Leadership Challenges

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: NIATx (Network for Improvement of Addiction Treatment) served as the national program office for the Robert Wood Johnson Foundation (RWJF) Paths to Recovery national program. NIATx and RWJF saw a need to reduce wait time for services, reduce no shows, increase admissions and improve retention in care.

Synopsis of the Work: Paths to Recovery taught leaders in substance abuse treatment agencies to use process improvement strategies originally developed by private industry to improve their business operations. An Executive Sponsor, usually the executive director, leads the team by ensuring that they have the resources and time to succeed. A key role of the Executive Sponsor is to choose and support the right in-house Change Leader, the person in charge of day to day change activities. NIATx staff identified several ways that an Executive Sponsor can foster organizational receptiveness to change, including impromptu visits to team meetings, reading and commenting on minutes of team meetings and rewarding and acknowledging "heroes."

Key Results: Some Paths to Recovery Executive Sponsors became champions right away. Other leaders embraced the NIATx model more slowly. Sometimes an executive who resisted at the start did eventually "take off," according to Jay Ford, a NIATx coach who advised and guided agencies in using process improvement strategies.

One Story Told: Tim Smith, executive director at Daybreak in Spokane, Wash "struggled with the NIATx model of incremental rapid-cycle changes and hesitated to become actively engaged. Then, a light turned on and he got it," according to coach Jay Ford. Since NIATx offers a range of learning resources—formal learning sessions, teleconferences, coaching and informal peer networking, the switch that caused the light to go on could have been any one or a cluster of factors. Whatever the cause, says Ford, Smith is going "great guns."

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