systems approach workbook a systems approach to substance use services and supports in canada

Systems Approach Workbook

A Systems Approach to Substance Use Services and Supports in Canada

Communication Tools: Sample PowerPoint presentation

The original template text for this file, as well as other useful material, is available in the Tools & Templates section of the Systems Approach website (www.nts-snt.ca). Production of this material has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.

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Outline

Background

Why pay attention to the treatment system?

Systems Approach recommendations

Tiered Model

Systems Approach implementation

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Treatment is one of 13 priorities under the National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances

40+ National Treatment Strategy Working Group members were tasked with producing recommendations toward “improving the quality, accessibility and range of options to treat harmful substance use, including substance use disorders”

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Background

Background (cont’d)

The Working Group released its report in October 2008

The report makes 20 system-level recommendations to Improve the quality, range

and accessibility of services and supports

Close the gap between “need” and “response”

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Why Pay Attention to the Treatment System?

Treatment for problematic substance use works and is an efficient use of resources

Substance use problems drive health and social costs beyond the addictions treatment field

Substance use is a major contributor to chronic diseases such as cancer and diabetes

There are large gaps in service and barriers to accessing the help people need

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Systems Approach Recommendations

Develop a continuum of services and supports Improve care, coordinate services and make better use of existing

investments by shifting the focus toward integrated, community-based care rather than specialized care

Look at the system using a tiered framework representing logical groupings of services and supports and varying levels of risk and harm

Develop knowledge exchange capacity Promote evidence-informed policy and practice

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Systems Approach Recommendations

Reduce stigma and discrimination Develop a targeted, evidence-based approach

Increase the understanding of substance use problems and the treatment system to reduce the barriers faced by those who might access the system and those who work within it

Develop a research program Support and enhance efforts to build system capacity

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Systems Approach Recommendations

Measure and monitor system performance Collect information in a consistent way to inform and monitor system

improvements

Promote leadership and implementation Coordinate allocation of resources

Develop collaborations across systems and sectors

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Tiered Model: A Service Perspective

Each tier represents a cluster of services and supports that Respond to varying levels of risk and harm

Address problems of similar severity and provide services of similar intensity and specialization

Movement within and across tiers is facilitated

In a comprehensive continuum, each tier has the tools, resources and supports required to meet population needs

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Lower-tier services and supports Meet the needs of the greater number of people

Represent a higher level of community integration and lower degree of specialization

Upper-tier services and supports Meet the needs of people with more severe substance use issues

Represent a higher level of specialization

Tiered Model: A Service Perspective

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Tiers represent groupings according to levels of individual risk and harm

Movement through connected tiers is facilitated as individual needs and risk/harm profiles change over time

Five Tiers 1: Individuals with low risk/harm 2: Individuals with moderate risk/harm 3: Individuals at risk of acute harm 4: Individuals experiencing harm 5: Individuals experiencing harm and with complex risk profiles

(e.g., concurrent disorders)

Tiered Model: A Population Perspective

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No wrong door

Availability and accessibility

Matching

Choice and eligibility

Flexibility

Responsiveness

Collaboration

Coordination

Tiered Model: Guiding Principles

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Flexible Responds to the particular needs of Canada’s jurisdictions and

populations, but…

Based on common principles that can be applied in any context

Promotes the efficient use of resources Emphasis on developing capacity in the lower tiers rather than relying on

more resource-intensive, specialized services

Benefits of the Tiered Model

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Variations of the Tiered Model can be found in

Healthy Minds, Healthy People: A Ten-Year Plan to Address Mental Health and Substance Use in British Columbia (2010)

The Action Plan for Mental Health in New Brunswick, 2011-18 (2011)

Creating Connections: Alberta’s Addiction and Mental Health Strategy (2011)

Variations of the Tiered Model

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EXAMPLES OF WHAT TO INCLUDE:

The reasons improvements are needed in your jurisdiction; for example:

Responding to or proactively addressing New research evidence Population trends An emerging problem An identified gap

The ways areas that are working well can support and be supported by system change

Systems Approach: Rationale for Change

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EXAMPLES OF WHAT TO INCLUDE:Address benefits to

The clients The services The practitioners The system

Cost savings associated with earlier intervention Reduced reliance on specialized, intensive services Reduced health and social impact of substance use

Systems Approach: Rationale for Change

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EXAMPLES OF OUTCOMES AND BENEFITS:

[TO BE CUSTOMIZED]

Increased partnerships and coordination between services

Improved client outcomes through increased access to appropriate services

Increased capacity to identify and address gaps in the service continuum

Systems Approach: Outcomes and Benefits

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EXAMPLES OF ACTIVITIES: [TO BE CUSTOMIZED]

Examined provincial strategy for consistency and guidance

Examined strategic plans for consistency with the Systems Approach

Identified areas of the system that need improvement or are working well

Identified benchmarks through provincial reports and national indicators (e.g., CIHI, National Treatment Indicators)

Systems Approach: Work to Date

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[TO BE CUSTOMIZED]

Systems Approach: Decisions Required

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[TO BE CUSTOMIZED]

Systems Approach: Next Steps

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www.nts-snt.ca

www.ccsa.ca

[ADD RELEVANT REGIONAL LINKS]

Additional Information

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