1. IMPROVING PATIENT FLOW, INCREASING PATIENT CENSUS VALLEY ALLIANCE TREATMENT SERVICES, INC. MORGANTOWN, WV

2. 1. AIM O Improving quality of care, while increasing patient census is among the most important challenge facing VATS. The usual tactic is to increase hours of service, offer more opportunities for group attendance, develop and enforce quality, standards of care, etc.; however, the less obvious, but most necessary effort, as a SELF PAY clinic, that is critical to increase patient census, is to consider variation in fiscal requirements and administration. O Variation in the fiscal (payment) requirements of patients has become a challenge, causing patients to leave treatment (rapid turnover), miss days of dosing and overburden nurses and therapists with wasted time completing unnecessary paperwork and other clinical/medical evaluations. Not only does this threaten patient quality of care, but it also causes enormous stress in the institution, making it increasingly difficult for the facility to display/report crucial outcomes measurement and performance improvement processes. It’s a vicious cycle that must be addressed. O The facility can reduce variation with an innovative, multiphase strategy that uses operations management and rigorous data analysis, combined with collaboration among referral networks. This strategy includes eliminating artificial variability by pacing the fiscal demands and requirements expected from the institution’s population of self-pay patients.

3. 2. CHANGE O Change #1 Require patients to pay for their entire week of services upfront. Therefore, if patients begin treatment on Monday, they will need to pay for Monday-Sunday $95 on their date of admission into the program. Hence, patients never fall behind on payment requirements. O Change #2 Change the required payment day from Monday to Friday. Therefore, patients will not detox for non-payment until Saturdays.

4. 3. RESULTS O Change #1 Results Less Admissions into the Program. No change in patient retention/increase in census. O Change #2 Results More Admissions and a Noticeable Increase in Patient Retention.

5. 4. NEXT STEPS O Adopted the payment day as FRIDAY. O Because most employed individuals have Friday as their payday, patients are able to pay their bill by Friday afternoon or before dosing on Saturday. O Prior to this change, patients would detox for non-payment from Monday  Friday if they were unable to pay; and, therefore, were unable to reach a stabilized dose.

6. 5. IMPACT O Once patients were offered the opportunity to pay prior to their dose on Saturday mornings, they no longer detoxed during the week for non-payment, which resulted in an overall increase in patient retention and census, because less patients were detoxed out of the program. O Therefore, retention outcomes improved and the measurement of a patient’s overall success in treatment was positively impacted as well