Solving One Problem at a Time

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: Staff at NIATx (Network for Improvement of Addiction Treatment) found that substance abuse treatment agencies were so eager to attack several problems at once that they were struggling to succeed at fixing any one of them.

Synopsis of the Work: Through NIATx, the national program office for the Robert Wood Johnson Foundation's Paths to Recovery national program, grantees learned to apply process improvement strategies originally developed by private industry to improve their business operations. These strategies emphasized incremental changes that were tested, revised, retested and adopted in a series of rapid-cycle changes. NIATx provided participating agencies with technical assistance, training and the services of a trained coach.

Key Results: NIATx focused improvement efforts on achieving four aims: reduce waiting times, reduce no-shows, increase admissions and increase continuation rates. Although the goal was for each agency to address all four aims in order to achieve systemwide transformation, NIATx coaches taught grantees to start small—with one aim, one level of care and one location at a time.

Some grantees learned the hard way and had already concluded that they were trying to do too much before the coach came to their rescue. But, Jay Ford, a NIATx staff member and Paths to Recovery coach laughs, "Some people, to be honest, already had jumped in fully clothed. They're not going to get out and put on a bathing suit; they're going to keep swimming."

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