Axis I Center of Barnwell: Reducing No-Shows

Paths to Recovery: Changing the Process of Care for Substance Abuse Programs

Field of Work: Increase access to substance abuse treatment by improving the quality and efficiency of the delivery system.

Problem Synopsis: Patients requesting substance abuse treatment encountered barriers such as difficult admission procedures, poorly designed telephone systems and an un-engaging reception staff. Instead of an appointment, they often received a request to "call back later."

Axis I opened in 1973 when the South Carolina legislature mandated that the 24,000 residents of rural Barnwell County be provided with alcohol and other drug treatment services. Adolescents make up 36 percent of Axis I clients.

By October 2002, the center was in dire straits due to state program and budget cuts. When The Axis I executive director heard about the Robert Wood Johnson Foundation (RWJF) Paths to Recovery national program, she saw it as a means to build the process improvement system the agency needed.

Synopsis of the Work: Axis I started by addressing the agency's high no-show rate for adult outpatient appointments, which hovered at 63 percent in October 2003. The agency undertook several strategies, including: telephone calls and home visits; supportive services; and warmly greeting clients.

Key Results: By March 2004, the no-show rate at Axis I Center dropped to 45 percent, a 28.6 percent decrease.