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About > The NIATx Model > Four Aims

The Four Aims

NIATx promotes systems change and innovation with a focus on four aims.

  1. Reduce waiting time between first request for service and first treatment session
  2. Reduce no-shows by reducing the number of patients who do not keep an appointment
  3. Increase admissions to treatment
  4. Increase continuation from the first through the fourth treatment session

The Four Aims offer providers effective ways to plan for, institute, and measure improvements in patient access and retention.

They also enable treatment organizations to create a culture of quality improvement while improving their bottom line.

NIATx Measures

The definition for the four aims is provided below.

Average Time from First Request to First Client Treatment Session

Measures the time elapsed between the date a client first contacts the agency requesting service and the date the client received their first treatment session, which can be an individual or group session. Waiting time represents the average time for a specific client population and will be calculated as follows:

Sum across all clients (date of first treatment - date of first contact)
(Number of clients who receive a first treatment session)


Measures the number of patients who do not keep an appointment. While it is important to recognize that many treatment agencies may have existing systems to calculate client no-shows, other agencies do not have such systems. The No-Show measure attempts to determine the number of clients who schedule a clinical assessment but fail to keep that appointment. Within NIATx, agencies typically look at client no-shows on a monthly basis, which is then calculated as follows:

(Number of clients with an assessment)
(Number of clients who schedule an assessment appointment)


This measure counts the number of unduplicated client admissions by provider.


Continuation measures the number of clients who attend four additional units of services (i.e., treatment sessions) within 30 days of their admission to treatment. How a unit of service is defined varies by level of care.