Building Financial Strength through Process Improvement

Submitted by: 09/02/2009
Keywords: business case, Reduce No-shows, Reduce Waiting Times

The mission of the Phoenix Center in Greenville, South Carolina is to change lives through prevention, intervention, and treatment. As Greenville county's largest provider of substance abuse treatment and prevention services, the Phoenix Center provides a continuum of services, including education, intervention, outpatient and intensive outpatient, adolescent counseling, family services, medical detox, therapeutic child treatment, and women's residential. Help is available for individuals and families affected by substance abuse from newborns to adults.

Adam Brickner joined the Phoenix Center as Executive Director in July 2008. With more than 20 years of experience in the substance abuse field, Brickner served as the first director of the Denver mayor's office of drug strategy and also as president and CEO of Baltimore Substance Abuse Systems, the designated authority to oversee substance abuse services for uninsured and underinsured residents of the City of Baltimore. "What I appreciate about the Phoenix Center is the opportunity to unite policy with application," says Brickner.

Brickner was pleased to join the NIATx Business Case Community of Commitment (COC) in the fall of 2008. "It was an honor for me that the state allowed me to attend," says Bricker. "I was interested in the COC because it promised interactive instruction, and the focus on maximizing existing resources was very compelling."

The fall 2008 COC began with a two-day workshop in Madison, Wisconsin. "Our small group was able to build relationships quickly and attack the issues from multiple angles," says Brickner. "The instructors' style fit well with our group's interest in practical application of process improvement."

Participants in the COC learn to view their organizations as businesses and clients as customers. Comments Brickner, "While we are a health care service, we are also a business that works to eliminate costly inefficiencies."

Brickner left the two-day training with a specific idea for a change project at the Phoenix Center: the admission process for the detox program. "I wanted our team to examine why our detox program had a waiting list and five empty beds at the same time."

To address this problem, the team tested several changes, including:

  • Eliminating scheduled appointments for detox admissions
  • Reducing the number of phone screen questions
  • Asking callers "What time can you be here today?" rather than telling them "We have an appointment available on…."
  • Posting anticipated admissions and discharge information so that all staff is aware of the number of detox beds available
  • Adjusting staff schedules to cover peak admission times

Bricker found the COC follow-up coaching and teleconference calls very valuable. "They gave me deadlines to target and kept me on track to report on the progress of our project."

The change project eliminated the detox waiting list, reduced no-shows by 56 percent, and increased utilization to 99 percent."

"We clearly saw a business case for process improvement," reports Brickner. "The increase in utilization represented a potential annual increase in revenues of $164,000."

Brickner also noted a change in attitudes across all aspects of the Phoenix Center. Staff now see Phoenix Center patients as customers.  Our perspective is that if a client comes in for help, we finish whatever process we can on the same day to engage them in a meaningful way so they will come back for treatment and hopefully, initiate a lifetime of recovery."

Adds Brickner, "I would definitely recommend the NIATx Business Case COC to other providers. Through the focused instruction, I could apply what I'd learned immediately. Now using data to measure change is part of our culture at The Phoenix Center."

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