Hospital-based outpatient treatment program increases access

The West End Clinic (WEC) Outpatient Addiction Services at the Massachusetts General Hospital participated in NIATx 200, a randomized controlled trial that studied the effectiveness of process improvement in addiction treatment. Change teams at WEC conducted a series of change projects to increase access to treatment. “The first PDSA cycles focused on our intake slots,” says Dr. Nalan Ward, director of WEC. “We were getting 15 calls each week but only had five or six intake slots.”

The change team examined the intake process and identified things they could change to improve it. “We realized that we had three different intake forms and found a way to streamline paperwork,” says Dr. Ward. When staff realized that the change was helping them do their jobs better, they were more excited about making additional changes.

As intakes began to increase, WEC also needed to be able to treat more people. “At the time, we only offered one group and were operating more like a private practice,” explains Dr. Ward. Today, WEC offers a variety of evidence-based group programs to accommodate clients’ needs. These include a day and an evening Intensive Outpatient Program, a young adult IOP for ages 18-25, and groups for aftercare such as Relapse Prevention, Seeking Safety, and Suboxone maintenance. In the past, the majority of WEC clients were alcohol dependent. Today, almost 35 percent of clients treated are opioid dependent.

Using the NIATx model at WEC has increased admissions and treatment options, and has also increased staff productivity. “Staff are working more efficiently and using their time more effectively. All are involved with one or more treatment group,” says Dr. Ward.

The next issue for WEC to tackle is space. “With the increase in admissions and group options, we gained more visibility within the hospital, which brought us more referrals. We have two group treatment rooms that are running all day long and need to add more.”

Participating in the NIATx 200 study made the NIATx model part of the way WEC operates. Another change project that offered an intake orientation group was successful in reducing no-shows and increasing clinician productivity.

Dr. Ward presented the results of WEC’s NIATx projects in poster sessions at the 23^rd Annual Meeting of the American Academy of Addiction Psychiatry in December 2012.  Click here to view the presentations.  

AAAP2012intakeposter.pdf

AAAP2012NIATXPoster.pdf