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Spectrum Health Systems
Lincoln Street Opiate Treatment
Support for this project was provided by NIATx through
a grant from the National Institute on Drug Abuse.
PDSA – What did you do and why?
• Identified need to improve participation during
treatment in the Lincoln St outpatient opiate
treatment program by reducing the wait time for
first counseling session
• Baseline data indicated current wait time for first
counseling session was 28 days after admission
• GOAL: to reduce wait time from 28 days to 10
PDSA – What did you do and why?
• Provide clinical staff a bonus to be available the
week following seeing a client for an intake to
schedule and meet with the client for a follow up
• Clinician in the follow up session will complete
the initial treatment plan and continuing care
plan, and check in with client on their
methadone dose and how program is meeting
the client’s needs
Decision Support – What
Happened and How do you Know?
• Review of data for the 2 months following this
change indicated that clients were seen on
average 7 days following their admission for first
counseling session
• Exceeded anticipated benchmark of reducing
from 28 days to 10 days by 3 days
• 93% of the admissions reviewed were seen
within one week of their admission date or less
Decision Support – What
Happened and How do you Know?
Wait Time to First Clinical Session
Avg Wait Time
Post Change
Prior to Change
Number of Days
Business Case and/or Strategic
Advantage for the Organization
• This change increased the number of counseling
sessions per client resulting in increased
revenue for the program
• 93% of clients showed for the scheduled session
the following week, resulting in increased
productivity for the clinician
• Increased sessions increases monitoring of
clients in early phases of treatment which should
have an impact on retention and clinic census
The Plan for Sustainability
• Plan to continue to positive changes to engage clients
sooner in the program and continue to reimburse
clinicians with a small bonus to ensure the practice
• The bonus amount paid is offset by the increased
revenue especially considering the low no show rate for
these appointments and the impact on retention and
census ongoing
• Team is now looking to follow the same process for
admissions that transfer directly from our inpatient detox
Cultural Impacts/Considerations
• Clinical staff were willing to be part of the
solution especially when their time was
recognized financially
• The positive feedback from these sessions has
encouraged clinical staff to continue the practice
• Feedback from clients has been positive, they
state they feel more supported at the beginning
of the program