management looking at processes from the
client’s perspective
• Priority setting for improvements to the
agencies processes that will lead to
achieving agency mission and goals
• Turning responsibility for experimental
changes over to a small group of employees
• Successes and failures...and investment by
both management and staff
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Keys to successful
change planning
1. Be specific in defining and setting
change objectives
2. Make objectives achievable but
challenging
3. Make sure all participants in the
change experiments are clear on their
roles and responsibilities
4. Plan to meet and review progress
frequently
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Next Steps
April 2009 Calls
2nd at 2:00pm and 17th at 11:00 am
Topic:
Conducting PDSA (Plan-Do-Study-Act)
Change Cycles
Check out the NIATx web site at www.niatx.net
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