1. Spectrum Health Systems Lincoln Street Opiate Treatment Program Support for this project was provided by NIATx through a grant from the National Institute on Drug Abuse.

2. 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 days

3. 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 session 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

4. 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

5. Decision Support – What Happened and How do you Know?

6. 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

7. 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 continues 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

8. 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 ongoing Feedback from clients has been positive, they state they feel more supported at the beginning of the program