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New Change Project: Methadone Counselor Access June 6, 2006

Posted by rredmond in General.

My hospital (Acadia in Bangor, Maine) decided to apply rapid cycle change to a problem in our methadone program.  Clients have been no-showing for scheduled counselor appointments at a high rate and productivity has been not good.  A high percentage of clients have not even been getting to the minimum requirement of one meeting per month with their counselor.  The change team mapped out a flow chart; did two walk-thru's; and conducted a focus group with six clients.  We discovered several areas for process change but went with the most glaring issue (discovered in the focus group) – clients were plain forgetting their appointments.  We've adjusted software (using the SMART program) to produce in-clinic reminders on the computer for the dosing nurse to start reminding clients for the last five days leading up to their appointment.   When we conclude the first PDSA cycle, I'll report the results.  I'd appreciate feedback and would especially like to hear if other programs in this collaborative have tried to tackle this issue. Rick Redmond



1. Angie - July 5, 2006

Hi Rick,

We are currently doing reminder phone calls for both of our outpatinet programs. At one site the calls work really well and we have seen a great increase in continuation and reduction of no-shows, however in the other site the increase in continuation flactuates and we have not reched our goal of 80% of clients continuing through to the 4th treatment session. Still trying to figure out why. I am interested in finding out about the SMART software to install in the site that is challenged. Do you have any information about where I can go to research??

Thanks so much.

Angie Maldonado
CFDFL (Florida)

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