Time to take ACTION: a national campaign aims to help providers increase access to and engagement in addiction treatment services.

by Fitzgerald, Maureen

Behavioral Healthcare • Sept, 2007 • Adopting Changes to Improve Outcomes Now

This is an exciting moment in the field of behavioral health," says Dr. David H. Gustafson, director of the Network for the Improvement of Addiction Treatment (NIATx). "We've learned a great deal about what works for substance abuse treatment agencies. With the ACTION Campaign, we have an extraordinary opportunity to share this knowledge with the field."

In partnership with several national organizations (table), NIATx will launch the Adopting Changes to Improve Outcomes Now (ACTION) Campaign next month. The ACTION Campaign promotes a set of changes that many organizations in the addiction treatment field seek to make.

"The dramatic results that the NIATx agencies experienced using process improvement methods led us to ask how we could broaden our reach to the entire field," explains Dr. Gustafson. "While the improvements had been impressive, we'd only reached a small number of organizations--a few hundred out of the 13,000 in the country. We feel that the field is ready for a transformation and that through a national campaign, we could reach a greater number of agencies and encourage them to make similar changes."

Joining ACTION is entirely free to providers, and all of the training and technical assistance materials--both print and electronic--are available to participating organizations at no cost.

A Partnership of Leading National Organizations

The Campaign formed a partnership among leading organizations as an effective way to reach the widest possible audience, and also because no single organization has ties to all the addiction treatment providers across the country.

"Our goal with the ACTION Campaign is to enroll at least 500 organizations that will learn to use process improvement strategies to create sustained benefits for treatment clients and the agencies that serve them," says Howard Shapiro, executive director of State Associations of Addiction Services (SAAS), one of the 12 organizations in the ACTION Campaign partnership.

The ACTION Campaign promotes the national adoption of proven practices for enhancing access and engagement. Specifically, these practices support three actions that can greatly increase a client's chance for recovery:

1. Rapid access

2. Enhanced engagement

3. Seamless transition between levels of care

These ACTIONs were selected because they proved to be successful when implemented by NIATx's 39 founding members, as well as many other organizations involved in NIATx projects. As of November 2006, NIATx members reported a 34.8% reduction in wait times, a 33% reduction in no-shows, a 21.5% increase in admissions, and a 22.3% increase in treatment continuation.

Promoting these proven practices serves a dual purpose: to respond to the changing needs of the American population, while at the same time providing effective and relevant training to the field.

"We have a lot planned to support providers who are new to this effort," says Dr. Gustafson.

Innovative Staff Training Opportunity

The ACTION Campaign incorporates the core principle of adult education that adults learn by doing. "We designed the Campaign tools to offer relevant training that treatment professionals can implement quickly--and see quick results as well," says Dr. Jay Ford, NIATx's chief research officer.

Treatment professionals who take part in the ACTION Campaign will be able to take advantage of training tools and instructions from the convenience of their own offices.

"This is in distinct contrast to our traditional method of training, where we send people away for a day or two of class work," adds Dr. Ford. "Frequently what was learned was never implemented because the organizational infrastructure did not adapt to support the new practice. In addition, the clinician received little support for implementation of complex new treatment models."

In contrast, organizations participating in the ACTION Campaign will learn to build a team, to test new practices, and to sustain them. A foundation of this approach is a learning collaborative model that encourages organizations to seek inspiration and motivation from their peers.

Participating in the ACTION Campaign allows clinicians to rapidly experience the benefits of the techniques they have learned. Through implementing proven practices in brief trials and comparing data pre- and postchange, staff will enhance their skills and learn how to measure their effectiveness.

"We all expect that there will be a greater emphasis on performance expectations in the months and years to come," adds Dr. Gustafson. The ACTION Campaign will provide treatment agencies with the opportunity to strengthen their ability to meet these expectations.

ACTION Campaign participants who make a commitment to adopting one of the three changes will receive an ACTION Kit that will include simple, practical tools for implementation. The ACTION Campaign Web site (www.actioncampaign.org) offers instructions, data collection tools, case studies, access to focused teleconferences, online learning tools, the NIATx process improvement workbook, and opportunities to participate in peer-learning training events.

Additional Benefits

"We see the ACTION Campaign creating a peer-learning network for treatment providers--strengthening the field," adds Dr. Gustafson.

The Campaign's partner organizations anticipate that ACTION will benefit all purchasers of treatment services--the federal government, state and local governments, public welfare agencies, the criminal justice system, and employers--by improving the quality of treatment and creating an organizational culture of process improvement.

Dr. Gustafson feels that the ACTION Campaign offers a process improvement model not only to addiction treatment providers but also to the mental health field: "Mental health providers also face significant problems and challenges in areas such as rapid access, engagement, and adhering to treatment. The process improvement methodology we use has been adapted from many other industries and can transfer easily to mental health treatment."

Maureen Fitzgerald is an Editor at the Network for the Improvement of Addiction Treatment (NIATx). She can be reached at (608) 890-0937 or maureen.fitzgerald@chess.wisc.edu. To learn more about the ACTION Campaign, visit www.actioncampaign.org.