A feasibility study of a web-based performance improvement system for substance abuse treatment providers.

This article reports on the feasibility of implementing a semiautomated performance improvement system — Patient Feedback (PF) — that enables real-time monitoring of patient ratings of therapeutic alliance, treatment satisfaction, and drug/alcohol use in outpatient substance abuse clinics. The Patient Feedback system comprises four main components: feedback surveys, feedback reports, feedback newsletters, and team meetings. The system was implemented in six clinics within the National Institute on Drug Abuse Clinical Trials Network (as part of protocol CTN-0016), ultimately involving a total of 39 clinicians and 6 clinic supervisors. Throughout the course of the study (consisting of five phases: training period, baseline, intervention, postintervention assessment, sustainability), there was an overall collection rate of 75.5% of the clinic patient census. In general, the clinicians in these clinics had very positive treatment satisfaction and alliance ratings throughout the study. However, one clinic had worse drug use scores at baseline than other participating clinics and showed a decrease in self-reported drug use at postintervention.

This project demonstrated that the implementation of the PF system is generally feasible from both a research and a clinical perspective. Moreover, it is notable that clinics continued to use the PF system after the intervention phase, without any additional support from the research infrastructure, suggesting that the implementation of the intervention is sustainable. However, it is unclear whether this sustainability can only be achieved after completing a research study during which research infrastructure was substantially involved. Therefore, before clinical implementation can be recommended, more evaluation of the sustainability of the system and its positive intervention effects needs to be done.

Related protocols: CTN-0016