NIATx: Looking forward to the next 10 years

Submitted by: 08/05/2013 by Maureen Fitzgerald

This year, NIATx celebrates a decade of bringing process improvement to the behavioral health field. From 39 substance abuse treatment providers in the original NIATx projects (Paths to Recovery I and II funded by the Robert Wood Johnson Foundation, and Strengthening Treatment Access and Retention, funded by SAMHSA’s Center for Substance Abuse Treatment), the NIATx community has grown to include nearly 3000 providers and systems of care representing substance abuse treatment and many other areas of behavioral health and social services.

“We never expected NIATx to grow so quickly,” says Dave Gustafson, Director of NIATx and the Center for Health Enhancement Systems Studies. “And we didn’t anticipate how well it would transfer to areas beyond substance abuse treatment,” he adds.

Todd Molfenter, co-Deputy Director of NIATx, served as a coach for treatment providers in the original projects. “When we first started we concentrated on some very basic customer service areas that were affecting access to and retention in addiction treatment,” says Molfenter, adding, “The NIATx focus on the customer has really made a difference in the way organizations address access issues today.”

Organizations looking for a simple improvement model that gets teams engaged and delivers results quickly continue to turn to the NIATx model. The NIATx website offers many resources for self-directed study, and the popular NIATx Change Leader Academy is available regularly at locations throughout the country. Local groups like states, counties, and provider associations continue to work with us to create local NIATx learning collaboratives. These collaboratives help groups of providers learn the basics of process improvement and improve customer service within their organizations or across systems of care.

The NIATx focus has expanded from access and retention to include transitions between levels of care, with a shift from individual provider organizations to large systems. The Wisconsin Mental Health Collaborative is working to reduce costly rehospitalizations for people served by the public mental health system. The NIATx scope has also extended to new service areas like elder care, public health, and child welfare. Our projects in the criminal justice system are linking addicted offenders to the critical treatment they need when they return to the community. (See related story on the NIATx Change Leader Academy for Criminal Justice professionals.)

“The initial work of NIATx has also broadened to include clinical interaction and client outcomes,” says Kim Johnson, who serves as co-Deputy Director with Molfenter.  “We continue to focus on the customer, with new projects that aim to make sure that the service they receive is effective.”

One example is the Ohio Buprenorphine Implementation Study, a NIDA-funded project that is testing ways to increase use of buprenorphine through payer-treatment agency partnerships with Ohio counties.

With its designation in 2012 as the networking coordinating office for the ATTC, in partnership with the University of Missouri-Kansas City, NIATx has expanded efforts to support implementation of evidence-based practices at the provider level. “Implementing a new practice is a change project,” says Johnson. “Successful implementation requires following the same principles and practices used to improve access or retention.”

In response to the rapidly changing funding environment, NIATx has led projects to help the field prepare for the changes anticipated with full implementation of health care reform. A current project, BHBusiness: Mastering Essential Business Operations, offers free training on the “back office” functions that affect organizations in a big way: billing systems, negotiating contracts, and adopting new technology.

What’s next?  

Technology is playing a growing role in behavioral health and social service management just as it is in other industries. Behavioral health treatment providers are using NIATx principles to implement health information technology. Other activities within the Center for Health Enhancement Systems Studies (CHESS), the research center that houses NIATx, are looking at ways that technology can support people with substance use disorders and the integration of substance abuse treatment with primary care.

CHESS has been developing and studying technological systems to support people with chronic illnesses for more than 20 years. Current studies are looking at implementation of A-CHESS (see related story), a smart phone application for recovery support. Another study is testing technology to integrate substance abuse treatment with primary care through a new tool called Seva. Also a smart phone application, Seva combines A-CHESS with electronic delivery of a cognitive behavioral therapy and data to identify treatment needs and support process improvement efforts in treatment organizations.

As NIATx enters its second decade, it remains committed to helping human service professionals and organizations improve access to services and make delivery systems more effective and efficient.

Says Molfenter, “NIATx projects and training initiatives will continue to offer the latest in process and systems’ improvement, along with practical tools to help you prepare for the future and succeed in the new environment of healthcare reform.”

“It’s been an exciting first decade and we’re looking forward to more rapid-cycle change in the next one,” adds Johnson.

In the months ahead, we’ll be marking our 10-year anniversary in a variety of activities. Watch your e-mail and upcoming issues of the NIATx E-news for details!  

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