. CARES is part of Denver Health and Hospital Authority and provides social model detoxification and residential treatment programs. The CARES detox program has over 20,000 admissions each year. The goals of the program are to provide a safe and humane detox, assessment of treatment need, referral to treatment, and motivational counseling. CARES Emergency Service Patrol Van Improving Continuation from Detox into Treatment – Denver CARES Tucson Learning Collaborative – July 2009

AIM (Plan) Problem is low rate of continuation from detox into treatment (Baseline rate of 2.7% of clients entering treatment within 30 days of discharge from detox) Goal is to increase continuation rate to 12.7% Current focus is on increasing the number of clients referred to and entering DUI education and treatment

CHANGE (Do)  Trained staff in motivational interviewing  Implemented new protocol for referring clients to DUI services  Trained staff on new protocol and on approved DUI providers  Started new forms to track referrals  Created a DUI treatment referral book for counselors and clients  Started giving clients names of 3 DUI providers  Began to have counselors schedule intake appointments  Invited DUI agencies to present their services to staff and directly to clients

RESULTS (Study) 16 DUI agencies presented information to staff; 13 programs presented directly to clients Clients have been admitted into treatment at 75 different agencies January 2008-April 2009January 2008-April % of clients discharged in May entered treatment within 30 days – Our best month ever!

NEXT STEPS (Act)  Increase the number of DUI treatment agencies presenting to staff and clients.  Increase the number of clients calling for intake appointments prior to discharge.  Increase the number of clients scheduling intake appointments prior to discharge.  Improve relationship with DUI providers by having CARES staff visit these agencies and meet their staff.

IMPACT (Business Case, Lessons Learned)  Learned to better serve our clients by having DUI treatment agencies communicate to CARES staff through in-services and directly talk to clients by having orientations with DUI providers on their services.  Learned the value of incentives – CARES does not allow cash incentives, so other methods of rewarding staff were used. We provided pizza parties, nominated staff who scheduled the most appointments for a Star awards ($50 value), and for Employee of the Month. Staff names were also placed in our monthly news letter congratulating them on their accomplishments.  Continuing to motivate staff is a key component of ensuring optimal outcomes. We revisited what was working and what was not working, emphasizing the importance of clients entering treatment as soon as possible.