NIATx for change across a system

Submitted by: 04/08/2015 by Maureen Fitzgerald

The NIATx model has been used extensively for change at the organizational level, and the success stories on the NIATx website provide hundreds of examples of NIATx tools and promising practices in action at treatment organizations across the country.  

NIATx has also been used at the systems-change model to promote changes at the regulatory, payer, and network levels. In a NIATx system-level change project for addiction treatment services, a state or other regulator or payer confronts issues and barriers in delivering quality service. These barriers include:

  • Lack of funding limits capacity or the ability to offer interventions such as medication-assisted therapy
  • Excessive paperwork, including licensing requirements for documentation, data collection forms for state data systems, and reimbursement forms
  • Regulatory requirements that are duplicative, unclear, or contradictory, and include burdensome documentation
  • Internal processes that cause delays due to long response times, licensing and contracting lag times, and multiple review requirements

The NIATx System-Level Toolkit gives detailed instructions for conducting a change project across an entire state or other system.

A system-level change project begins with the same essential NIATx tool that providers use to identify problems in service delivery in their treatment organizations: the walk-through.

A system-level change project also incorporates the most important of the NIATx principles: to understand and involve the customer.

A current example of a NIATx system level change project is the Wisconsin Mental Health Learning Collaborative. Since the project began in 2010, more than 30 of the states’ 72 counties have tested system-level changes designed to reduce readmission rates for psychiatric hospital stays and for substance abuse treatment.

Is your organization using NIATx tools and techniques to conduct a system-level change project? We’d like to hear from you! To share your story, contact Maureen Fitzgerald at

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