Hoffman Kim A, Green Carla A, Ford James H, Wisdom Jennifer P, Gustafson David H, McCarty Dennis
Department of Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., CB 669, Portland, OR 97239, USA.
J Behav Health Serv Res. 2012 Jul;39(3):234-44. doi: 10.1007/s11414-011-9270-y.
Process and quality improvement techniques have been successfully applied in health care arenas, but efforts to institute these strategies in alcohol and drug treatment are underdeveloped. The Network for the Improvement of Addiction Treatment (NIATx) teaches participating substance abuse treatment agencies to use process improvement strategies to increase client access to, and retention in, treatment. NIATx recommends five principles to promote organizational change: (1) understand and involve the customer, (2) fix key problems, (3) pick a powerful change leader, (4) get ideas from outside the organization, and (5) use rapid cycle testing. Using case studies, supplemented with cross-agency analyses of interview data, this paper profiles participating NIATx treatment agencies that illustrate successful applications of each principle. Results suggest that organizations can successfully integrate and apply the five principles as they develop and test change strategies, improving access and retention in treatment, and agencies' financial status. Upcoming changes requiring increased provision of behavioral health care will result in greater demand for services. Treatment organizations, already struggling to meet demand and client needs, will need strategies that improve the quality of care they provide without significantly increasing costs. The five NIATx principles have potential for helping agencies achieve these goals.
流程与质量改进技术已在医疗保健领域成功应用，但在酒精和药物治疗领域推行这些策略的工作尚不完善。成瘾治疗改进网络（NIATx）教导参与的药物滥用治疗机构运用流程改进策略，以增加客户接受治疗的机会并提高其治疗留存率。NIATx推荐五条促进组织变革的原则：（1）了解并让客户参与；（2）解决关键问题；（3）挑选有影响力的变革领导者；（4）从组织外部获取想法；（5）采用快速循环测试。本文通过案例研究，并辅以对访谈数据的跨机构分析，介绍了参与NIATx的治疗机构，这些案例说明了每条原则的成功应用。结果表明，各组织在制定和测试变革策略时能够成功整合并应用这五条原则，从而改善治疗的可及性和留存率以及机构的财务状况。即将到来的变革要求增加行为健康护理的提供，这将导致对服务的需求更大。治疗机构已经在努力满足需求和客户需求，它们将需要在不显著增加成本的情况下提高所提供护理质量的策略。NIATx的五条原则有潜力帮助机构实现这些目标。
