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."

Leaders in most organizations face many challenges, including matching the right person to the job. Executive directors of substance abuse treatment agencies are not exempt from these challenges.

Synopsis of the Work: The Robert Wood Johnson Foundation (RWJF) Paths to Recovery national program taught leaders in substance abuse treatment agencies to use process improvement strategies originally developed by private industry to improve their business operations. National Program Office Staff identified the top leadership qualities of an effective change leader as:

• Willingness to challenge the status quo
• Ability to get results and verify them with data
• Persistence
• Respect from staff at all levels of the organization
• Goal-oriented and focused on change-project objectives

Other key qualities, according to the NPO, are enthusiasm, energy and an ability to instill optimism in staff.

Key Results: Coaches provided ongoing support as change leaders confronted typical project problems such as delays, waning enthusiasm for change, resistance or confusion among staff and difficulties collecting data. For one coach, the key is making sure change leaders know what they are getting into. "They need to know the specifics—when is the kickoff with other agencies, when do they need a course in 'rapid-cycle change 101'. Even more important they need to know how important their roles are and they have to hear that more than once. If they get that, they begin to understand their role clearly early on and can bring other staff aboard."