Partnership for Advancing Recovery in Kentucky Using NIATX Technology for Continuing Care: Opening the Cage Door Will press lever for drugs!

Partnership for Advancing Recovery in Kentucky

Using NIATX Technology for Continuing Care: Opening the

Cage Door

Will press

lever for drugs!

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•PARK AIM: Increase continuation and PARK AIM: Increase continuation and decrease dropouts through a statewide decrease dropouts through a statewide

system of care that embraces system of care that embraces community linkages and collaborative community linkages and collaborative

planning.planning.

Target evidence based Target evidence based categories: categories:

Continuing Care &Wraparound Continuing Care &Wraparound SupportsSupports

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• The majority of those discharged from treatment do not receive the NIDA (1999) recommended 90 days of continuous care (White, in press).

• 80% of individuals who relapse after treatment do so in the first 90 days (Hubbard et al., 2001).

• The majority of substance dependent individuals only achieve stable recovery after 3-4 treatment episodes over multiple years (Anglin et al., 1997; Dennis et al., 2005).

More about Treatment

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• Only 17% of individuals who complete treatment in one level of care successfully access the next recommended level of care (OAS, 2005).

• Linking treatment to recovery supports improves outcomes 20-22% (Dennis, 2007)

• Only 20% of adults and 36% of adolescents receive any professionally-directed post-discharge continuing care. (Godley et al., 2001; McKay, 2001)

Treatment & Recovery

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NIATX: Five Principles• Understand and involve the customer

• Fix key problems

• Pick a powerful Change Leader

• Get ideas from outside the organization

• Use rapid-cycle testing

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Why a Walk-through?

The walk-through…– Helps understand the customer and organizational

processes– Provides a new perspective

• Allows you to feel what it’s like• Lets you see the process for what it is

– Seeks out and identifies real problems – Generates ideas for improvement– Keeps you asking why?…and why? again

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Executive Sponsor• Vision

– Provides a clear link to a strategic plan– Sets a clear aim for the Change Project

• Engagement– Supports the change leader– Periodically attends change team meetings– Personally invites change team participants

• Leadership– Removes barriers to change– Connects the dots– Communicates clearly, concisely, and constantly

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Change Team Responsibilities

• Meet regularly

• Ensure accountability – Record and distribute minutes– Assign tasks and responsibilities

• Identify potential solutions– Quickly test one idea– Measure the impact of the change

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Making Changes

• PDSA Cycles – Plan the change– Do the plan– Study the results– Act on the new knowledge

• Adapt• Adopt• Abandon

• Two-week-long cycles

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Strategies to Support Recovery

Improve the continuity of care

Individuals discharged from intensive levels of addiction treatment should be transferred to outpatient treatment before leaving the treatment system (APA, 1995; ASAM, 2001)

Use a recovery plan (as opposed to a treatment plan) (White & Kurtz, 2006; Scott, Dennis & Foss, 2005)

(Dennis & Scott, 2007)

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Emerging Strategies to Support Long-Term Recovery

Telephone-based continuing care (McKay

et al., 2004)

Recovery Management Checkups (Dennis et al., 2003; Scott et al., 2005)

Assertive Continuing Care (Godley et al., 2004)

Resource Guide access and training for counselors (Carise et al., 2006)

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DVD Introduction to Next

Level of Care

Use of TRAIN & Essential Learning

for Training and Tracking

Statewide Video Interest Circles

Targeting Evidence Based

Practices

Regional Video Conferencing for Training & Process

ImprovementUse of

Physicians Portalfor EMR Access &

Internet BasedClient Tracking

Software

Telehealth Network

for Primary and Medical Specialty

Care

Use of HBO Addictions video clips in

treatment groups

In House Video Production

Caney Digital Media

Interactive Video Game

Generation Rx for Prevention

Voicent Auto Reminder Telephone Calls

KTOS Assessments

Using PDAVideo Meetings

between Levels of Care Client & Counselor

Counselor

KRCC & Kentucky Technology Strategies

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Video Introduction to Next Level of Care

• Video created to demystify first visit to outpatient offices

• Video re-shot to better capture desired messages

• Video given to Hospital for units

• Case Managers with portable DVD player

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0%

10%

20%

30%

40%

50%

60%

70%

BaselineOctober

May June July August September

Percentage Substance Abuse Continuing Care from ARH- Hospital to KRCC Outpatient from Dual Units Versus Baseline

Appointments Kept Dual Unit Clients Only

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Video Handoffs

• Clients at Next Step Recovery Center and Bailey Center Crisis Stabilization Units have video meetings with next level of care counselor

• Clients in the Hospital Have had video handoffs with community counselor- currently discontinued

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Resource Guide

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Thanks for your attention!

• For more information contact:

Louise.howell@krccnet.com David Mathews wdmathews@aol.com Lou Kurtz louis.kurtz@ky.gov Wendy Morris wmorris@arh.org Jenniferstamper@chrysalishouse.org Pam Combs Pcombs@arh.org