A Case Study: Changing Organizational Processes and Culture to Improve Treatment Access and Retention

The APT Foundation is a non-profit substance abuse treatment and research organization founded nearly 40 years ago in New Haven, CT. APT provides a range of clinical services including primary health care to approximately 4000 persons each year. In mid-2006, APT adopted the NIATx rapid cycle process improvement approach that promotes a series of techniques designed to help organizations improve both treatment access and retention by focusing on several key data points as measures of success. Using this approach, the census in medication assisted treatment has grown from 1300 (June 2006) clients to the present census of 2216 (January 2009) as wait time to treatment dropped from an average of 23 days (Jan 2006) to 2.5 days (Jan 2009) APT has created an access center that provides an average of 175 walk-in evaluations every month compared to an average of 30 scheduled evaluations/month in 2006. Access Center also provides more than 100 open groups/month compared to15 closed groups/month in 2006.

Additional resources generated by increased census are used to provide more primary care services for this often multi-need population. APT has also instituted free influenza vaccinations at the point of service for clients, free hepatitis vaccination and free overdose prevention education and resources.

Focus on treatment access and retention has fostered many changes that were designed by staff to create a low-barrier system and improve client engagement and participation. Continuously reviewing data, and selecting changes that moved APT toward its access/retention goals has shifted organizational culture.