Implementation of a technology-based, quality improvement system at outpatient substance abuse treatment programs: A qualitative analysis.
Modifiable variables such as length of treatment, therapeutic relationship, and treatment environment are associated with successful outcomes for substance and alcohol dependent individuals, and permit and support incorporation of quality improvement (QI) systems in treatment settings to enhance consumer satisfaction. Initiated in 2006 and based on completed CTN protocol CTN-0016 (“Patient Feedback : A Performance Improvement Study in Outpatient Addiction Treatment Settings”), the Patient Feedback (PF) study, is a randomized effectiveness trial implementing a QI system at 20 outpatient, substance abuse treatment programs in Pennsylvania and New York. Patients in group therapy sessions complete anonymous surveys on a weekly basis evaluating treatment satisfaction and therapeutic alliance with their group counselors. Surveys are processed and two types of feedback reports are generated for clinicians to download via a password-protected website. Caseload reports display aggregated feedback from group clients for individual clinicians. Clinic reports display aggregated feedback from all group clients for all participating clinicians. During monthly staff meetings, clinic reports are discussed and strategies are developed to address specific areas where there is opportunity for improvement.
Key findings from staff interviews supporting the acceptability of the PF system include: 1) endorsement of PF and its usefulness in providing constructive feedback, 2) clinic reports are valued as an effective tool to identify areas for improvement, and 3) team meetings are useful in cultivating open discussions regarding significant therapeutic issues. Additional findings reflecting differences in clinic funding, technology utilization, and clinician caseloads will be presented. In conclusion, differences in clinic structure, organization, and available treatment services present unique opportunities for PF study implementation. These differences impact staff involvement, interest, and motivation of the PF system.
Related protocols: CTN-0016