Sustaining Change

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Sustaining Change
Reduce Waiting  No-Shows ? Increase Admissions 
Continuation
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Agenda

• Making the business case for sustainability
• Principles of sustainability
• Q-A period
• Survey of next steps
• Resources for continued learning

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Review of our Tutorials

• Conducting a Walk-Through
• Gathering Baseline Data
• Setting a Change Objective
• Using the Quick Start Road Map
• Conducting PDSA Change Cycles
• Sustaining Change

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Key to Sustainability Making the Business Case

• Economics drives an agencys ability to provide
  services
• A positive economic impact is an important
  leverage point for change
• Services that drain resources are rarely
  continued

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What do we mean by the Business Case?

• Process improvements can impact your
• Financial bottom line
• Organizational climate
• Efficiency and productivity
• Relationship with referral sources
• Staff retention
• Client satisfaction
• Treatment outcome

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Example 1
Increase in Admissions/MonthCommunity Resource
Center
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Example 2
Reduced No-Shows
Franklin-Williamson Human Services
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Example 3
Monthly Revenue Increase Franklin Williamson
Human Services
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Sustainability

• Sustainability of change is not easy.
• Up to 70 of improvements are not sustained.

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Definition

• Sustainability exists when a newly implemented
  process
• continues to improve over time,
• becomes the way things are done around here and
  
• does not return to the old process that existed
  before the improvement project began.

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Sustainability Model
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Process
1. Does the change improve efficiency? 2. Are the
benefits obvious, supported by evidence and
believed by stakeholders? 3. Can the change be
adapted or spread to the whole organization? 4.
Is there a system for monitoring and continually
improving the process?
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Staff

• Has the staff been informed of the change and
  trained to sustain the process?
• Do staff feel empowered as part of the change
  process and believe the improvement will be
  sustained?
• Do agency leaders take responsibility for efforts
  to sustain the change process and communicate
  regularly with staff?

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Organization

• Is the improvement consistent with the agencys
  strategic aims?
• Are staff, facilities and equipment, job
  descriptions, policies, procedures and
  communication systems appropriate for sustaining
  the improved process?

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One Secret to Sustaining
Change

• Make it as easy as possible for people to use
  the new methods and very difficult for them to
  revert to old ways of doing business.

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Who do you need?

• A Sustain Leader who understands the change
  and can monitor performance to make sure the
  change is sustained.

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In SummaryWhat Needs to be Done

• Update all documents and operating procedures
• Train all staff in the new procedures
• Hold an official launch of the new protocol
• Have a clear method for monitoring the new
  process
• Verify maintenance of the change periodically

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Learning Resources

• Join the ACTION Campaign
• Adopting Changes to Improve Outcomes Now
• www.actioncampaign.org
• Download Action Kits for improving access,
  engagement, and transition between levels of care

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Learning Resources

• NIATx
• Network for the Improvement of Addiction
  Treatment
• www.niatx.net

• NIATx Workbook
• Videos on Process Improvement
• Tools to help with improvement projects
• Case studies
• Promising practices and strategies

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Thank you for joining us!

• Best wishes to all of you as you experiment
  with improving access, engagement and retention.
  Your clients will appreciate it!
• - The CATES staff at UCLA and the Pacific
  Southwest ATTC

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