Making "Stone Soup": Improvements in Clinic Access and Retention in Addiction Treatment
Making "Stone Soup": Improvements in Clinic Access and Retention in Addiction Treatment
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DOI：
10.1016/s1553-7250(07)33011-0
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发表时间：
2007-02-01
影响因子：
2.3
通讯作者：
Molfenter, Todd
中科院分区：
文献类型：
--
作者：
Capoccia, Victor A.;Cotter, Frances;Molfenter, Todd
背景：成瘾治疗改善网络 (NIATx) 为 39 个治疗组织提供协作学习机会和技术支持，以减少首次请求服务和第一次治疗之间的等待时间，减少未预约（缺席）的患者数量，增加接受治疗的人数，并增加从第一次到第四次治疗的持续时间。阿卡迪亚的按需故事治疗：由于容量限制，只有 25% 的客户安排门诊护理在阿卡迪亚医院（缅因州班戈）进行评估预约时，只有 19% 的患者接受了治疗。引入了各种变化，包括增加工作人员的可用性，以便在客户到达时（上午 7:30）立即为客户提供评估，建立临床医生库来处理客户过多的情况，以及允许当天进入重症门诊或化学依赖服务。这些流程改进将第一次接触到第一次治疗的时间从 4.1 天缩短到 1.3 天 (68%)，减少了客户缺席的情况，并增加了治疗的持续性和跨护理级别的转移。讨论：各组织在 NIATx 计划中取得的成功应该有助于在其他服务提供领域实施变革。
Background: The Network for Improvement of Addiction Treatment (NIATx) provides 39 treatment organizations with collaborative learning opportunities and technical support to reduce waiting time between the first request for service and the first treatment session, reduce the number of patients who do not keep an appointment (no-shows), increase the number of people admitted to treatment, and increase continuation from the first through the fourth treatment session.Acadia's Story-Treatment on Demand: Given capacity constraints, only 25% of the clients scheduled for outpatient care at Acadia Hospital (Bangor, Maine) showed up for their assessment appointments, and only 19% made it into treatment. A variety of changes were introduced, including increasing staff availability to provide clients with assessments immediately on arrival (at 7: 30 A.M.), establishing a clinician pool to handle client overflow, and allowing for same-day admission to intensive outpatient or chemical dependency services. These process improvements reduced the time from first contact to the first treatment session from 4.1 to 1.3 days (68%), reduced client no-shows, and increased continuation in treatment and transfers across levels of care.Discussion: The successes experienced by organizations in the NIATx initiative should be useful for implementing change in other fields of service delivery.