Help Wanted: Building a better EBP implementation tool

August 28, 2013

You’ve been hearing about evidence-based practices (EBPs) for quite some time. SAMHSA now offers more than 300 intervention summaries in the National Registry of Evidence-based Programs and Practices.  The ATTC Network’s mission is to promote implementation of evidence-based practices. NIATx initiatives like the Ohio Buprenorphine Study focus on removing barriers to the implementation of EBPs.

You’ve probably learned about EBPs at conferences and attended trainings. Maybe you’ve even tried out a new EPB in your workplace.  But chances are EBPs are not fully integrated into services at your agency. We know that “one and done” trainings aren’t enough to change paradigms and old habits.

So what does it take to fully implement an EBP?  As The Institute of Medicine report “Crossing the Quality Chasm” states, “It now takes an average of 17 years for new knowledge generated by randomized controlled trials to be incorporated into practice, and even then application is highly uneven.” In one study people with substance use disorders were the least likely to receive evidenced-based care compared to a list of other diseases.  
We have to do better.
NIATx and the ATTC Network Coordinating Office have teamed up to develop a new website, TheNetwork of Practice, with three goals:
  1. Link substance abuse treatment providers to researchers so they can learn from each other, and through this interaction find ways to collaborate on practical research.
  2. Promote the adoption of EBPS.
  3. Create an online learning community.
To meet these goals, the Network of Practice website includes two main components: an implementation checklist and a discussion forum.
We need your help! is currently in “draft” mode and has only been pilot-tested with a small audience. We’re inviting you to test the site and give us some feedback. As you try it out, consider the following questions:
  • Is the site easy to use? What could we do to improve it?
  • In what ways would you like to connect with your peers about implementing EBPs?
  • How can we best connect you to the researchers behind EBPs?
Please send your comments to Stephanie Richards by September 30. Your ideas and suggestions will help us design the best possible interactive tool to connect you to researchers and peers and support your efforts to implement EBPs.

Stephanie Richards, MPH
Outreach Specialist
NIATx/Center for Health Enhancement Systems Studies (CHESS)
University of Wisconsin-Madison

*The Network of Practice website was funded by the National Institute on Drug Abuse (NIDA).

No appointment necessary

August 21, 2013

Maureen Fitzgerald
ATTC Network Coordinating Office and NIATx

Walk-ins are often welcome at hair salons and restaurants. Can they work at your treatment organization?

Just ask
Lynn M. Madden, CEO of the  APT Foundation, a non-profit substance abuse and mental health treatment organization in New Haven, CT. The APT Foundation has eliminated scheduled appointments completely for all outpatient programming.

“We’ve created a single front door to help our clients get into treatment as quickly as possible,” says Madden.

When Madden joined the APT Foundation in 2006, the average waiting time from evaluation to first treatment was 22 days. One of the first things she did was change the screening process to create an “access center,” combining all the screening functions that existed across five locations into a single unit. A committee that included Madden, members of the APT board, and staff improved the work flow, changing the order of the administrative and clinical processes. With a single front door in place, APT began to offer walk-in hours.

“In the first year, our average time to treatment decreased to 8 days. By the second year, it was down to 2 days, and today most people receive their first treatment or medication, or both, on the same day they walk in.”
The change in the intake and admission process aligned with changes in the clinical processes as well.  “That initial evaluation ends with a treatment plan that’s based on client input and preferences,” she explains. “The clinician then invites the person to enter treatment that day, and if a physical is required, that can also happen on the spot.”

Client involvement in the treatment plan is key. “People who are seeking care know the most about what they need,” says Madden. “Rather than prescribing, we invite clients to select what they need in terms of treatment.”

Outpatient group therapy offerings
are updated regularly on the agency’s website and include traditional 12-step groups along with groups on topics such as mindfulness, job seeking skills, and relapse prevention.

“Prioritizing offerings based on client preferences has improved clinical outcomes, increased staff efficiency, and our stabilized our finances,” says Madden. In fiscal year 2013, the APT Foundation treated 6,792 patients, completed 2,954 walk-in evaluations, gave away almost $2 million in reduced rate or free care, and ended with an operating gain of a half a million dollars. “And that was after returning cash incentives to our employees,” adds Madden.

Overall, the APT Foundation has found that streamlining the admissions process brings in more clients. “The people who come in on a walk-in basis are typically those most in need of care. And we have a data set now of thousands that shows they are getting as well or better than clients who were less acute, but who entered care under the old system with appointments and prescriptive practices.”

Madden encourages other organizations to consider adopting a no-appointment-required system. “By putting administrative and clinical processes in a different order, we were able to meet our goal to get clients into care as quickly as possible.”
Lynn Madden, CEO, APT Foundation

Want to know more about how the APT Foundation eliminated scheduled appointments?  How they overcame barriers to open scheduling? What reducing waiting times would mean at your organization? Post your comment or question below!  

Better Together: Welcome to the ATTC/NIATx Service Improvement Blog!

August 7, 2013
Quick:  Can you name two things that belong together?

Let us get you started –
                  Peanut Butter & Jelly
                  Paper & Pencils
                  Fred & Ginger
                  Mario & Luigi
                  Salt & Pepper

There are just some things in life that are better together. 

By themselves, they are certainly adequate.

Together, however, the pair produces a much more desirable result.
For years, the Addiction Technology Transfer Center (ATTC) Network has worked to improve the clinical practices used to treat substance use disorders by promoting the adoption and implementation of evidence-based and promising practices in recovery-oriented systems of care.

For years, NIATx has worked to improve the business practices of addiction treatment providers by improving the cost and effectiveness of the care delivery system.

Sometimes our paths have crossed.

But never have we really presented our two organizations as symbiotic partners sharing a common vision. In the increasingly complex and competitive health care environment, it’s about time we did.

While NIATx and the ATTC Network focus separately on different aspects of improving the services received by people with substance use disorders, together both organizations are firmly committed to the belief that better services lead to better outcomes resulting in transformed lives and healthier people, families and communities.

Welcome to the new Service Improvement Blog, co-sponsored by the ATTC Network Coordinating Office and NIATx. Through this blog, we will c. We will feature practical tips, techniques, and tools to make it easier to manage programs and provide services. We will share stories from providers and feature guest bloggers, including scientists, people in recovery, and outside the field experts, who will share what is happening in their spheres of influence that might be useful or eventually have an impact on your work.

We want to be responsive to your interests and needs, and so we need your participation. While NIATx and the ATTC Network are better together, the kind of true innovation that will improve services for people with substance use disorders now and in the future will only really come if all of us who are committed to this work engage in discussion and collective action. We welcome your comments, posts and requests, and look forward to moving our work forward together.

Laurie Krom      Kim Johnson, Co-Director
Director, Educational Services             
ATTC Network Coordinating Office