Reducing Pretreatment Dropout Rates in Outpatient Substance Abuse Clinics
The project aims to reduce the number of clients who fail to attend their scheduled first appointment at an outpatient substance abuse clinic by 25%. The project will commence on 7/07/08 and is expected to be completed by 7/09/08, with a review of outcomes on 8/12/08. The project team consists of Oisin Friel as the guidance team member and Sue Weston, Linda Miller, Barbara Jane Murray, Loretta Elkins, and Karen Hanzal Jones as project team members with fundamental knowledge.
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About Reducing Pretreatment Dropout Rates in Outpatient Substance Abuse Clinics
PowerPoint presentation about 'Reducing Pretreatment Dropout Rates in Outpatient Substance Abuse Clinics'. This presentation describes the topic on The project aims to reduce the number of clients who fail to attend their scheduled first appointment at an outpatient substance abuse clinic by 25%. The project will commence on 7/07/08 and is expected to be completed by 7/09/08, with a review of outcomes on 8/12/08. The project team consists of Oisin Friel as the guidance team member and Sue Weston, Linda Miller, Barbara Jane Murray, Loretta Elkins, and Karen Hanzal Jones as project team members with fundamental knowledge.. The key topics included in this slideshow are Pretreatment dropout, outpatient substance abuse clinic, reduce rates, project team, review outcomes,. Download this presentation absolutely free.
1. Name Oisin Friel Location Ryde Drug & Alcohol Services Pretreatment dropout from outpatient substance abuse clinic
2. Mission Statement Project Aim: Reduce the number of clients by 25% who fail to attend for scheduled first appointment Time frame: Proposed commencement date:7/07/08 Anticipated completion date: 7/09/08 Date of Review of Outcomes of Project: 8/12/08
3. Team Members & Role Guidance team member: Oisin Friel Project team members with fundamental knowledge and who worked on the project: Oisin Friel, Sue Weston, Linda Miller, Barbara Jane Murray, Loretta Elkins, Karen Hanzal-Jones
4. Evidence for there being a problem worth solving An monthly audit was conducted of clinicians diaries for 2007 to determine the number of kept appointments in relation to scheduled appointments arranged for new clients to the service. 380 allocated appointments of one hour duration were reserved for new clients from January to December. The study revealed a 33% failed to attend rate in the twelve month period.
5. Failed to attend rate 2007 (33%)
6. Evidence for there being a problem worth solving Clinicians experienced frustration due to: Time wasted waiting for client to attend appointment Uncertainty about why clients failed to attend appointment Inability to attend to other work responsibilities Difficulty in organising work diary events
7. High Order Flow Chart of Intake Process Development of drug problem Inability to resolve problem Decision to consult GP GP confirms problems is serious Referral to D&A service Contact D&A service See clinician for assessment Receive treatment Follow up care Discharge
8. Detailed Flow Chart of area of Interest Client contacts service Speaks to intake officer Client given service details, date, time etc Appointment typed into computerised diary Appointment made with clinician Completed intake form filed Leaves message on voice mail Service returns call x 2 Message left Confirms clients request for this service Intake form completed Check for next available appointment Client arrives / CTC / FTA If other service requests appointment client must call to confirm Client calls to confirm If CTC new appointment arranged
9. Process Improvement Exercise Brainstorming possible reasons for problem Multivoting All team involved Group similar ideas / concepts together Secret ballot voting to choose biggest problem areas Represent as Ishikawa diagram (fishbone)
10. Cause and effect diagram Other Co morbid problems Cognitive Impairment External agencies Client fails to show for appointment Family / Money Forgot appointment Psychosis Motivation Too hard Couldnt be bothered Partner forbade it No one told me Too busy Had another appointment Too wet Too cold Drug, alcohol affected Too awkward to find place No money to get there Too unwell Didnt write appointment down In jail / hospital Assaulted Problem resolved Coerced Got new job Self harmed Slept in Scared Anxious Shame Crisis passed Not ready Got date/time wrong Confusion No transport Missed the bus Kids sick
11. Pareto Analysis Sheet Category Frequency Percentage Cumulative % Shame/fear 9 26 26 Lack of motivation 8 22 48 Forgot appointment 6 17 65 Overslept 5 13 78 Co morbid problems 4 11 89 Crisis passed 4 11 100 Total 36
12. Pareto Chart Reasons for failure to attend scheduled appointment
13. Intervention Clinicians to call clients prior to assessment date to: Introduce oneself to client Confirm appointment date and time Develop initial rapport Alay anxiety about coming to service
14. Intervention Implementation period: Two months All clinicians involved Data collected by admin assistant APPOINTMENTS SCHEDULING LOG (7/7/08 7/9/08) Client Identifier Date of Client Call Date of Scheduled Appointment Did Client keep Appointment? If CTC date of new appointment Did Client keep Appointment? 1 2/7/08 8/7/08 Yes 2 2/7/08 8/7/08 No 15/7/08 Yes 3 3/7/08 9/7/08 Yes
15. Outcome of Study
16. Strategies to Sustain Improvement Incorporate the changes made into the intake process Alter the method by which clinicians are notified of new clients placed in their computerised diaries so as to alert them to call the client prior to appointment time Monitor strategy on a monthly basis
17. Other PDSA Cycles to consider Reduce the lag time to first appointment Monitor dropout rate post assessment Record reasons clients give for cancelling appointments Stay linked to the ACTION Campaign ( www.actioncampaign.org ) to review research into addiction treatment improvements