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Partnership for Advancing Recovery in Kentucky
Using NIATX Technology for Continuing Care: Opening the
Cage Door
Will press
lever for drugs!
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•PARK AIM: Increase continuation and PARK AIM: Increase continuation and decrease dropouts through a statewide decrease dropouts through a statewide
system of care that embraces system of care that embraces community linkages and collaborative community linkages and collaborative
planning.planning.
Target evidence based Target evidence based categories: categories:
Continuing Care &Wraparound Continuing Care &Wraparound SupportsSupports
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• The majority of those discharged from treatment do not receive the NIDA (1999) recommended 90 days of continuous care (White, in press).
• 80% of individuals who relapse after treatment do so in the first 90 days (Hubbard et al., 2001).
• The majority of substance dependent individuals only achieve stable recovery after 3-4 treatment episodes over multiple years (Anglin et al., 1997; Dennis et al., 2005).
More about Treatment
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• Only 17% of individuals who complete treatment in one level of care successfully access the next recommended level of care (OAS, 2005).
• Linking treatment to recovery supports improves outcomes 20-22% (Dennis, 2007)
• Only 20% of adults and 36% of adolescents receive any professionally-directed post-discharge continuing care. (Godley et al., 2001; McKay, 2001)
Treatment & Recovery
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NIATX: Five Principles• Understand and involve the customer
• Fix key problems
• Pick a powerful Change Leader
• Get ideas from outside the organization
• Use rapid-cycle testing
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Why a Walk-through?
The walk-through…– Helps understand the customer and organizational
processes– Provides a new perspective
• Allows you to feel what it’s like• Lets you see the process for what it is
– Seeks out and identifies real problems – Generates ideas for improvement– Keeps you asking why?…and why? again
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Executive Sponsor• Vision
– Provides a clear link to a strategic plan– Sets a clear aim for the Change Project
• Engagement– Supports the change leader– Periodically attends change team meetings– Personally invites change team participants
• Leadership– Removes barriers to change– Connects the dots– Communicates clearly, concisely, and constantly
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Change Team Responsibilities
• Meet regularly
• Ensure accountability – Record and distribute minutes– Assign tasks and responsibilities
• Identify potential solutions– Quickly test one idea– Measure the impact of the change
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Making Changes
• PDSA Cycles – Plan the change– Do the plan– Study the results– Act on the new knowledge
• Adapt• Adopt• Abandon
• Two-week-long cycles
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Strategies to Support Recovery
Improve the continuity of care
Individuals discharged from intensive levels of addiction treatment should be transferred to outpatient treatment before leaving the treatment system (APA, 1995; ASAM, 2001)
Use a recovery plan (as opposed to a treatment plan) (White & Kurtz, 2006; Scott, Dennis & Foss, 2005)
(Dennis & Scott, 2007)
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Emerging Strategies to Support Long-Term Recovery
Telephone-based continuing care (McKay
et al., 2004)
Recovery Management Checkups (Dennis et al., 2003; Scott et al., 2005)
Assertive Continuing Care (Godley et al., 2004)
Resource Guide access and training for counselors (Carise et al., 2006)
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DVD Introduction to Next
Level of Care
Use of TRAIN & Essential Learning
for Training and Tracking
Statewide Video Interest Circles
Targeting Evidence Based
Practices
Regional Video Conferencing for Training & Process
ImprovementUse of
Physicians Portalfor EMR Access &
Internet BasedClient Tracking
Software
Telehealth Network
for Primary and Medical Specialty
Care
Use of HBO Addictions video clips in
treatment groups
In House Video Production
Caney Digital Media
Interactive Video Game
Generation Rx for Prevention
Voicent Auto Reminder Telephone Calls
KTOS Assessments
Using PDAVideo Meetings
between Levels of Care Client & Counselor
Counselor
KRCC & Kentucky Technology Strategies
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Video Introduction to Next Level of Care
• Video created to demystify first visit to outpatient offices
• Video re-shot to better capture desired messages
• Video given to Hospital for units
• Case Managers with portable DVD player
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0%
10%
20%
30%
40%
50%
60%
70%
BaselineOctober
May June July August September
Percentage Substance Abuse Continuing Care from ARH- Hospital to KRCC Outpatient from Dual Units Versus Baseline
Appointments Kept Dual Unit Clients Only
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Video Handoffs
• Clients at Next Step Recovery Center and Bailey Center Crisis Stabilization Units have video meetings with next level of care counselor
• Clients in the Hospital Have had video handoffs with community counselor- currently discontinued
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Resource Guide
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Thanks for your attention!
• For more information contact:
[email protected] David Mathews [email protected] Lou Kurtz [email protected] Wendy Morris [email protected] [email protected] Pam Combs [email protected]
