How to Perform a Walk-through

Use the Walk-through Recording Template for cues about what to look for during your walk-through and to record your reactions.

To start any improvement effort, the Change Leader and one other person, ideally the Executive Sponsor, conduct a walk-through to experience what it’s like to be a customer of your agency or facility. The walk-through helps you understand the customer’s perspective and the organizational processes that inhibit access to and retention in treatment.

The knowledge that you gain from the walk-through will help you understand where your priorities should be and what kinds of changes will ultimately have the biggest impact on customer perceptions and the budget.

Understanding what your customers want and need— and what’s working for them and what isn’t in the way you currently do business — is critical if you want to make changes that matter. By “matter,” we mean that the changes will improve the quality of care provided to clients and will have a positive impact on the business (by driving up revenues and/or driving down costs).

One of the best ways to understand your customers is to walk through the process as they do. Actually make the phone call, drive to the facility, enter the facility, and meet the receptionist. Assume this is your first time ever. What's it like? How does it feel? What works? What doesn't?

PLAN the Walk-through

1. Ask the Change Leader and one other person to play the roles of "client" and "family member." They will need to be detail-oriented and committed to making the most of this exercise. To ensure that their experiences will be as realistic and informative as possible, have them present themselves as dealing with an addiction you are familiar with, and thus are able to consider the needs of people with that particular addiction issue.

2. Let the staff know in advance that you will be doing the walk-through exercise. Ask them to treat the team members as they would anyone else.

DO the Walk-through

3. Have the Change Leader and one other person go through the experience just as a typical client and family member would. The walk-through should begin with a customer’s first contact with your agency: an addict or family member interested in obtaining treatment services making a first call for information.

4. Try to think and feel as a client or family member would. Observe your surroundings and consider what a client or family might be thinking or feeling at any given moment. Record your observations and feelings.

5. At each step, ask the staff to tell you what changes (other than hiring new staff) would improve the experience for the client, family member, and staff. Write down their ideas and feelings as well as your own.

STUDY the Results

6. Make a list of the areas that need improvement along with suggested changes to attempt. Include the perspectives of the client, family member, and staff. Sort the ideas into those that are directly linked with your team’s improvement project and those that are unrelated.

7. As a team, discuss what went well with the walk through, what didn’t go well or was confusing, and what you would do differently the next time around.

ACT on the results

8. Share the results with your Executive Sponsor.

• Discuss how to incorporate the relevant change ideas into your project
• Have the Executive Sponsor decide how to handle the ideas that are not directly related to your project
• Use PDSA to implement any change that the Executive Sponsor wants to implement immediately
• Share your lessons learned about doing walk-throughs in your organization

Outcomes

• Notes from walk-through
• List of practices that seem to work well from walk-through
• List of practices that don’t work well/need to be changed

Observation Tips

First Contact

• When you called the agency, did you get a busy signal, voice mail, an automated greeting, or did a live person answer the call?
• Did the agency offer you an appointment on your first call?
• How many days would a typical client have to wait for the next available assessment appointment?
• Would a typical client have to miss work to make the appointment?
• Would a typical client have difficulty reaching the site?
• Is transportation available?

Assessment

On the day of the appointment, arrive at the clinic or office, with the following question in mind: What would it be like if you had never been to the site before?

Continue to make note of your impressions as a client or family member new to substance abuse treatment:

• Complete the entire intake process.
• Fill out all required forms.
• Does the family member typically accompany the client through the entire intake process?
• How long does a typical client spend in the waiting room? Wait for that amount of time.
• If the client is required to undress, you should undress.
• Is a urine test required?
• How many days would a typical client have to wait until the next available first treatment appointment?
• The "client" and "family" member should each record all their thoughts and feelings about this process.
• Ask staff: What percent of clients don’t show for their treatment appointment?