discovering changes that are improvements for your organization

Reduce Waiting & No-Shows Increase Admissions & Continuation www.NIATx.net

Discovering Changes That Are Improvements for Your Organization

Reduce Waiting & No-Shows Increase Admissions & Continuation

Sam Price, Ten Sixteen Recovery Network

Rebecca Emmenecker, Riverhaven Coordinating Agency

Kim Kern, List Psychological Services

Deb Ronk, Arbor Circle


Five X Five

Starring:Sam price


A SURPRISE FOR YOU!Small group exercise

Your Row = Your Team


Structure of Exercise

• Minimum of Three Active Team Participants in a row

• One observer/timer/referee per team

• This is not a competition across teams/rows…it’s about each team’s improvement against their baseline


The R-Ducky Rules:

• Everyone of Team must touch the duck with both the right hand and the left hand

• The duck must travel to each person.

• You get three attempts

• Your timekeeper will score: Baseline…Change #1…Change #2


Duck Observations

What did you learn?


What did you learn?

• Better process vs. increased hand-eye coordination/speed?

• Practice, practice, practice!

• Optimal group size!

• Working as a team!


With A Little “Helf” From My Friends


Resources Abound at the Web Site

• The URL is www.NIATx.net

• Toolkits, Templates, Testimonials, Ideas, Promising Practices, Success Stories, Examples …

• Bookmark Recommended


NIATx was originally a partnership oftwo grant programs

The Center for Substance Abuse TreatmentStrengthening Treatment Access and Retention

and

The Robert Wood Johnson Foundation Paths to Recovery


Where Credit Belongs

• NIATx National Program Office is at the University of Wisconsin – Madison

• The “guru” and director is David Gustafson, PhD – a process engineer

• Integration of Engineering Department and Behavioral Health Researchers

• Many of the principles are adapted from the work of earlier/current quality gurus


A Universal Approach to Improvement

• Applies to SA or MH or Integrated Treatment…and more

• Works across institutions, functions, subject matters, levels of care, settings…

• Customized to your identified goals and needs

• It’s a map and compass (not a full “Turn by Turn” GPS Navigation System)…”Recalculating” is the team’s job


Statistics and a Conclusion• 19 million Americans

need treatment

• 25% are able to access treatment

• 50% of those in treatment do not complete

• The way services are delivered is a barrier to both access and retention

Substance Abuse and Mental Health Services Administration, 2002


The “Frosty Freeze” Case Study

A “Walkthrough” of Frosty Freeze:

Small group activity

• The Perspective of The Customer?• Who is your change team? • Who is your change leader? • Buy-in from staff?


Deciding your first PDSA

• Where do you start? One small change!

• Nominal Group Technique Overview.


One more exercise!

Small Group Activity:

What is your starting place?


Five Key PrinciplesEvidence-based predictors of change

• Understand and involve the customer

• Focus on key problems

• Select the right change agent

• Seek ideas from outside the field and organization

• Do rapid-cycle testing


NIATx Aims

Reduce Waiting Times

Reduce No-Shows

Increase Admissions

Increase Continuation Rates


Come back after the break!

• This duck is a gift for you, sort of like a bribe. We will give this to you if you make a deal with us that you will return for the second half of our presentation….

• Don’t you want to know more about how to implement the NIATx ideas in your agency?

• See you right after the break! Thank you!


Discovering Changes That Are Improvements for Your Organization

Reduce Waiting & No-Shows Increase Admissions & Continuation

Sam Price, Ten Sixteen Recovery Network

Rebecca Emmenecker, Riverhaven Coordinating Agency

Kim Kern, List Psychological

Deb Ronk, Arbor Circle

…


5 X 5 presentation

Starring:Sam price


Frosty Freeze

• Break into small groups.

• Read Frosty Freeze together.

• Identify “concerns” found in the FF walk through.


Conducting a Change Exercise

PDSA cycles Plan the changeDo the planStudy the resultsAct on the new

knowledge

Rapid cycle changes Changes should be

doable in 2 weeks


PDSA

Create a PDSA for your group using Frosty Freeze. Remember:

start with one small change.


Skipping the “P” in PDSA


Hunches Theories

Ideas

Changes That Result

in Improvemen

t

A P

S D

APS

D

A P

S DD S

P ADATA

Change CyclesPD-SA-Sustain

Rapid cycle changes should be do-able in 2 weeks !!!!!Maybe…..


How will you sustain change?

Small Group Activity:

• Ideas to sustain the change after the (rapid change cycle) PDSA is concluded.


PDSA: The Bigger PictureWalk

ThroughGenerate

IdeasPlan

ChangePilot Test

Adjust the Plan

Do ChangeStudyData

Show Benefit/ Educate

Celebrate

Stop and try New

Change

Adjust Change

Sustain ChangeAct


Going up????• Elevator Speech: what is it?

• Example of an elevator speech.


Write an Elevator Speech

Small Group Activity

• What would you say to describe NIATx?

• Benefits

• What do they want to hear?


DUCK!!!!!

• Wow, that was a close one!

• We’re giving you a gift….if you weren’t here for the first half: ask someone that was here what it represents!


Assistance From MDCH’s Point Person for MI Coaches

Phil Chvojka (Shove-oak- ah)

[email protected]


Thank you!!!Kim Kern:

• [email protected]

Sam Price:


Deb Ronk:


Rebecca Emmenecker: [email protected]

discovering changes that are improvements for your organization

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