It is important for institutions and practitioners to stay up to date on treatment models. As more and more research is conducted and gathered on addiction, treatment methods should correlate and adapt. Improving addiction treatment models affects quality of care and success of recovery for patients, and it develops the knowledge and experience of practitioners. This is known by people working within the addiction treatment community. But it is also pressured in the general medical care world. And this burden of responsibility might add further stress to the proceedings. Especially in times when funding is low and resources are restricted, the effectiveness of existing addiction services must be as high as possible. Basically, improving treatment models can help institutions do the best with what they have.
However, it can be difficult to implement changes, even when they are for the better, for numerous reasons. Bureaucracy and administration often slow down the process. Organisational change can be a huge project. And one that is constantly on-going. However, it is important to keep working on improving treatment models. There are strategies out there to encourage the effort and make the process smoother, more efficient, and more possible.
For example, the Network for the Improvement of Addiction Treatment (NIATx) strives towards the goal of improving treatment models. It teaches strategies to create change in a manageable and organised way. Whatever the treatment model changes an intuition chooses to implement, it recommends five basic principles to follow. The first is to understand the client. The second is to fix key issues. The third is the choose a powerful leader. The fourth is to gather ideas from external sources. And the fifth is to implement rapid-cycle testing. According to studies, the implementation of most, if not all, of these five points leads to successful improvement of treatment models.
The first principle – to understand the client – is based on the idea, or the truth, that organizational changes orientate around the ‘customer’. Addiction treatment is, first and foremost, about helping people overcome addiction. Therefore, a key focus in the improvement of treatment models should be the person depending upon and benefiting from the services. For example, organised change could lead to the improved treatment of individual cases, rather than a general application of standard protocols. The goal could be to enhance the use of individualised treatment plans, which would improve such things as dual diagnosis, the involvement of criminal justice, domestic abuse protection, child-care, and accommodation requirements for patients. Basically, this first principle of improving treatment models is to sensitively focus on the needs of the client.
The second principle – to fix key problems – helps the improvement of treatment models by homing in on the critical elements of an institution. It seems obvious, but the biggest and most important problems should take priority. In times of organisational change, those are the things you want to fix or improve first. This might vary from place to place. It might be a lack of material resources, staff shortages, maintenance issues, financial problems, lack of training or experience, etc. However, the general rule is easy to follow. It is then up to individual treatment centres to identify their most pressing concerns. But this identification of key problems is an important part of the general treatment improvement plan.
The third principle – choose a powerful leader – refers to a leader who will act strongly in a time of change. This might not be the same person who works well in managing day-to-day upkeep. It should be somebody who is open and willing to implement change to improve models of treatment. This person should, therefore, exhibit authority and be respected enough to motivate groups of people. They should also be powerful and sociable, able to work effectively with others, and motivating. Having a clear vision is also important, as is being able to express it to their team, and they should be committed to achieving it. Change can be difficult, even when it is in an effort to improve treatment models, therefore a powerful leader should be chosen to help overcome resistance to it.
The fourth principle – gather ideas from external sources – means seeking input from other places. Looking outward can encourage fresh perspectives and new angles on how to improve treatment models. Institutions can learn from the failures and successes and others, before making those same mistakes or following those same leads themselves. For addiction treatment centres, this might mean looking at other health care processes outside addiction. It could also mean examining the procedures of other addiction treatment centres. Or even looking at commercial business models and consumer-orientated companies. Thinking outside the addiction treatment box could lead to surprisingly applicable improvements for treatment models.
The fifth principle – use rapid-cycle testing – which is based on the idea of identifying issues and creating solutions. It enforces the concept that when organisational change is made to improve treatment models, it should be tested to measure its effectiveness. Once a new process is implemented, its outcomes should be assessed, and then changed further accordingly. This method can ensure that changes are tried and tested before being applied on a big scale. It is often wise to test changes with a small sample of patients and staff to see how feasibly they work. If it works, it can be institutionalised. That’s when large-scale improvements of treatment models can be put in place.
This is an example of just one strategy that can help improve treatment models. However, there are many more out there. And there are many precise methods of change. But the principles of NIATx are simple and adaptable. They approach organisational change in a logical way. To improve a system, of course you need vision and focus, knowledge of problems, strong leadership, wider perspectives, and testing strategies. And in the world of addiction treatment, you also need the endurance and passion of knowing that organisational changes to improve treatment models will greatly help the lives of many, many vulnerable people. That is probably the most important principle of all.
- ↑ https://www.icpsr.umich.edu/icpsrweb/NAHDAP/studies/34406
Independent NonMedical Prescriber, UK Addiction Treatment Centres
Geoff Mascall has been a visiting lecturer at the University of West of England and has run many educational sessions for medical and allied health professionals during his...