KATHLEEN REVILLE, CHANGE LEADERKAREN BLANCHETTE, TEAM MEMBER

MICHAEL CARTER, TEAM MEMBERKATHY WHITEHEAD, TEAM MEMBER

SANDY MARTINS, TEAM MEMBERJO-ANNE NEWTON, TEAM MEMBER

HENRY YOUNG, TEAM MEMBER

Seven Hills Behavioral Health NIATx Project

1. AIM

The aim of this NIATx project was to reduce wait time in our Methadone Treatment Facility which supports nearly 800 individuals per day.

At the beginning of the project, the wait time from walk in/call in to treatment was approximately 12 days, with wait times ranging from 7 days to 32.

2. Change

First change initiative was to designate Wednesdays as Walk In Wednesdays (or Wacky Wednesdays as renamed by staff). It was a disaster.

Reviewed data and developed second change project around Initial Clinical Assessment (ICA) and urine analysis (UA). Rather than send out UA for analysis, which would frequently come back “bad” (methadone and/or benzos with no prescription) and cause delay as we performed another UA, we switched to Quick-Strip UA and, if clean, scheduled ICA followed by titration. This reduced number of days waiting for UA to come back, and therefore, wait time between ICA and titration was reduced.

3. Results

By eliminating the days waiting for UA results to come back, readministering UA to be sure clean, and waiting again for results, we reduced our wait time from 12 days to 6.

Clients are much more satisfied because they don’t have to wait as long between appointments and staff are happier because things move more smoothly.

4. Next Steps

We abandoned the Walk In Wednesdays because the impact on wait time was negligible and we didn’t want a staff revolt.

We adopted the new ICA/UA procedure because it reduced our wait time by half, had minimal impact on staff and minimal impact on budget. We will use this procedure going forward.

5. Impact

Customers are happy with the reduced wait time. This leads to better follow through for appointments. Positive word of mouth in community has increased census.

An important lesson was to not throw in the NIATx towel due to a poor outcome on the first change project. To say that the first project was unsuccessful is an understatement, yet the team rallied, tried a new approach, and was successful.